Hi Bruce! Glad we are morale boosters - Whoo Hoo Go Members! ![]() Avoid anti-d's for the tests he wants to order. For some reason, they really impact the HPA (hypothalmic pituitary axis). Oh if you are clinically depressed, yeah... you need to be on them, but you need to talk to your doctor about putting you on a formula that won't impact endocrine testing. You will need to go in fasting for the blood draws, and ideally, you need to be there 8:00 a.m. ish. I'd avoid alcohol the night/day before. There is some talk that caffeine can affect cortisol testing, as it can (short term) raise ACTH which can raise cortisol, (but I don't think but very mildly) but I always did things normally, including my morning coffee (1-2 cups). My serum cortisol a.m. tests were always normal - go figure. The "gold standard" for Cushings screening is the 24 hr urine free cortisol. If you have 3 times the upper limit of normal, that is diagnostic for the disease. Insomnia is part of the program, part of the symptomology, so if you can't sleep, you can't sleep. ![]() Hope this helps ![]() Sorry for being late responding... this recovery stuff post surgery is a slow go... lol. ![]() Minnie | 