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Thyroid UK
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got saliva results ( cortisol )

The results are what I thought, guess I'm here as part of my pity party for myself. They looked practically flat-line. My 8am was 5, normal is 13-24. At 8am should be the highest for the day. You're doing well if you're near the top, at 24. For the day, my "cortisol load" was 14, normal is 22 to 46.

I think I've had Adrenal fatigue for years. Any stress just throws me back down. I couldn't get out of bed last year. Now here I am, feeling a little better after trying for the past year, and still, I see these poor tests results. I've tried diet, supplements, less stress....on and on....

I think the Adrenal is the primary problem and it keeps my thyroid suppressed. My free T3 is always below normal. I'm on Armour, 1 grain. If I try and raise it, my body rebels with negative reaction. I get splitting headaches, worse fatigue, and high blood pressure. Otherwise, I have blood pressure that drops when I bend over, then stand up...so I get dizzy. I know that's from the Adrenal fatigue.

So....how to correct the Adrenal fatigue. I should probably check into the cause further and have a ACTH stim test? I read this should be done, before you start any hydrocortisone. I think I will need the HC. Was on it a few years ago, then my doctor suddenly died and I gradually went off. I did ok, until my life got very hectic and stressful....then I got to where I about collapsed. I'm 5-6 and was 125 to 130+....my weight dropped to 113. I was too weak to even care to eat. Now I'm 120 to 125. That's more low adrenal then hypothyroidism! Any advice? Thanks!

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Where do you live artemiss? I'm asking because the way you've said about your weight makes me think you might be in the USA.

Are you a Facebook user? If so, this is an excellent group facebook.com/groups/FTPOAdr...

I too have low cortisol. My am was higher than yours, but I only managed a total of 6.2 for the rest of the day. I take 4 x Nutri Adrenal Extra, 1 x Nutri AdrenoMax, 17.5mg hydrocortisone and 3 g Vit C for adrenals. That's just an example and I had to work up to that one step at a time.

Try and find a doctor of functional medicine or integrative medicine or, in the USA a chiropractic doctor. They are the ones most likely to help you.

You'll need to work on your adrenals before you can fully tolerate and utilise your thyroid meds.


Do they do ACTH levels and 24 hour urinary cortisol in the UK? That would be a start. You need to find out if it's the adrenals or the pituitary gland first. If ACTH is abnormally low, then it's the pituitary gland not signalling. These would be less invasive tests than the Synacthen. If ACTH is normal, then the adrenals are not responding.

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I think they can do both. How often they actually do, I wouldn't know as I've never been tested on the NHS. I personally believe my problems are pituitary related, possibly from a childhood head injury, but so far I can't prove it. It's one of the things I need to work on.

Do you recommend, or believe in, different treatment if it's pituitary rather than adrenal? If you don't want to hijack the thread, you're welcome to PM me.


No difference in treatment for low cortisol. But if ACTH is low then the other pituitary hormones need to be checked as well. There may be a requirement to replace other hormones, not just thyroid and cortisol.

Synacthen just blasts the adrenals to find out if they are capable of functioning. The ACTH level is much less invasive for a start. And 24 hour urinary cortisol clearance can indicate that the total cortisol output for the day is normal but the rhythm is off. In Artemiss case, it looks like 24 hour cortisol would be low. But is it her pituitary or her adrenals?

The electrolytes need to be checked because the heart response to raising the thyroid replacement could be because potassium is high.

She needs a full work up and not just semi random picking and choosing of tests which is what seems to happen all too often.

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You all are supporting my own thoughts to get some more clarification on this. I am in US. I don't want to just up and start using HC until I know more. I know from some past tests, few years ago, had very low DHEA and very low testosterone. Had breast cancer and been doing natural treatment and this included using bio-identical hormone replacement, so have been trying to replace sex hormones, but not really followed by a doctor now. I know my free T3 and free T4 are low, but can't get them up. I just thought I needed to address the Adrenals first, but can't help wonder how the pituitary is functioning.

Would love to find a doctor who would know all this. I don't know why we learn about it and see it happening, but doctors seem so clueless. I may have to drive out of area to Chicago or Indianapolis, seems silly to have to, but I'll do what I have to.

I see someone mentioned treatment adrenal vs pituitary. If it's adrenal insuffiency, I know I'll need HC and maybe a long time, if not forever just by how my history has been... This may be enough for my thyroid to function normally, I hope. If pituitary, I would have to always be on HC, as well as thyroid and sex hormone supplements.

I'd like to know if it's Pituitary, because I think they'd know to monitor things better. I would need labwork done, periodically, to check everything and adjust doses as needed.

I am in some facebook groups, through "Stop the Thyroid Madness" for thyroid, Midwest, and adrenal...but get better response and info here!

Thanks, Jen


Right Jen, you know the drill. Your old doctor was right. Too bad he died. Those old guys knew a lot more than these young whippersnappers. And they knew they were stuck with their patients for the long haul. These young ones move around too much so they don't stick around long enough to find out they make mistakes.

I've Hypothalamic pituitary axis issues so am on HRT forever, thyroid forever and now going to investigate further the cortisol problem. My prolactin is still top of range at post menopause. I make sure the nutrition is optimal. Vitamin D is optimal. But stress response sucks. I hear you. Been there with the inappetance, weight loss and weakness. Got better but never good. This is a killer. Now porked out due to deadness of inadequate dosing but getting better but stress response sucks biggie time.

I cannot make head nor tail of the Stop the Thyroid Madness in regards to the adrenal advice. It's too limited. Maybe it works for a lot of people but so does T4.


yeh, my doctor died from a brain anureysm. I really miss him. Have seen 2 since. This last one just quit at the clinic I went to. This saliva test just is confirming things more. I feel angry, so many years of wasted time.

After my breast cancer, almost 4 years ago, I lost weight and tried to be very healthy. My estrogen levels dropped to such low levels, the lab could not detect any...just said <12 or below 12. I'm thinking about things like this now and it's like a puzzle coming together. Back then I was 49 ( almost 53 now ) and the doctor who died, started me on sex hormone replacement. We need Estrogen. After he died, no doctor wanted to touch me with the hormones because of my history of breast cancer. So I ran out of the bio-identical creams I was using and did I suffer....hot flashes all day and night. Lived by a fan for months until I found ways to get more hormone creams. Now I realize I really did need the replacement hormones it wasn't just for menopause reasons.

I've lived a life trying to shield myself from stress and always feeling guilty. Never understood it all, but now I am. Spent all my 40s thinking I was Bipolar and was tried on every psych med there was. At one point, my weight ballooned to 200#s on all that crap. When I got the breast cancer, I didn't care. Thought it was a relief to have everything come to an end. It was stage 3 and I didn't do chemo, radiation....nothing. Had the surgery though.

I did end up learning things on natural remedies and that got me motivated and then I found this good doctor. He helped me and we were on the right track when he died.

I've learned all I can from Stop the Thyroid Madness, but am open to learning more. There's 2 chapters in the book on it and lengthy interpretations in the back on the saliva tests. I also have Dr. Wilson's book, "Adrenal Fatigue" and have read others.

I always have trouble in Fall. get worse and swing back and forth with energy levels. I thought it had to do with rapid cycling and bipolar. I know the Hypothalamus has to do with circadian rhythms, right? what about seasonal patterns?

I also have, with my eyes, pupils that are noticably different in size. Thought they'd always been this way. Makes me wonder about pituitary and how sometimes there's a tumor. Not worried, just wonder.

Thanks, Jen

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Jen, you have to make sure to give yourself a major vitamin D boost. Back in September 2009 I spent two weeks in Grenada. I thought, great. All that sun is going to keep me going for the winter and I won't get SAD.............hah! Wow. Was it ever the worst by February. I didn't take vitamin D during the winter months.

I didn't pay that much attention to taking the vitamin D until end of 2012. I would take it but not regularly. Now I make sure I get at least 20,000 IU per week. Sometimes even more. This has had a positive effect on mood when the days are dark. Summer is so short. I love waking up in the morning and seeing a blue blue sky. It feels so good. But the days get shorter and shorter so, like now, it's past 7 a.m. and it looks like night outside. :(


I agree about the Vit D. It's also great for cancer prevention, which I have to watch. I often take 10,000 ius a day. I have the drops, 1000ius per drop. I often have my level checked when blood work is done. So many people are too low and don't know. People aren't told to be screened.

My daughter, 20, wasn't feeling well and I wondered about her thyroid, so the doctor ordered tests. I'm glad I asked for him to include Vit D, hers came back low, 21. After getting it back up, she was better.


I caught s**t from the endo when my vitamin D blood level came back above range. (95) I cut back a bit. That was January 2013 after I took 50,000 IU per week during December. I hadn't been taking the D3 regularly and wanted to find out if the Carlson 4,000 IU had in it what it says on the label. It does. LOL!

Aren't you a bit overdoing it at 10K IU per day? I know people who take 4K per day and their D levels are between 50 and 60.

Mind you, contrary to popular myth, it's not toxic. unHealth Canada does not permit the sale of more than 1,000 IU doses. Ridiculous idiots. I think they want everyone on bisphosphonates and flu shots.


I got mine up to 93 and my doctor was thrilled. He's the one that died. Then in summer, I slacked off and it came right back down. A good level is 50 to 70, but for cancer prevention, even higher. I'm at very high risk for cancer reoccurance.

I admit, some days I miss a dose, so maybe 5 days a week I take 10000ius? I want to get it back up 80s-90s. next blood work, I'll see where I'm at.


There's all sorts of stuff about MK-4, MK-7 etc. MK-4 is supposed to be better but I can't get it except in chicken liver and beef kidneys etc. I take the Carlson 5 mg K2... 10 mg once or twice per week. Thorne research sells MK-4 drops but I can't import them to Canada. Verboten!!! I can't even import the Carlson product. Not legally. I have my 'stash' at home. LOL. It's all so bizarre. I have my 'vitamin mules' who bring stuff across the border. Just insane what unHealth Canada does to the population.

I've eaten Natto but even though supposedly if someone eats it for 30 days after that they get to like it, I'm not crazy about the stuff. There's something like 4,000 mg of K2 per serving. There are people in Japan who eat it for breakfast every day! I figured out, eat it when it's just defrosted or it gets super slimy.

The government has a contract with the manufacturers of osteoporosis medication so why make it easy for people to prevent osteoporosis naturally? Money money money...


Yes, I have vit k2, suppose to help with Vit D right?

It's not much better in Capitalism USA! All about the money and profit. Statin drug business really booming....oh I could go on and on....

Vitamin mules, good one! With the help of the internet we can usually get things we want. I've chatted with people who get HC on their own and would let me know how If I wanted.


I was thinking of another thing that helps with SAD. SAD is a type of atypical depression. There's the fatigue, carb craving, etc...

What helps is Chromium. The way this helps is chromium helps with our glucose metabolism. It helps our bodies have better insulin sensitivity. On the internet, look up "chromium connection". You can find many studies proving this, but chromium connection is a good site. In fact, I got the book.


I too have adrenal fatigue that is preventing me from raising my NDT ( 8 months now) and I feel awful all the time - similar symptoms to you. Headaches are a particular problem.

Please check your iron/ferritin levels as you need to be in the upper range of normal in order ( especially women) to utilise T3 properly, otherwise it just pools in the tissues. I have just found this out - the iron has had the added affect of stopping my hair loss too. Check VIt D and B vits too.

I found some of the adrenal support meds too stimulating for me, causing more problems, as they affect the whole gland rather than just the cortex, so find a gentle one that heals and supports rather than stimulates ( that;s the last thing the adrenals need is they are struggling). I use Kinesiology to help me find out what supplements my body does and does not want and also how much to take.

Mu problem is that - every time I crawl back up to feeling better, life whammy's me with another mountain of stress so that I fall back down the hole and have to start all over again. I guess there are so many times a person can do this before they " crash & burn" - which is where I am at now. Good luck to you.


I agree with all you're saying and have been working to get Ferritin up from in the 50s. Soon to be rechecked. Aiming for 70 to 90. Taking Iron supplements and eating liver every week.

I have a history like yours and never realized until recently. We have to learn to protect ourselves. We have to learn to stop feeling guilty and so responsible for everything.

In the book, "Adrenal Fatigue" he shows patterns, including Adrenal exhaustion over and over. Every time you recover, life throws more at you, and back down you go. That's why I'm thinking I'll need the HC. I don't ever seem to have any reserves left.

I don't know if my Adrenal glands can ever completely recover or are they too damaged....from stress, auto-immune or what? Or it's the pituitary not sending signals like it should.

I'll be finding all this out and once the Adrenals are taken care of and supported then I can see about getting my thyroid levels up.

I've read that Stop the Thyroid Madness book and she says that with low cortisol, there can be high free T3 and continued hypo-thyroid symptoms....but not with me. I have very low cortisol and below range free T3. All I can do is 1 grain of Armour. Without that 1 grain, I have a bloated belly. If I try and go any higher, splitting headache, high blood pressure, weakness....So I just stay at the 1 grain. I believe the Adrenal glands are fighting to suppress things, They are trying to conserve and force your body to rest. Raising the thyroid hormones are in effect increasing the metabolism, which the Adrenals can't handle.

Yes...have dealt with the hair loss also and heard Iron will help. Also taking biotin 5000mcg and watching my sex hormone levels. Been taking lots of vitamins including Vitamin C, all the Bs and extra B5...none of it ever seems to help, also all the top adrenal herbs.... I spend so much money at Vitacost, it's crazy!

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Agreed totally. Same same same..... I'm spending time lying in my hammock today. I need to recharge the batteries. Ferritin is excellent, B12 excellent.... can't imagine folate is low because I take B complex often enough. Vitamin D is great. Had my vitamin A checked too. Excellent.

I had to lay off the liver loving..... hemoglobin 160... ferritin went over 100.... not inflammation. Just too much of a good thing.

Abuse in childhood and early adulthood will cause permanent HPA problems. I wonder sometimes if some people who come to this forum and have persistent problems with adrenal fatigue have a history of childhood abuse. This is not a controversial issue as to diagnosis and lifelong problems. But endos usually are not savvy about asking the right questions. There needs to be coordinated care between psychiatry and endocrinology in these cases.


your so right. Dr. Mercola says, about Rheumatoid arthritis ( and probably other auto-immune illnesses) that childhood abuse/neglect is a reoccurring theme. I have a good Adrenal fatigue book and half of it is devoted to healing mentally.

I learned the hard way, that you can eat right, exercise and do everything healthy, but it won't work unless you find peace and love yourself. I've gotten into spirituality. The learning never ends does it?


and don't forget about getting the Emotional Vampires out of your life..... Sometimes a serious 'housecleaning' of relationships is warranted.


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