a high elbow is going to put more pressure on your bottom finger which is going to change how the arrow acts as a hole when shot. It doesnt change the tiller of the bow....what it does is change the requirements for tiller that YOU need as a shooter. Its a lot like comparing split finger vs 3 under. YOu can do themboth with onebow but you may have a problem shooting a bow that is not tillered for its intended purpose. The tiller requirement is different for both because of the pressure thats applied on the string.
How you grip or heel a bow also effects what kind of tiller you'll need in a bow. A guy who shoots with a high wrist, vs one with a LOT of heel pressure are going to get different results when it comes to tuning. Most of us fall in a more medium instead of this amount of extreme. So we are able to get away with a general tillered bow because it fits the mass's. it doesnt mean it fits everyone!
If you ride a heavy top finger, or a heavy bottom finger, it could be creating these problems....its a simple test really, try it with your bareshaft, just stay fairly close or you could (likely will) break it....if it doesnt straighten things out. shoot some with a heavy top finger...than shoot some with a heavy bottom finger.....
Another thing to try is if you're shooting split...try 3 under, or visa versa.
A nock high is ok to a point...most of us are around the 3/8 to 1/2 but 3/4 isnt out of the question or really out of the norm. If you're going past this you're got tiller problems....or as mentioned, string pressure, bow hand pressure...or a combination of them.