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testing for high cortisol
May 19, 2004

I understand that high cortisol can cause numerous symptoms and I seem to have many of thses. But I am told that diagnosis is very hard, because even the 24 hour urine tests often misses it and may give false negatives once every four times for someone who is positive. Is this true?How do you test properly for high cortisol, when there are things such as cyclical cushing's syndrome that can be cycled out at the time one does the tests?

Can hypercortisolim cause lipodystrophy too? Problem is that even 2 1/2years after infection, they still cannot tell me if my immune system is overactive or underactive and, with low sensitivity for these endocrine tests and the interference with results by various meds, how does one get a proper and reliable test?I need to shed 30 pounds now of newly acquired weight around my torso and waist - felt good at first after losing nealry 30 pounds during primary infection phase, but now I am nearly 60 pounds above that!

Your advise on symptoms of high cortisol, how best to diagnose it and whether HIV itself tends to cause it would be appreciated. Thank you very much.

Response from Dr. Henry

It would help if you provided some information about your HIV status, which HIV medications you are on, what other medications you are taking, what other types of infections you have had, etc. The diagnosis of Cushing's Disease in the setting of HIV is usual-more often a diagnosis of low cortisol levels is made in the setting of HIV infection. KH



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