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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Elevated Cortisol Levels Be Treated?

HI my name is Nancy. I had a MRI of the pituitary gland they found a very small tumor 2mmx2mmx2mm on the proximal posterior pituitary. They checked much cortisol levels it was high 46. I am doing the one day dexamethasome to see if levels go down. If they do not I would like to recommend the 24 hour urine cortisol. Does there sound like a reasonable request?
Wed, 26 Sep 2018
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General & Family Physician,  's  Response
Hi,

In fact, 2 hours of urinary cortisol is also done to know excessive cortisone.

However, this test is better done to rule out a disease. This mean we request this test if the chance of excess is low. In such cases if the 24 hours test is OK we will be sure and no further tests would be required.

However, if the chances of Cushing disease (excessive cortisone) is high then we straight away go to the suppression test.

Secondly the 24 tests do not tell us whether the small tumour is responsible for the excess or not, the suppression test will tell this as well.

So I think the suppression test is fine for you because even if we do the 24 hours urine test, the suppression test will still be needed.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Mahboob Ur Rahman , General & Family Physician
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How Can Elevated Cortisol Levels Be Treated?

Hi, In fact, 2 hours of urinary cortisol is also done to know excessive cortisone. However, this test is better done to rule out a disease. This mean we request this test if the chance of excess is low. In such cases if the 24 hours test is OK we will be sure and no further tests would be required. However, if the chances of Cushing disease (excessive cortisone) is high then we straight away go to the suppression test. Secondly the 24 tests do not tell us whether the small tumour is responsible for the excess or not, the suppression test will tell this as well. So I think the suppression test is fine for you because even if we do the 24 hours urine test, the suppression test will still be needed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mahboob Ur Rahman , General & Family Physician