Thyroid UK
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Testing Cortisol

Good Afternoon.

I have been so unwell the last few weeks.

One if my biggest issues is waking in the morning. Ive had days off work where I can sleep untill 5pm.

I think it would be a good idea to test my cortisool levels. However can i do this when i am taking Levo?

Also where is the best place to look for the test?

Further to that what can i do to improve the situation?

Im going to loose my Job if things dont improve soon. x

13 Replies


I'm not 100% sure if you take your levo on the day of the stress test. I think you can tho.

Get the adrenal stress test from here. You get a little reduction in cost and you have a "sponsor" to order it thought. I use Genova labs for my stress test.



HI simon.. at the TPA conference last week, Doctors Skinner and Peatfield were basically saying that nobody gets the cortisol tests right so they're not really useful and that Dr Wilson's questionnaire is more relevant... Do you get what you're expecting from the Genova tests?


Hi red

Oh was dr Peatsfield there? I'm surprised you say that as dr P asked me to get a stress test done! Lol I have done in the past, dr Wilsons on line test.... And read his book. My initial test was low and the last test I had done showed lows and highs. I still think it could be my adrenals still now! :0/


Total points 133 (anything above 132 being severe) with severity marker 2.4 so again in the highest range. Thing is now what???


Does the questionnaire differentiate between low and high cortisol? Because the treatment is different for each problem.


I dont think it does Humanbean. Just fefers to Adrenal fatigue.


Hello..... Have you taken the adrenal low reserve test.. it's more reliable than any clinical tests...

If you score highly on this then it's certainly an adrenal thing...

what's your temperature.. if it's low then it's just the thyroid thing.. this could be that you're not getting on with Levothyroxine... have you tried T3 or NDT?


Total points 133 (anything above 132 being severe) with severity marker 2.4 so again in the highest range. Thing is now what???


If you are concerned about the levo interfering then just don't take it on the day of your adrenal test. Or take the levo at night, after you have produced all your samples, just before you go to sleep.

I tested my adrenals with the Genova saliva test. It was quite easy. After I had produced each sample I put it in the freezer, as per the instructions. I did four samples on the same day at the times I was told to. All the samples got put into the freezer so by the following morning they were frozen solid. I packaged it up and arranged for a courier to pick it up that day. Although, obviously, since the samples are frozen you probably have a little bit of leeway as to when they are collected. Just don't let them defrost.

It turned out I had high cortisol (much to my surprise). Dealing with it is still a work in progress.


These short videos discuss cortisol. I think you will be enlightened.



Did the Dr wilson test. Total points 133 (anything above 132 being severe) with severity marker 2.4 so again in the highest range. Thing is now what???


Which one of these will be most helpful? Sorry for all the hand holding but I'm struggling t understand or retain any of it. I used to be a relatively intellegent individual but now I've become a complete moron!

Adrenal Stress Profile (ASI): Cortisol/DHEA

Specimen requirements: Saliva

Cost: £75.00

Order Code: END01

Turn around time: 7 days

This saliva test can detect imbalances in the daily circadian secretions of the stress hormones cortisol and DHEA. Imbalances in these hormones can indicate an inappropriate response that can negatively impact energy levels, emotions, and many other health complaints. These include anxiety, chronic inflammatory conditions, allergies, chronic fatigue syndrome, insomnia, depression, migraines, headaches, recurrent infections, menstrual difficulties and infertility.

Comprehensive Adrenal Stress Profile: Cortisol/DHEA/Secretory IgA (SIgA)

Specimen requirements: Saliva

Cost: £97.00

Order Code: END02

Turn around time: 10 days

The Comprehensive Adrenal Stress Profile comprises of the standard Adrenal Stress Profile, which assesses cortisol and DHEA levels, and a Secretory IgA (SIgA) test. Stress is cumulative, and emotional, physical and/or metabolic stress affects the body in the same way. Chronic maladaption of stress, signalled by imbalances of cortisol, DHEA and SIgA can lead to the most common health complaints of the 21st century. Both excesses and deficiencies of DHEA and cortisol have been implicated in the aetiology of various illnesses and immune suppression. Therefore preventative and therapeutic approaches should emphasise the critical importance of maintaining the proper equilibrium of these adrenal hormones. How an individual copes with the actual stress on a physiological level is largely dependant on nutritional status, lifestyle factors, and the period of time subjected to stress. Emotional behaviour and personal attitudes can be closely interlinked with physiological expression of stress.

Cortisol Awakening Response: Cortisol

Specimen requirements: Saliva

Cost: 71.25

Order Code: END04 (Discounted Price for TUK only)

Turn around time: 7 days

The Cortisol Awakening Response (CAR) test is a new salivary assay available to assess adrenal dysfunction. The CAR test involves measuring five separate salivary samples over an hour after waking, and has been extensively researched and validated as a means of analysing hypothalamic-pituitary-adrenocortical (HPA) axis activity.


You might be able to persuade your GP to give you the short synacthen test, which is relatively cheap and shows up cortisol deficiency 60% of the time. But you need to educate him/her that the test should be done at least twice. If the result is between 83nmol/L and 497nmol/L this falls into the range where you could have pituitary-induced hypoadrenalism. If the result of the second test is still between these limits then 'this is an indication to evaluate ACTH reserve' i.e. have a more sensitive test such as the insulin stress test or the glucagon stimulation test. See . If you have ever suffered head injury or had anything that might have damaged your pituitary gland such as cranial radiation or autoimmune disease, then this might be a tipping factor in making your GP take you seriously. Pituitary damage after head injury (even just concussion) happens in around 30% of cases and is often missed, see our website for the research. I've found that a nicely typed letter to a GP putting your points briefly and clearly, and supporting them with research from peer-reviewed journals sometimes works. I do hope you manage to hang on to your job!

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