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EndocrineWeb Community Advice

Diagnosis Help Needed! Hypothyroid/Cushing's/PCOS

From: AlexisHudson - 3 years 10 weeks ago

29 y/o Female

I went to an endocrinologist 3 years ago for irregular periods, facial hair and a history of ovarian cysts (that all resolved on their own). I was given a saliva cortisol test at the time and after follow ups over the course of the year was given a vague PCOS diagnosis and was told that if I missed my period for over 4 months, I should give my Endo a call. I have not seen her in over 2 years and my periods have been more regular than ever.

Two and half weeks ago I went into the hospital for minor same day surgery (unrelated). My endo has privileges at the same hospital and thanks to electronic medical records, the surgical nurse looked through my medical history and asked 'if I still had Cushing's'? Needless to say, it spurred me to give my endo a call a few days later, asking for an explanation and to set up an appointment. She explained that Cushing's was ruled out and it was put on my problem list so that insurance would cover the testing.

So I saw her for a general check up this week, since my husband and I have are planning to start trying to conceive in the very near future. I told her that overall I am in good health, my periods are regular but mentioned that I have gained a good amount of weight in the past 2 years, but I attributed it to the stress of starting a business, and I seem to have, what I deem, as poor wound healing. I have been getting discolored scarring from minor injuries and after my (minor) surgery I developed a hematoma. Turns out I have gained a full 30 pounds in 2 years. She did a full work up and made me redo the cortisol saliva test (for which I have not yet gotten the results). She called me on Friday to tell me that I'm hypothyroid because my TSH is 4.11 and she put me on 100mcg of Levothyroxin, particularly because we are discussing conception. She also brought me back for a Thyroid ABS, I'm assuming to rule out Hashimoto's. Needless to say, I put myself through an endocrinology crash course this weekend.

So far, these are the irregular results I have:
Estradiol 71
ACTH 54
Testosterone 76.99
Cholesterol 262 (has been 220 since I was 17, always because of a high HDL)
LDL 172
Cortisol 22.7
Chronically low vitamin D

Thankfully, I don't seem to have insulin resistance. My A1C is normal. T4, LH, FSH, Prolactin, Progesterone are normal. No striae or buffalo hump.

So my question for everyone is, have you seen these type of hormone irregularities as a result of strictly hypothyroidism? Do any of you have PCOS and/or Cushing's in addition to HT? It seems curious to me that everything is high, I would think that many of these hormones work in a negative feedback fashion so that one that is high would make another very low, but that doesn't seem to be the case (ie. my estradiol and testosterone). I have asked my endo about T3 and adrenal stress testing--- any others I should ask about? Could surgery have skewed any of these results slightly? Is there any diagnosis I am overlooking? Any suggestions on supplementation? Any and all thoughts/suggestions would be appreciated.

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Hey AlexisHudson,
Wondering your experience regarding this two years later...
I have a similar story. I am mid-30s with PCOS and just saw an Endocrinologist for the first time as an adult. Waiting on the saliva cortisol testing for Cushing's, but bloodwork showed elevated testosterone (not unusual with PCOS), high cholesterol, chronically low vitamin D, and elevated thyroid antibodies. Doctor wants to start me on low dose of Levothyroxine for the thyroid. I'm been overweight since 2nd grade and have a terrible time shedding pounds despite serious diet and exercise. There are definitely connections between PCOS and all these things... Thanks! Ella

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