Adrenal saliva test results;cortisol v high.can... - Thyroid UK

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Adrenal saliva test results;cortisol v high.can anyone advise,please?.where do i go from here..

cloud1 profile image

I did the cortisol/dhea testing.was surprised (because i expected too low levels)to find have v high morn cortisol;29.7(how does that compare w other people on here?)the next 2 samples were normal;5.9 and 6.2.Then bedtime was bit high;3.3.Total cortisol 45.1.

I took the samples on a rather stressful morn and (unusually)i had suffered a bit of insomnia;so hadnt slept enough(which affects my health v badly).I wasnt sure therefore whether i shouldnt have used those samples(and do them again on a more 'normal' day)but just sent them anyway.

Do these results suggest that i do not have adrenal exhaustion(or at least not in sevete stage)as i am producing plenty of cortisol?it says on the lab report that i have 'Resistance Stage2-Maladaptation:a relatively rare scenario.which,it says,gen indicatesa state of long term stressors depleting adrenal reserves in the face of an acute stressor causing an excess cortisol response.'Oh dear,doesnt sound good.does this mean i dont need hydrocortisol?or what about adrenal glandular extracts?i was thinking i'd need one of these.I want to make sure my adrenals are suported before start ndt,perhaps.

I have read recently ,on a post,about supplement Seriphos which encourages pituatary gland to stop send signals to adrenals for more cortisol production.So i am think of try that ,at least..

Oh,also dhea levels are low;am:0.42,and pm:0.24(v low).so would this indicate need supplement dhea?Thanks

11 Replies

24-HOUR CORTISOL SALIVA TEST: An at-home test to evaluate your circadian cortisol levels at key times during a 24 hour period. Those will healthy adrenal function will have the follow results: 8 am: at the literal top of the range 11 am-noon: in the upper quarter, and often about a quarter below the top 4-5 pm: mid-range 11 pm to midnight: at the very bottom. A DHEA above midrange is good, but 8 can mean the adrenals are compensating for a problem. You will need to be off any adrenal support supplement, any medication containing cortisol, any herbs that support adrenal function, or zinc or licorice root for at least two weeks prior to testing. Avoid food when spitting into vials. If you wear dentures, remove them to prevent denture adhesives from tainting the spit.

This is from the STTM website.

Hi there Cloud.

Is this test free done on the NHS or is it private a test you send off for? Could you please send me the details.

Kind regards

cloud1 profile image
cloud1 in reply to Pixiefeet86

Hi,its the private home test from Genova labs.costs £71.25 and u mention thyroid uk to get a discount(and they are named as ur practitioner). .U canfind details on the thyroid uk website.

Pixiefeet86 profile image
Pixiefeet86 in reply to cloud1

Thank you for this. I shal look for the details.

Hello Cloud,

I done the ASI test as well but mine was low, wouldn't think having more cort would be a good Idea, I had that because mine was low. Mr private Dr said that DHEA regulates the production of cort, so if you are high - that would slow it down. kind regards

Hi My Endo says that the only reliable Adrenal test is 24 urine collection , with a cortisol tablet ( script) at midnight and a blood test at 9a. For this reason she will not accept any other test from her patients. basically ,as she does not want to treat with cortisone if not needed.

Best wishes,


in reply to Jackie

If an Endo told me it was daylight, I would STILL turn the light on!

Of course an Endo wont recognise salivary testing, they don't recognise adrenal fatigue/exhaustion (or whatever other description you want to use) AT ALL!

If Endos were any good at resolving the problems most if us have on this forum, it, and dozens of others like it wouldn't exist! :-(

Bear in mind Endos (individually and collectively) swear blind that TSH is the only, and gold-standard test for hypothyroidism and regulating thyroid replacement.

Of course no one wants to be taking hydrocortisone if not needed, it most isn't something to be played around with at a whim.

The problem in this case, is the reading truly representative of a "usual" day, or is is the result of the extra stress? Even adrenal glands that are not outputting at their most efficient level can rise to the stimulus of stress, it is only in extreme cases when they can't (ie. Addisons) but it is certainly it is not hinting that low level are a problem, so I wouldn't be rushing out to supplement with the aim of adding to cortisol levels, but there is always a problem with any one-off test, (of any type) and retesting is not a cheap thing :-(

Certainly high cortisol and low DHEA is a classic situation with hyperadrenalism in the earlier stages before "adrenal fatigue" and the extra cortisol is also known to reduce the conversion of T4 to T3. I don't have any personal experience of dealing with this situation as I am LONG past this stage, but there is plenty of advice around on dealing with it... research, research and more research as ever is the next stage.

Reducing the source of the hyperadrenalism is the answer of course... but how!?!?

Stress?... well good luck with reducing that! ;-)

Supplemental DHEA in isolation can be very hit and miss... some do well with it some don't. I personally do, but only small amounts (25mg) as in men it is prone to end up as Oestrogen.

I particularly thought this Doctor's advice pretty interesting - but again don't take any of that as gospel truth without lots of research, however the advice on regulating blood glucose in this sort of situation I thought very wise... Insulin resistance has been a BIG issue in my own situation, and I have only made progress since I dramatically cut out carbs!

Jackie profile image
Jackie in reply to

Hi In some ways I agree. There are exceptional consultants and terrible ones. I am having a battle at the moment with my new cardio, the outcome is a matter of life and death with my complicated conditions., However, my Endo is extremely good, follows all the USA research and does a lot of her own, well known for it actually. The test I described I have had 3 times. The first time , when I first saw her, very low, then when my thyroid stable twice. It improved quite a bit,when my thyroid properly treated ( armour and T3) it is low still than desirable but I am in a position where it is far too dangerous for me ever to have cortisone, even local in an injection. However, otherwise she would have treated me.To have treatment when not necessary is not advisable for any one. If needed fine, very good. Incidentally my TSH has always been immeasurable and I have hypo, autoimmune.

I do not force my opinion on anyone.personally i always prefer to know all about something, especially regard to drugs. Some times they can cause other problems or more harm than good. The less we take is good. I say this having 6 pages of repeat vital drugs from the GP for myself. I still refuse any I do not feel would be worth the risk to me.Even though all my drugs are recommended and requested from my many consultants, good ones, except the new one that I got landed with!

Best wishes,


in reply to Jackie

Oddly enough, I stumbled onto this page shortly after writing that post.... says a lot and is the polite way to look at it I thought:

Talks about stuff like low dose Naltrexone etc. and it's very American but the principle seems appropriate.

Jackie profile image
Jackie in reply to

HI Yes, interesting. I have found this in many years of consultations. I always ack ones not instictively happy with, does not mean "nice". Whenever I have not lived to regret it. 6 times been told to report docs to GMC, by other consultants. Yes that bad, although "so called" top ones. If they do not listen , useless! Of course ,I do not, human and I am complicated. I always write and tell them usually I have an apology! However, the circumstances are a slightly different now, I have tried writing to him. Seeing him on Thursday, again , so ready to do battle!I have had many cardios over the years as so many do not understand my very complicated conditions. caused MI`s, strokes and some of my arrests to name but a few! However, unfortunately rare to find a Cardio who does listen. Common old story amongst docs, " What is the difference between a Cardio and God?", answer " God does not think he is a Cardio. I hope that does not offend , my new Priest thought it was funny too! So true!Actually my other consultant often say they do not having any communications from him, except my own letters. I say "He, is a Cardio", they understand perfectly!However, written "advance directive" for next time in hospital, I hope it works!That was on the advice of 2 very good consultants.

best wishes,


Thanks all.I am not at all keen on taking powerful substances like hydrocortisone...but thought i mite need to if adrenals were really 'clapped out'.I am knid of relieved that this doesnt seem to be the case.I will try research a bit but was hoping for 'ready answers' as i not really up to doing it myself lately(if ever well enough..)Its still a bit of a mystery to me,what this test reveals.If i went ahead and just started ndt would that not be advisable with high cortisol/stress?maybe i need something to nourish adrenals;herbs for stress like rhodiola and ashwagandha.I have actually already made some efgort to cut down carbs(and i hardly have any sugar at all;incl honey etc.and no other refined food.)but i still have my gluten free porridge in morn and usually some rice or potatoes for dinner..or quinoa.I really dont see how one can cut out carbs dramatically (what do u replace with;protein and fats?)and carbs are is tricky.

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