On Thursday my private endo told me to get AM cortisol tested by blood (said to forget about saliva/urine tests)
It came back slightly raised at 544 (133-537)
I'm not due to see him for another 4-6 weeks when follow up thyroid tests are due. And at £140 an appointment I can't really afford to see him before then aswell.
I sent the results to his secretary today but he only works privately on Thursday's. She called me to say she'd rang him with the results and he said they're probably normal but wants to see my notes on Thursday (probably can't remember who I am)
I'm off work tomorrow and wondering if I should go and show them to my gp? Or should I wait to hear from the endo?
I also have an nhs endo appointment in 4 weeks that I was going to cancel as i was referred for thyroid and pcos and the private one is helping with that probably much better than the nhs would.
Not sure what to do. Would like my mind put at rest but I find it hard to accept slightly raised is normal. Maybe because I've lost trust in "normal" since learning about thyroid.
Thanks
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Salphy
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If Cushing's syndrome is suspected, the amount of cortisol in your body can be measured in your:
urine
blood
saliva
Before the format of the NHS Choices disease pages was changed it used to mention that saliva testing was used to measure cortisol in the middle of the night in patients suspected of having Cushing's Syndrome or Disease. Obviously it is difficult to get blood samples taken in the middle of the night so saliva samples are convenient, and are clearly accurate enough to be used as part of testing when the NHS feels like it.
Regarding your cortisol result I suspect that you'll be told that it is only slightly over the range and is not important. I doubt very much that it will trigger testing for Cushing's.
However, if you can afford it, a private saliva test is useful. You would need to test at 4 points during the day (paying for more isn't necessary), and you would need both cortisol and DHEA to be tested. The only two companies I know of that do this type of testing are :
Note that Genova is an awkward company, and deals with patients at arm's length. There are special instructions on how to order and how to get your results from them.
I would suggest asking both companies for their reference ranges for the cortisol test before ordering. If either of them includes zero as being part of the healthy range for any of the samples then I'd query it. I am totally convinced that having zero cortisol is only healthy for a corpse.
In the end you will probably have to try and reduce your cortisol yourself. There are various adaptogens that help some people, plus other supplements that people can take which work for some. It is really trial and error.
Note that having high cortisol makes it harder to tolerate thyroid meds, although some people find that high cortisol reduces naturally if thyroid meds are raised to optimal. More trial and error, sadly.
It is important to realise that quite a few of the drugs and supplements listed can't be stopped just when we feel like it. In those circumstances people have to accept that their cortisol results will be affected by what they are taking, and that stopping the drugs/supplements simply can't be done.
It is also worth pointing out that some of the substances listed in those links can lower cortisol, some raise cortisol, and neither of the links specify which is which - you will have to research what effect occurs with anything you are taking.
The one result is not especially helpful- for a full picture as quoted you do need dhea and the 4 cortisol tests.
Your result is only slightly over range - adaptagens like holy basil ( tulsi in tea format) and ashwaganda can help.
I know Genova has altered their ranges and now include 0 in the ranges in the afternoon of the cortisol - I totally agree that’s daft. Who wants to produce nothing!
Dhea is especially helpful and so you’d have to pay privately for that.
In answer to your question I would doubt anything would be said re your results. I doubt they would even know how to address it. ( melatonin also reduces levels too)
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