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Bloodwork


db2504

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I have had high a.m. cortisol(per bloodwork) for a couple of years. My latest was around 25. Technically, they'll probably want to test her for Cushing's disease by starting out with a 24-hour urine cortisol. That is what my doctors have done over the last few years. If that is elevated, they'll move on into more detailed testing. My urine cortisol is low-normal, so it rules Cushings out for me.

For me, I think it is just the stress of getting up in the morning and not having eaten before labwork. My worst part of the day is ALWAYS morning, and then I feel better as the day goes on. So I feel, either due to POTS or maybe not, I just have a hard time in the morning and my body is trying to help by spitting out cortisol.

OR, do I feel so bad in the mornings because my cortisol is higher??

I have no exact clue, but that is my opinion!

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ANA is a test for autoantibodies - so it tests for autoimmune disease. It can come up positive in many autoimmune diseases, including Sjogren's, but is commonly associated with Lupus. With a positive ANA, depending on what her symptoms and previous blood tests look like, they might need to do more specific testing (like anti-dsDNA, rheumatoid factor, Sjogren's antibody testing, etc) to determine the cause. Sometimes it can just be a false positive elevation. What a positive ANA means will really depend on the doctor's interpretation of your daughter's symptoms, any other test results that were done, etc.

High A.M. cortisol can be seen in endocrine diseases (like Cushing's) or adrenal disease, or it can be mildly elevated due to something simple, like nervousness over bloodwork, pain when the needle was inserted, or even, as was the case with me when I first got sick, Hyper POTS. As two of my POTS specialists (and an endocrinologist who was familiar with the disorder) explained, if you have excessive levels of norepinephrine or epinephrine (adrenaline), the body may produce a little more cortisol than usual to try and counteract the adrenaline. So, what your doctor does about it or how it's interpreted depends on how high it is (all labs have different reference ranges), what her symptoms are, and any other tests that have been run. However, if they're concerned, they might do additional testing (for example, 24 hour urine, CRH stim, or dexamethasone suppression) to rule out Cushing's or other diseases.

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