Is Your Cortisol Elevated?


Hypercortisolism Care in Montgomery County, Maryland

As an experienced adrenal specialist based in Montgomery County, Maryland, I am dedicated to providing individualized care to those dealing with high cortisol levels in my community.

Conveniently located in Rockville, my practice offers virtual and in-person services, extending support to nearby areas such as Chevy Chase, Bethesda, North Bethesda, Potomac, North Potomac, Gaithersburg, Germantown, Frederick, Silver Spring, Northern Virginia, Howard County, Anne Arundel, and the Eastern Shore of Maryland, ensuring comprehensive care. 

With the mission of improving patients’ quality of life, my practice specializes in providing personalized therapies and evidence-based strategies for the assessment and management of hypercortisolemia.

Mild Hypercortisolemia: How to Identify Elevated Cortisol Levels

Elevated blood cortisol, a stress hormone, can contribute to various health issues, including weight gain, diabetes, insulin resistance, high blood pressure, osteoporosis, PCOS, and notably, cardiovascular disease.

Low Dose Dexamethasone Suppression Test (LDS)

The Low Dose Dexamethasone Suppression Test is a straightforward and effective blood test used to identify individuals with a mild elevation in cortisol. Typically covered by insurance, this test involves a two-step process:

  1. The patient is administered a 1 mg oral dexamethasone tablet precisely at 11 pm on any given day of the week, requiring an endocrinologist’s prescription.
  2. Subsequently, the patient undergoes blood work (cortisol testing) the following morning between 7-9 AM. A positive result is indicated by a serum cortisol level exceeding 1.8 mcg/dL.

Risk Factors Associated with Elevated Blood Cortisol

If you are experiencing any of the following conditions, you may qualify for the aforementioned test:

  • Difficult-to-control type 2 diabetes
  • Use of three or more medications for type 2 diabetes
  • Dependence on high doses of insulin for type 2 diabetes (indicative of a “severe insulin resistance” state)
  • Use of three or more medications, including a diuretic, to manage very high blood pressure (resistant hypertension).
  • Presence of adrenal tumors or masses
  • History or diagnosis of PCOS
  • Unexplained osteoporosis or bone fractures
  • Unexplained rapid weight gain, such as gaining 30 lbs in 3 months
  • Unexplained muscle loss or weakness

If you meet any of these criteria, consider discussing the possibility of this blood test with your endocrinologist to assess and address potential mild hypercortisolemia.

Dr. Tashko