Elevated cortisol level- what does it mean?

I will try to be brief here: I went to the endocrinologist and had an extensive workup done for polycystic ovarian syndrome because I am fat, hairy, have bad skin and have a mom and sister with PCOS. The doctor kept scheduling me six weeks in advance and would always schedule me for afternoon appointments when I had worked all night the night before so I had to reschedule my appointment three times (to avoid sleep deprivation induced auto accidents), after which his receptionist informed me that I was no longer his patient. I had no idea there was an upper limit on the number of times you could reschedule an appointment, but I digress...

Anyway, my lab results were sent to my but now I have no doc to help me interpret them. All appear normal, except my 24 hours urinary cortisol level, which is WAY elevated. A normal result is supposed to be 105 or less; mine is 693! Aside from an adrenal tumor, what could cause this? And moreover, what the hell do I do to fix it? I have an appointment with another endo doc next month, but meanwhile I am stressing over this. Anyone shed any light for me? Thanks in advance!

http://stress.about.com/cs/cortisol/a/cortstress.htm

Good luck with the new endo. Hope you get to the root of your problems soon!

http://stress.about.com/cs/cortisol/a/cortstress.htm

Good luck with the new endo. Hope you get to the root of your problems soon!

Are you taking any medications???

Are you taking any medications???

I don't know much about this and you may have already thought about it, but remember that cortisol waxes and wanes... peaking in the morning and dropping a lot by the evening (I think like 90%).. and I think sometimes it is out of whack for night shift workers. I only noticed it b/c you mentioned night shift in your post.

Hope it turns out well :)

edit: Couldn't help looking a little more:

My book lists tumors (adenomas and carcinomas), adrenal hyperplasia, and therapeutic use of glucocorticoids (steroids) as causes of increased cortisol secretion. It also says that additional lab findings may include: > blood glucose, >WBC, > lymphocyte count, > Na+,

A bunch of info on Cushing's syndrome for you:

http://www.emedicine.com/emerg/topic117.htm

http://www.emedicine.com/med/topic485.htm#section~differentials

I don't know much about this and you may have already thought about it, but remember that cortisol waxes and wanes... peaking in the morning and dropping a lot by the evening (I think like 90%).. and I think sometimes it is out of whack for night shift workers. I only noticed it b/c you mentioned night shift in your post.

Hope it turns out well :)

edit: Couldn't help looking a little more:

My book lists tumors (adenomas and carcinomas), adrenal hyperplasia, and therapeutic use of glucocorticoids (steroids) as causes of increased cortisol secretion. It also says that additional lab findings may include: > blood glucose, >WBC, > lymphocyte count, > Na+,

A bunch of info on Cushing's syndrome for you:

http://www.emedicine.com/emerg/topic117.htm

http://www.emedicine.com/med/topic485.htm#section~differentials

Just remember, your doctor is there for YOU, not vice versa. Tell them your scheduling needs, insist on an AM apt if thats what works for you. I got this from "laboratory tests and diagnostic procedures" 3rd ed., by chernecky and berger. Increased urine cortisol can be amenorrhea, cushing syndrome, hyperthyroid, lung ca, pituitary tumor, pregnancy, stress and the drug corticotropin.....so see your NP or dr.

Just remember, your doctor is there for YOU, not vice versa. Tell them your scheduling needs, insist on an AM apt if thats what works for you. I got this from "laboratory tests and diagnostic procedures" 3rd ed., by chernecky and berger. Increased urine cortisol can be amenorrhea, cushing syndrome, hyperthyroid, lung ca, pituitary tumor, pregnancy, stress and the drug corticotropin.....so see your NP or dr.

Are you taking any medications???

I am, but I checked them out and none of them should interfere with this test. As far as my doctor being there for me (which someone else posted), the doc who ordered this test refuses to have anything else to do with me at this point because I had to reschedule three times, and will not discuss the results with me. I am retaining tons of water in my hands; I guess I will just have to wait till January till the new endo can see me.

Are you taking any medications???

I am, but I checked them out and none of them should interfere with this test. As far as my doctor being there for me (which someone else posted), the doc who ordered this test refuses to have anything else to do with me at this point because I had to reschedule three times, and will not discuss the results with me. I am retaining tons of water in my hands; I guess I will just have to wait till January till the new endo can see me.

What I meant is that when you go see your new dr. they should be there for you, thats one criteria that I would insist on before chosing them as my specialist or PCP. But if your hands are swelling and you don't feel well, then PLEASE go to the ED!!! If posible, go to a university ED that has endos. in house so you can get to the bottom of this!