Pre 9am cortisol test

[minxabroad]

If the Pre 9am cortisol blood test comes back within the normal range,, does that rule out any cortisol problems?

[greygoose]

Depends where in the range. The range is rather wide, usually, and you need it near the top, rather than the bottom.

[minxabroad in reply to greygoose]

So if my result were at the lower end of the normal range, is that when the 24 hour urine test would usually be advised?

[greygoose in reply to minxabroad]

It would be a good idea, yes.

[Hidden]

Do you know what your result was? Doctors who don't have a lot of experience of cortisol issues tend to say "normal" when the result was in the range, however the levels change throughout the day.

[minxabroad in reply to Hidden]

Hidden greygoose My result was 250 nmol/L. The ref. Range was 185-624. I asked the gp about the number being on the lower side of normal but as it was within range she was not concerned.

[Hidden in reply to minxabroad]

That is quite a low reading for that time of day, it should be around 500. Like the other poster suggests you need a synacthen test, 24 hr urines are only really used to measure high cortisol rather than low. Low cortisol results in feeling nauseous, being sleepy, light headed & can progress to shaking & feeling really unwell which needs hospital intervention.

[minxabroad in reply to Hidden]

Interestingly those are some of the symptoms I am having. I am not sure how to approach the gp about the test though as she has already said the number is nothing to be concerned with. I will simply have to ask her I guess.

[Vallillyann1]

My result was fairly similar to yours, my Endo sent me for synacthen test which I again I managed to get results in bottom of range. It confirms I have low cortisol rather than Addison’s or secondary adrenal insufficiency. Ii take a saliva test every few months to check all is ok.

[minxabroad in reply to Vallillyann1]

Vallillyann1 Are there symptoms with having low cortisol? Do they have any suggestions of how you can improve the cortisol level?

[Vallillyann1 in reply to minxabroad]

Sorry for late response...low cortisol has lots of symptoms with main one being fatigue, brain fog, struggle to get out of bed in morning, nausea & inability to manage stress of any kind, anxiety and allergies.

Dr Peatfield talks about it in his book, dr Wilson is another good read. Stop the Thyroid madness has a good section on website.

To start managing it, you will need to understand what is happening with your cortisol levels during the day - Saliva testing by genova Diagnostics is good one to use. You can use Thyroid Uk as your practitioner. From there, you can work out what to do to help support your body. Do you have thyroid issues too? My adrenals were so weak, I was struggling to manage my thyroid meds.

You need some more information before you set off on any type of treatment plan

[minxabroad in reply to Vallillyann1]

Thank you very much for that information. Yes, I have hypothyroidism. They say that my medication is fine as my number is within the range. I did not realise that there could be a connection between Hypothyroidism and low cortisol. Unfortunately paying for the saliva test is not possible at the moment. I am guessing the NHS do not offer or recognise it?

[Vallillyann1 in reply to minxabroad]

Sadly, NHS don’t recognise it. In range means nothing ! I was in range with TSH 6.1, low t4 and when I got it tested very low t3. I was bed bound by then. I’ve had to become my own advocate, it’s really tough but waiting for my doctors support would mean I would still be in bed !

[minxabroad in reply to Vallillyann1]

Yes I agree, which is why sites like this are helpful. Without the available finances though, private testing is not an option which is so frustrating. Thank you very much for your help

[Howard39]

Hi

Far better to have the saliva test which shows cortisol over 4 specific times and v important dhea. That is always left out.

Regenerus do the test and e mail the results- you can use Genova but need a gp/ specialist or use thyroid uk to authorise the test. The first option is faster.

I took part in a trial and the most common group was high cortisol and low dhea by some distance. Then low cortisol and low dhea.

Www. Dr Sarah Myhill under adrenal gear box is a good read.

I’d await full results b4 making changes.

Good luck,

And yes you can help low cortisol and low dhea. Higher levels are more tricky to control.