Hello!
Thank you for taking time to review this post. If a person has struggled with weight (40+ BMI for over 20 years) is it worthwhile to have cortisol levels tested? If so, are there any interventions that are proven to be effective?
Obesity alone is not a particularly specific sign of cortisol excess (i.e., Cushing’s syndrome / Cushing’s disease). So unless there are other suggestive signs / symptoms we would typically not recommend testing in this situation.
With that said, the appropriate first-line testing for Cushing’s includes any of:
- late-night salivary cortisol (two measurements),
- 24-hour urinary free cortisol (UFC) excretion (two measurements), or
- overnight dexamethasone suppression test (1 mg)
Thank you very much doctor. I just have one follow up question. Can elevated cortisol levels cause obesity even if one doesn’t have Cushings? If so, are they interventions for that?
Abnormal / inappropriately elevated cortisol levels are the hallmark of Cushing’s.
This is different than the usual discussion on the internet about “stress” in general being a risk factor for obesity. In that case, the interventions shouldn’t be directed specifically at lowering physiologic cortisol levels, but rather at the psychosocial stressors and dietary habits.