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Dr. Said Low T Could be Because of High Cortisol Levels

so today i went to the endocrinologist and he wants to check why my cortisol is extremely high. a urine 24 hour test came back high in 2018. it seems my high cortisol is tanking my testosterone. i also have a microadenoma and he suspects it could be causing cushing disease, weird tho because i don’t have physical symptoms of it.

i have seen acth at 60 ish while cortisol urine at 93.6 normal range is 4.0-50 ish.

also cortisol am have seen it normal and high.

he also said that if cortisol is high acth must be low?

every time i ask docs about training they say it shouldn’t be an issue.

what’s your opinion, should i drop training tho?

You need to test saliva cortisol 4 times per day. The blood and urine cortisol tests can give you only the total amount but timing is more important. And yes microadenoma can be causing you to secrete more ACTH which can be rising the cortisol.

You need to take care of that adenoma. Are you taking cabergoline?

I say low testosterone could be why you have high cortisol, it goes both ways. Testosterone, TRT lowers cortisol. Training with high cortisol and low testosterone can cause an increase in cortisol.

Your doctor is only half right because exercising with high cortisol is a double-edged sword. As far as testing cortisol once daily, I can’t believe doctors are still doing it. Your cortisol could be normal in the morning and flip upside down midday or late at night.

Exercise and circulating cortisol levels: the intensity threshold effect.

Collectively, the cortisol findings support the view that moderate to high intensity exercise provokes increases in circulating cortisol levels. These increases seem due to a combination of hemoconcentration and HPA axis stimulus (ACTH). In contrast, low intensity exercise (40%) does not result in significant increases in cortisol levels, but, once corrections for plasma volume reduction occurred and circadian factors were examined, low intensity exercise actually resulted in a reduction in circulating cortisol levels.

i talked about the saliva testing and dr said he doesn’t do it and wants to try 24 hour urine test and that i should do one am cortisol and that same day take a medicine at night (around 11 pm, but before 12 am) and take another cortisol test am to see if cortisol drops with the medicine.

my doubt is, should acth actually drop if cortisol is high? no cabergoline. prolactin doesn’t seem to be a concern to the endo because if it was he would already put me on cabergoline or something else.

I’m going to repost what i replied to @vonko1988 about what dr wants to do. i talked about the saliva testing and dr said he doesn’t do it and wants to try 24 hour urine test and that i should do one am cortisol and that same day take a medicine at night (around 11 pm, but before 12 am) and take another cortisol test am to see if cortisol drops with the medicine.

so how can i fix this issue tho? dr says i could be having cushing disease because of the tumor. will i not be able to weightlift again or do any high intesity exercises again?

i mean, i feel better when not exercising, but i want to do that again for several reasons.

I would disagree with you about the cause effect here.
Very often pituitary tumor causes cushing disease, its not the low testosterone. Otherwise I 100 percent agree especially about the doctors stupidity.

@Riaero bro if the doctor is not willing to order you some test you do it on your own and pay. 4 times saliva cortisol is the best cortisol test because only that test measures the amount of cortisol in the tissues. Blood cortisol measures only the circulating bound to proteins cortisol in the blood and is almost useless. The 24 hour urine can give some picture but not as good as the saliva. The doctor is stupid like most of them.

About the tumor - how much is your prolactin? It is true some tumors are not affected by caber, but most are. You need to find a doctor knowledgeable in that. This tumor need to be fixed. If it is more than 10mm you should consider removing it with a gamma knife. Your hormones will never be optimal with this tumor.

Even if you start a hormone therapy it will be like in the Chernobyl movie where they tried to distinguish the nuclear fuel with water. In your case unlike most of us you need to attack the root cause.

prolactin level is in range. it is a microadenoma.

thanks a lot for replying!

In range but how much exactly. The so called range is too wide…

prolactin: 13 from 4.0-15.

this is from a quick copy and paste from my older thread.

My prolactin is 25 with the same range. Not high enough to mess with.

I disagree here. You are on TRT but he is not and he has a tumor.

Mine was like 16-17 in this range and I benefited a lot from bringing it down to 10.

I would suggest to him to start 2x0.25mg caber per week.

If he has a tumor then he likely has a doctor that found the tumor and I’m sure the doc has a plan. If not then he needs to find a doc that has a plan. Caber is nothing to play with.

i’m not doing this without a doctor advising it and if i’ll do it on my own i’ll look for more opinions on this and look for info.

thanks for the suggestion and for replying!

i think only one doctor worried about my prolactin and was not an endo. endo right now is checking why my acth and cortisol are high and if tumor is the reason.

thanks for replying!

Keep me updated on what the docs says about the ACTH & high cortisol. Very interested

for sure. i’ll try to keep you guys updated!


total cortisol (AM) ug/dl 14.64 in a range of 6.02-18.40

total cortisol (AM) with dexamethasone taken the night before at around 11 pm ug/dl 0.81 in a range of 6.02-18.40

i have seen acth in the 60 ish.

thoughts on labs?

@Riaero I read something the other day saying AM cortisol isn’t the best time to check it. My cortisol at 2pm was

if I remember correctly, last time i checked my cortisol pm it was in the 17 ish too and it was high.

@Riaero Can you update us? Were you diagnosed with Cushing’s?