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Hello Kathy B,

My late father-in-law told his medical students,"Never become an interesting patient." Let's see if we can fill in some pieces of your medical puzzle.

High levels of cortisol may be the starting point.

The most common cause of increased plasma cortisol levels in women is a high circulating concentration of estrogen. This happens with estrogen therapy and during pregnancy. The result is increased concentration of cortisol-binding globulin. In your case, your cortisol levels tested low until two years ago. The question is what changed in the last two years to cause blood levels of cortisol to increase.

Cortisol levels are regulated by adrenocorticotropic hormone (ACTH), which is synthesized by the pituitary in response to corticotropin-releasing hormone (CRH). CRH is released in a cyclic fashion by the hypothalamus, resulting in peaks between 6 a.m.-8 a.m. and a drop around 11 p.m in plasma ACTH and cortisol levels.

Insomnia, low sex drive, constipation,irritable bowel syndrome, increased susceptibility to getting upper respiratory infections, and increased risk for cardiovascular heart disease are signs of high cortisol levels.

An increased or normal cortisol concentration in the morning along with a level that does not drop in the afternoon and evening suggest an overproduction of cortisol and Cushing syndrome. If this excess cortisol is suppressed during a dexamethasone suppression test, it suggests that the excess cortisol is due to increased pituitary ACTH production.

In response to your question about the correlation between cortisol and neurotransmitters, the adrenal glands secrete glucocorticoid, such as cortisol, which interact with the serotonin receptors in the brain. Serotonin is a neurotransmitter.

Kathy B., I suggest you schedule an evaluation with an endocrinologist who can take a closer look at your adrenal glands and pituitary glands.

I hope this is helpful.

Regards,
Maryann

September 7, 2014 - 5:24am

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