This is my cortisol photo
F.a.o humanbean: This is my cortisol photo - Thyroid UK
F.a.o humanbean
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130396
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I won't keep repeating the units of measurement because they are on the photo.
Result 1 : 13 (12 - 22)
Result 2 : 7.6 (5 - 9)
Result 3 : 7.2 (3 - 7)
Result 4 : 3.3 (1 - 3)
Total : 31.1 (21 - 41)
Based on the recommendations on STTM :
"We noted repeatedly that those will healthy adrenal function will have the following saliva results:
8 am: at the literal tip top of the range
11 am-noon: in the upper quarter
4-5 pm: mid-range
11 pm to midnight: at the very bottom (literally)."
Source : stopthethyroidmadness.com/l...
Result 1 : Low in range and needs to be at the top, let's say 21 just for argument.
Result 2 : A smidgen low - needs to be about 8.5.
Result 3 : Much too high and needs to be about 5.
Result 4 : Too high and needs to be about 1.
Total : Based on those idealised levels your total should be about 35.5
So overall, you don't have quite enough cortisol, and it isn't spread out throughout the day in the right pattern - you need more earlier in the first half of the day and less in the second half.
I'll post this, but I'll continue later, I have to go out.
Oh, you did say these results were out of date, but how old are they?
hi humanbean I had one of these tests done over a year ago now..it showed low over the first three and high on the last...I am baffled as to why no doctor or Endocrinologist ever acknowledge this test? I have shown it to them and each time they say they are not conclusive. To me they are very conclusive!
Surely the blood cortisol test they do doesn t reflect the cortisol levels as it's taken one time in the day?
This test is always advocated on sites here and other sites so it's a puzzle.
I agree it makes no sense. Particularly since even the NHS uses night-time saliva testing for cortisol when testing for Cushing's Disease :
nhs.uk/Conditions/Cushings-...
NASA and the US military have been experimenting with saliva testing, and it is commonly mentioned in research papers. Take a look at some of the references on this page :
en.wikipedia.org/wiki/Saliv...
I also did a search on Google Scholar for "saliva and cortisol" and got back nearly 34000 results, so at least some of them must have been using saliva for testing, rather than doing other things.
But clearly, the NHS feels it doesn't need to move with the times. 
Hi 130396, I promised I would continue my reply to you, so here goes. Don't forget this is all based on my own experience, so please check and double check everything I say. The tedious, repetitive, and really frustrating caution I had to use in raising my dose of T3 was, in my opinion, due to having periods of the day when my cortisol was too high (over the range).
Obviously people with really low cortisol are not going to benefit from the techniques I had to use. And some people will adapt to T3 a lot faster than me anyway. I got the feeling that I had to coax and encourage my body to stop over-producing cortisol. I suspect I've had high cortisol for over 40 years. And from reading posts from others with high cortisol, stopping over-production is really hard to do. It's extremely stubborn! I also worry that any form of psychological or physical stress could send my cortisol straight back up again.
I am actually on T3 only, but you might be able to adapt some of the techniques I used to your own situation.
When I first started T3-only (this year) the situation I was in was :
First half of the day - My cortisol was over the range.
Second half of the day - My cortisol was in range but still too high for comfort.
My ultimate aim - I wanted to take T3 in the morning in the hope of developing some energy to get my day started. But I found high cortisol made it almost impossible to tolerate.
How I got round this problem :
I didn't want, ultimately, to take most of my T3 in the evening (even though my cortisol was lower then) because it interfered with my sleep too much - I was prepared to take a tiny dose though and that does help me.
1) I started taking a dose of T3 at about 2pm when I thought my cortisol was dropping from being over the range to being within range. I got some brief palpitations and my heart briefly went a little faster than usual. I stayed on the dose I was on until these effects wore off and I felt comfortable.
2) Then I added a small dose early in the evening. And again waited until I adapted, kept tabs on my blood pressure, heart rate, and my temperature.
3) Then I added a little more (1/4 tablet) at 2pm. When I adapted to that I moved that latest 1/4 tablet addition to early in the morning. That took a lot longer to adapt to (weeks).
From that point onwards I followed the same pattern - add a tiny bit of T3 to my 2pm dose, and once I adjusted I tried moving the time I took it.
I actually spent much more time moving my T3 dose around, altering the distribution of doses, changing the size of individual doses, than I did adding more T3 to my total dose. Several times I couldn't tolerate the extra and had to drop back to my previous dose for a few weeks. Then I'd have a second attempt and it worked.
Sometimes I would spend weeks shifting things around, hoping that my body would finally accept some more T3 in the morning. If I got it wrong, or moved it to first thing in the morning too quickly I would get jittery, hot, and sweaty, despite still having a lower than normal temperature.
It was only when I got to my final dose (but didn't know it) that going up in dose didn't work. I spent an uncomfortable week being hot and sweaty, heart going a little too fast, then dropped back for a few weeks. The second time I went up the situation repeated. So this time I realised I didn't need any more and dropped back permanently. I've since re-distributed my doses again, and that experiment took ages too.
Some suggestions : If you take your levo at night, try taking it in the morning. If you take it in the morning, try taking it at night. As far as the T3 you take is concerned, try and cater for your low/high cortisol, and try taking it when your body is switching from an under-production to an over-production. With a bit of luck it might help. And once you've adapted try shifting tiny amounts to when you hope to have more energy, and just see what happens. You can always revert to a previous dose or a previous pattern of dosing. If possible, keep detailed records of experiments you've tried and symptoms you had.
Another thing that helps is to look for vitamins, minerals, adaptogens, and amino acids which help your adrenals to cope and recover. I don't know what you already take, or what medications you take that might cause interactions or problems, so I don't intend to make any suggestions - there is loads of info on the web about supplements for adrenal health.
I hope I haven't been too repetitive.
Thank you so much for putting all that together.
I really don't know what my current cortisol situation is. All I know is that when NHS endo took my off NDT and put me onto levo all my current symptoms started up
I never feel tired at all. I don't find at any point in the day I'm flagging or running out of energy.
My head goes weird after I've been up and about for couple of hours.
My other symptoms I listed on my original thread.
I had increased t3 by another 5 mcgs a couple of weeks ago now but I have dropped that for the last two days to see if my banging heart stops in the evening.
My temperature seems to run OK. It's a little lower in the mornings. About 97.6 but steadily rises throughout the day and gets to 98.6 shortly after lunchtime.
When I was taking the extra 5mcgs in the mid afternoon my temperature would rise to about 99.0 that's why I decided to drop it for the time being
As I'm.writing this my head feels awful.
I take vit B12. 450mg chelated magnesium. 3000 vit D. a multivitamin. I also am now taking 300mg ferrous gluconate twice a day.
My other med is 20mg nortriptyline at night.
I just don't know what to do about cortisol as I don't get symptoms of either high or low.
Many thanks
Rose
Low nutrients caused me to have head problems (pain and pressure feelings although nothing ever showed externally). In my case getting my iron levels up was the biggest help in getting rid of the problem. B12 and gluten issues were also contributing to the problem. The other issue I have is, once I cut down on my iron or stop it all together it drops like a stone, so I have to stay on a fairly decent dose all the time. I've had gut problems for years, like so many people with thyroid problems.
Have you done anything about improving your gut health? Gone gluten-free for example? Do you take probiotics? Do you know if you have problems with lactose?
Going gluten-free did little to help my gut (although my indigestion isn't as bad as it used to be), but did help my head. I stagger much less than I used to (B12 helped with this too), and the bad temper problems I had have vanished. I used to worry I was going to kill someone in a fit of rage. And so often the rage would just come out of nowhere and be triggered by nothing that I could explain. So going gf has been tremendously good for my head/brain, and also my marriage. I think I must have a condition called gluten ataxia, based on what improved when I gave up gluten.
I do hope you find a solution to your problems. Have you considered buying NDT on the internet? Self-medicating might get rid of all your problems fairly quickly... You already know NDT has worked for you before.
I actually wasn't brilliant on NDT. I didn't feel any different than I did on t3 only or the combo. I had continual butterflies in my tummy and hot flushes which the Warwickshire endo said was due to low ft3 and not converting.
Combo, t3 only and NDT didn't get rid of them plus my ft3 was still low on them. BUT...... Once I was stopped on NDT by NHS endo these horrible symptoms started up amd as yet are still ongoing.
I did go gluten free for a time but made no difference. Also took a hood prebiotic for ages but again no difference.
I've been trying to get iron supplement added as I have very low saturation % and I'd been fighting for a year to be allowed to take it. Finally, in September of this year I saw a Professor of haemotoligy at Guys Hospital for my blood condition and she said it was fine for me to have prescribed and didn't understand why my local consultant haematologist had forbid me to take it.
I did tell the professor all of my symptoms and she said they are typical of hypothyroid and unrelated to my blood condition.
Rose
Edit : The following discussion about buying prescription-strength iron supplements is aimed at people with a substantial or severe deficiency of iron, not people with a minor deficiency.
If you know you have iron problems, and you know you need to supplement, then prescription-strength iron can be bought from many pharmacies without a prescription (not Boots, they insist on a prescription). You don't need to beg or fight or ask your doctor for his permission - hooray! The important thing to be aware of with any type of iron supplement is how much actual iron there is in the supplement.
So, for example, I supplemented with ferrous fumarate 210mg in boxes of 84 (enough for 1 tablet 3 times a day for 28 days) from my local Lloyds and Tesco pharmacies. Each tablet had 210mg of ferrous fumarate in it. But only 69mg of that was actually iron. So the elemental iron was 69mg per pill, and three per day of them (which was the maximum dose) gave me 207mg of iron per day.
By contrast, a sachet of Spatone, which many people use, has 5mg of elemental iron per sachet. Some people manage to raise iron on this, but many don't.
Different types of iron will absorb at different rates.
I was prescribed the dose I gave above for just two months. I ended up taking it for nearly two years (buying it myself) because I simply didn't absorb it well. I paid for my own testing. I was fed up of begging.
Since iron is poisonous in overdose , people taking iron should test regularly. Most people should test every 3 months or so. But it could be less frequently if you know for certain that you are absorbing slowly. Ferritin shouldn't go above mid-range.
My ferritin was 84 top of range 204.
My iron saturation is low 19% just above bottom of range.
The problem I had in getting iron prescribed was because I have a serious blood condition it's a mild form of blood cancer. Because my bone marrow makes too many platelets. So I saw the professor who is expert in this rare blood cancer and she said because I didn't have the red blood cell cancer it was definitely OK for me to take iron supplement.
I think I told you that I had stopped the small 5mcgs increase if t3 that I started almost two weeks ago as I was worried I was taking too much because I was getting pounding heart in the evenings and my temperature was up to 99.
Well today, my temp hasn't yet got to 98.6 yet and usually by this time it's normal. So I'll see if I've got pounding heart tonight and if I haven't I'll try to add the extra 5mcgs tomorrow. Maybe I should add it to one of the 10mcgs doses instead of taking it separately at 3pm?
Why do you think I never feel tired now?
And my head goes weird instead. Well I say instead as I think that it goes horrible as a way if saying I'm tired.
Texting and reading and concentrating on reading and texting makes my head feel like it's filling up and goes all like pressure inside my head.
Did you read all my symptoms??
Thanks so much
Rose
I'm sorry, I can't find your post with all your symptoms. Can you give me a link, please?
A ferritin level of 84 with top of range being 204 isn't too bad. However, if your iron saturation is low and your serum iron is low, then the apparent "good" level of ferritin may be due to inflammation. I don't know what the safe or correct treatment is for iron supplementation under these circumstances, so I can't help.
You might find something helpful on this site if you have a good poke around :
Fluctuations in temperature are often associated with adrenal problems. For more info you could take a look at this site :
drrind.com/therapies/metabo...
You could try taking the extra 5mcg about an hour before the pounding heart starts (if it starts at a regular time) and see if that prevents it happening. If you have previously taken NDT (which contains T3 of course), and you have spent time on T3 only, your heart may be telling you that you need more T3. If you are really worried you could try taking just an 1/8th. If it is more than you need then any overdose symptoms will wear off quite quickly if you take such a small amount. Since you aren't sure whether or not you need it I would keep the tiny dose separate, just so you can identify any effects of that specific dose. You could always experiment with moving it after a while to see how it affects you.
I don't know why you never feel tired but your head goes weird. You comments about your head have reminded me of a weird problem I had a while ago. I'd forgotten about it until now. It affected me mainly when I was driving and was quite scary and very, very weird. I'd be driving along and would suddenly feel as if my head was being pulled upwards by an invisible force. I'd feel it in my neck muscles. After the feeling started I felt as though the top of my head was coming off. I would feel as though I wasn't in complete control of my body, or my body wasn't really part of me. But if I had to brake or turn a corner or stop for traffic lights I would be perfectly capable of doing so - but my muscles would just feel very stiff.
I think the head problem I had was a combination of things - tiredness even though I felt hyper-alert, low thyroid, high cortisol, low iron, and low nutrients generally. The weird feeling hasn't happened for quite a long time now. As I said, I'd forgotten it happened.
healthunlocked.com/thyroidu...
FOUND IT!!!
This is the link
Rose
Hi Rose,
Well, that explains everything. You are under-medicated and the comments you got on that thread still apply.
If I've understood correctly you are currently taking :
75mcg T4 + 10mcg T3 + 10mcg T3 + 5mcg T3
i.e. a total of 75mcg T4 + 25mcg T3.
Depending on the "value" of T3, this is the equivalent of either :
3x : 75 + 75 = 150mcg T4
or
4x : 75 + 100 = 175mcg T4
So you still aren't taking the equivalent of the NDT you were taking previously even now.
So you are still under-medicated. My suggestions about how to increase your T3 were probably rather timid in your case. You've taken it before, either as NDT or as T3, and you know you did better than you are doing now.
All the heart thumping you are getting, the weird head sensations, and the seriously wobbly legs are probably caused by under medication. And since these drops in medication have been very sudden, then it has made things even worse, and has affected your adrenal response too.
From the blood test results you gave on that other thread you haven't had a good level of T3 since you were taken off NDT. Any suggestion by your endo that your T3 was too high are, quite simply, lies.
Omg...... You do seriously think I am undermedicated still!!!!
I dropped the extra 5mcgs t3 yesterday as I was worried I was taking just a bit too much as the heart was banging and my temperature had gone up to 99.0
My temperatures are usually about 97.4 when I wake up but do steadily rise through the day to reach normal by mid afternoon. They don't jump up and down.
So you really really think the head thing, flushes, sweats, chills and not getting off to sleep very well are ALL due to undermedicated???
What would you think I should do now?
Should I add the extra 5mcgs in the morning to see if it helps my weird head feelings that come on about 11am every day.
Oh I can't thank you enough.
Bless you.
Ps I know the flushes aren't menopause as been through that at least 13years ago
Thank you so, so much
What was my 2 grains of Nature throid equal to in mcgs?
Roughly 200mcg T4, based on the replies you got on your other thread. Or just under 80mcg T4 + 20mcg T3.
Did you feel under or over-medicated on that?
If you don't feel comfortable about taking any more T3 then please don't take it. Only you know how bad you feel.
Just a thought...
Something I've done in the past when I've been nervous about raising my dose, and wasn't sure it was a good idea...
Instead of raising it, I've reduced it by a small amount (1/8 or 1/4 of a tablet) for a few days. If I feel worse then I know that reducing it was the wrong thing to do.
My post starts with tsh 1.26 it was a month ago.
I don't know how to give you the link.
Hope you xan find it. It lists my symptoms. Too many I'm afraid
Maybe if you look at it you might be able to make some sense of it
