My afternoon (4 pm) serum cortisol was 21.4 ug/dl (the normal range was 3.1-16.7). Apparently, serum cortisol from one time point is not the best test for Cushing's, but is this high enough that I likely have Cushing's? Some background: I am a 29 year-old woman and have had most of the symptoms of Cushing's for years, including fatigue, weight gain (much of it abdominal), round face, big buffalo hump, easy bruising, irregular periods, many infections, poor wound healing, irritability, anxiety, muscle weakness, severe joint pain, poor memory/concentration, headaches, edema, abdominal pain, facial hair, dizziness, and many more. I also have a lot of white shiny stretch marks (some about 1 cm wide), but they are not purple (sometimes they're pink).
When my PCP called about my test results she said that everything was normal, and then I looked at the results online. Not only was the cortisol high, but my white blood cell count was high (I probably have another sinus infection),my Vitamin D was low, my TSH has increased (from 2.6 last summer to 3.3 now), and my alkaline phosphatase is high. She probably thought I had PCOS, but my free testosterone was near the low end of the range. I think I'm going to have to either beg or argue with my PCP to get a referral to an endocrinologist. I'm afraid that she is going to say that serum cortisol 30% above the top of the normal range is nothing, and that I am just depressed. Unfortunately, I've had this experience before when doctors just blew off my severe abdominal pain for 3 years, and were still insisting I was just depressed after my gallbladder had collapsed and I could barely walk. If they did that with something obvious, then what chance do I stand with getting a Cushing's diagnosis?