Your results :
Sample 1 : 0.273 ref 0.097-0.337 mcg/dL
Sample 2 : 0.137 ref 0.027 - 0.106 mcg/dL
Sample 3 : 0.152 ref 0.013 - 0.068 mcg/dL
Sample 4 : 0.010 ref < = 0.034 mcg/dL
DHEA 7-9am 102 ref 71-640 pg/mL
Optimal results for cortisol are described in Example 1 in this link :
• Morning at the top of the range
• Noon approximately 75% of the range
• Evening close to 50% of the range
• Nighttime at the bottom of the range
Comparing your results to the optimal results we get :
1 : Optimal = 0.337 --- Yours = 0.273 --- You produce 81% of the cortisol that you should.
2 : Optimal = 0.08625 --- Yours = 0.137 --- You produce 158% of the cortisol that you should.
3 : Optimal = 0.0405 --- Yours = 0.152 --- You produce 338% of the cortisol that you should.
4 : Optimal = 0.00 --- Yours = 0.010 --- I'm not happy with the reference range, but I'll carry on anyway.
Totals : Optimal = 0.46375 --- Yours = 0.572 --- You produce 123% of the cortisol that you should.
DHEA : I don't know what is optimal, but your result is 5.5% of the way through the range which is very low.
Sample 4 has a reference range of <= 0.034 mcg/dL. This reference range includes 0. This is clearly nonsense. Having a cortisol level of zero would only be healthy for a corpse. Despite this I've seen reference ranges including zero for saliva test results in many cases during the last year or so, usually for the bedtime sample, but I've also seen a few results including zero in the reference range even for a late afternoon sample. Clearly the body produces very little cortisol at bedtime but it should not be a zero amount, so I'm not impressed by the testing companies including this in the reference range. It suggests that they haven't excluded sick people from their data when determining the ranges.
Overall you are producing too much cortisol each day. The pattern of your results, with the first sample being too low and later samples getting further and further from optimal is a typical pattern that occurs often.
As thyroid dysfunction worsens, cortisol starts to rise. It may rise very high indeed. It may stay high all day for years. I think you have probably been in this state for a while, but you have now started going downhill from this high cortisol state.
Eventually the body can no longer keep on producing high levels of cortisol, and levels start to fall. A common pattern is what has started happening with yours - the earliest one starts to fall, then later in the day the adrenal glands try to make up the slack, but over time the fall in levels gets worse and starts affecting cortisol levels later in the day. This is referred to as "adrenal fatigue", but the mainstream medical profession doesn't acknowledge that this condition exists. They only believe in "adrenal insufficiency" - Addison's Disease - where the body can't produce cortisol at all or produces almost none. But that is as far as they will go.
People who have succeeded in improving their pattern of cortisol output and adrenal health have found that by increasing the first sample result then the results later in the day fall by themselves.
So, some suggestions :
A couple of useful links :
I think you should try an adrenal glandular fairly early in the morning. Don't take glandulars after 1pm. The most popular ones I know of are Nutri-Adrenal and Nutri-Adrenal Extra (NAX), and Adrenavive glandulars, but I don't know which one you ought to take. And of course there are other brands, but I don't know which ones are good. Look at Amazon for adrenal glandulars and read the reviews. One thing to be aware of is that some glandulars may contain adrenaline which causes a problem for some people. Taking just adrenal cortex should avoid the adrenaline (epinephrine) issue. Look for reviews of adrenal products on Amazon or similar sites.
Be aware that some people don't do well with adrenal supplements of this type i.e. made out of bits of the adrenal glands of other animals. If they don't agree with you stop taking them.
You definitely need some vitamins and minerals to support your adrenal glands. Avoid multi-vitamins and multi-minerals (although a good B Complex is essential). Look for links on the subject of adrenal fatigue supplements.
You really need to take a substantial amount of vitamin C per day, preferably a minimum of 2 g per day, but more if you can cope with it.
It is essential to reduce stress as much as possible and that includes physiological stress. So, keep nutrients optimal, but also work on getting your gut working as well as possible. Probiotics in high doses are good. You can make your own probiotics with food - things like kefir and sauerkraut, for example.
Eat regularly, don't miss breakfast, eat enough protein and enough healthy fats, and drink an adrenal cocktail every day (if you can). Do a search for "adrenal cocktail" recipes and pick the one that appeals to you. I couldn't stomach the salt myself, but do try to get some down you.
Avoid big spikes and drops in your blood sugar, if at all possible.
Some info on healthy eating - I don't think very low carb or fasting help with adrenal fatigue, so don't go extreme in any diet :
You have to register for above program but it's free. There is also loads on healthy eating at this link :
The above links may be for diabetics, but are healthy for anyone.
Go to this link : stopthethyroidmadness.com/s...
scroll down to the section on "Adrenal Information" and read the links.
When you do another saliva test, be aware that various supplements can affect the results - some things lower cortisol, and some will raise it - you have to research and find out which is which from the following lists.
The Dr Lam website has a lot on adrenal fatigue :
Click on each of the blue boxes to the right of the phone number.
I also wrote a post for someone else on the subject of their adrenals - you may find some of it helpful :
One thing that should help is getting enough sleep, but if cortisol is too high at bedtime and getting to sleep is difficult then do some research on the following which may help with lowering cortisol :
Seriphos - interplexus.com/data-sheets...
Phosphatidyl serine - lots of brands available - google for more info.
Adaptogens - I've already mentioned these in an earlier post I think. Different ones help in different ways. For example Rhodiola Rosea perks people up. Holy Basil calms them down. So, experiment with timing and dose and do lots of research.