I am a 38-year-old female with a history of hypothyroidism for 5 years. After a work-up with an Endocrinologist for severely suppressed TSH levels while on Synthroid, a 24-hour free cortisol urine test (lab values 20-100) showed values of 121. A pituitary MRI was negative. A repeat 24-hour urine showed a cortisol level of 22. How do you know which test is correct? Should re-testing be done and is there still a concern for Cushing's? Also, does Cushing's present with chronic yeast infections? I understand that Cushing's is difficult to diagnose, however, with two such different lab values where do you go from here? Thank you!    Dr. McLaughlin's Answer

  I have two questions of most importance. What is the correlation of liver disease with diabetes mellitus and how toxic is dioxin/agent orange to the human liver? I would be very appreciative if the above questions could be answered.    Dr. McLaughlin's Answer