Most people with Cushing's syndrome have pathologically low cortisol early in the day and pathologically high cortisol late in the day.
"Most people, even people with Cushing's, have pathologically low cortisol early in the day, pathologically high cortisol late in the day." (said at 0:08:35)
The claim that patients with Cushing's syndrome have pathologically low cortisol early in the day is contradicted by established clinical evidence. Cushing's syndrome is characterized by autonomous, excessive cortisol secretion and a disruption of the normal circadian rhythm. Diurnal cortisol profile studies show that early-morning cortisol in patients with Cushing's syndrome is either elevated or within normal ranges, and significantly higher than in healthy controls across all time points, rather than pathologically low. The hallmark circadian abnormality in Cushing's syndrome is the failure of cortisol to decline to its normal nadir at late night (resulting in pathologically high late-night cortisol), not early-day cortisol deficiency.
- contradicts: Diurnal Salivary Cortisol Profiles in Patients with Cushing's Syndrome. (Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association 2022)
"At each of the five time points, salivary cortisol was significantly higher in patients with CS compared to the control group (p≤0.001)." (abstract, results, passage verified)
pubmedfull study (doi) - contradicts: Late-night salivary cortisol as a screening test for Cushing's syndrome. (The Journal of clinical endocrinology and metabolism 1998)
"Salivary cortisol measured at 0700 h demonstrated significant overlap between groups, even though it was significantly elevated in patients with proven Cushing's syndrome (23.0 +/- 4.2 nmol/L), as compared with normal subjects (14.5 +/- 0.8 nmol/L) or with patients in whom Cushing's was excluded or not firmly established (15.3 +/- 1.5 nmol/L)." (abstract, results, passage verified)
pubmedfull study (doi)