In the very very early stages of cushings, can you have normal cortisol and acth but later into the disease both or one can increase?

The definition of Cushing disease is an elevated cortisol level, therefore if your cortisol level is normal you don’t have Cushing disease. ACTH level is dependent on the cause of hypercortisolism . If you have cushings disease the ACTH level will be elevated. If you have Cushing’s syndrome ACTH, which is produced in the pituitary gland would be low. This is a simplified answer to a complex illne