Cortisol and ACTH Test

I'm getting this done. Since I'm nocturnal my doc said to do it in the afternoon, but I wonder if I should either go back to earlier schedule or just get up early and do it then? I have some symptoms of adrenal fatigue such as weight loss, fatigue, diarhhea, nerves/jittery and all the other stuff. I just wonder if I should do the saliva test as well. My doc says it's not accurate. My father said just do that too and pay for it online.

My vitamin D is down to 25 now but calcium is normal at 9.8 and pth is in normal range now too. I did start supplementing again but only at 2000 iu now due to symptoms of back pain and urination/headaches at a higher dose. B12 is still high at over 2000 but the homocystine test was normal.

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6 Replies

  • I think you should get up early and do it then. Your doctor is a bit of a clown, isn't he. Doesn't matter if you're a night owl, your cortisol production still follows the same 24 hour pattern. So, a 9 o'clock serum cortisol test should still be done at 9 o'clock!

    As for the saliva test being inaccurate, it's a darn sight more accurate than the serum test, and also lets you see the whole film, rather than just one snap shot. I think your doctor's got a bit confused. Totally out of his depth, I think!

  • I can't remember what this docs reasons were for saying that. I don't think it's helpful to say the doc is a clown though?

    I will do my best to get up early for the test but I'm worried that I'll have a low Bg then if I don't get enough sleep or a high and that could skew the test maybe. I often go low in the am and sometimes high from the stress and lack of sleep etc.

    Do we need to fast for this one?

    The saliva test should be easier done at home obviously.

    Thanks GG.

  • In my opinion, a little light humour always helps. But, if you don't appreciate my sense of humour...

  • I'm all for that- it just didn't come across that way. At that time.

  • The point is: are you a night owl as your cortisol rhythm is wrong or because you have worked permanent nights for many decades and have adapted? Even that adaptation can ruin your health as human were designed to get up with the dawn and sleep with dusk. You should have the test in the am even if you've had little sleep and the saliva test is helpful, too, to see the pattern. I think the doctor is just trying to avoid an argument about your ability to get up early enough and, as the tests almost always come back "normal" (unless you have full blown Addisons or Cushings), he knows it doesn't really matter when you have it done, as the NHS won't do anything with the results.

  • i was told by the lab and my Endocrinologist, to do the tests when i normally wake up, late in the day. The cortisol /diurnal rhythm, changes depending on what your schedule is. My Endo accused me of making my own low AM Cortisol, due to my bad sleep wake schedule. The problem is, that i came to her for help, because i couldn't get up to get my son to school, without becoming extremely ill.

    here is a research paper from oxford university:

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