Adrenals saliva Test results, wisdoms please?

[Sally56]

Can I ask for some help in reading my latest adrenals saliva test please. I am no longer having adrenaline rushes (awful) but am in the aftermath of 5 weeks of them. I am 5 weeks off from HC, I no longer take T3, I have for the past 7 days been taking compounded NDT. My symptoms are fatigue, weak, brain fogged.

[Hidden]

Although your results come within normal limits they are quite flat & warrant further investigation. You say you were on Hydrocortisone, what were you on it for? Were they given to you by a doctor or did you self medicate?

[Sally56 in reply to Hidden]

Hi Pauline,

I asked my Endo why he put me on HC and it was because he thought the adrenaline rushes I was having were auto immune. I have a few auto immune issues. But it made me worse and I was only on it for approx 3 weeks and weaned off it slowly.

Can you explain what 'warrant further investigation' means please? I was hoping to go on an Adrenal supplement of some sort? Thanks.

[Hidden in reply to Sally56]

You need further investigations as to why your cortisol levels are low at the start of the day when they should be at their highest. I'm not sure that the Endo you saw is very conversant on pituitary/adrenal issues as he just put you on HC almost for a whim & didnt do any further testing before he did! I can't comment on Adrenal supplements as I don't believe i them. I have adrenal insufficiency so am HC in order to live.

[Sally56 in reply to Hidden]

Hi Pauline,

Okay thank you very much for your input. Because of this latest health crisis and hospitlisation, my Endo Prof and my Adrenals Professor are talking at last! However, my overall picture doesn't look too bad, it's when the cortisol results are broken down into 4 time frames by the Saliva Testing that a more informative story is told. At this point HC is not considered necessary by both of them?

[SeasideSusie Remembering]

Sally56

Samples 2, 3 and 4 follow the normal "curve" as you can see on the graphic. Sample 1 is too low and should be a lot higher, cortisol is highest in the morning and lowers throughout the day.

According to rt3-adrenals.org/cortisol_t... optimal levels are:

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

[Sally56 in reply to SeasideSusie]

Hi Susie,

Thanks for the link. Very helpful. So my morning cortisol needs assistance? Should I take an Adrenal supplement? How do you target just the low morning cortisol?

[SeasideSusie Remembering in reply to Sally56]

Sally56

Yes your morning cortisol should be higher, as Pauline has said. I don't know how to target just one low result I'm afraid.

[Sally56 in reply to SeasideSusie]

Okay Susie,

Thanks. Is this an unusual result?

[SeasideSusie Remembering in reply to Sally56]

Sally56

Is this an unusual result?

I don't know, it's not "normal" in that your first two levels don't follow the natural curve but your adrenal professor will know far more than I do, I just know that the morning level should be the highest of the day.

[Sally56 in reply to SeasideSusie]

Ok thank you Susie.

[Sally56 in reply to Sally56]

Unfortunately, I cannot show my saliva results to my professor. Like most Doctors he would consider these saliva results as Maverick.

I feel a little confused about the results. I am taking NDT now and after only a week, am having hyper type feelings, which could also be my adrenals unable to cope withe the t3 demand for cortisol? Is it possible for me to take an adrenal support? I have purchased the Jarrow Adrenal support but I'm too scared to take it? Any thoughts please?

[holyshedballs in reply to Sally56]

Hi Sally

if I was indoor position I would show the saliva tests to the doctors if they come from a United Kingdom Accreditation Service (UKAS) accredited laboratory. UKAS carry inspections to check that labs are good enough to be reliable.

NHS doctors are not bound to NHS tests. If a patient presents a doctor with the results of private tests obtained from a United Kingdom Accreditation Service (UKAS) accredited laboratory, the NHS doctor SHOULD accept those results as proper evidence.

All doctors should follow the General Medical Council's Code of Practice, Good Medical Practice. This states at paragraph 16b that doctors "must provide effective treatments based on the best available evidence". If your lab results come from a UKAS accredited laboratory, the doctor SHOULD accept those results as proper evidence.

They may say that salivary cortisol tests are not good, but there is plenty of evidence on the internet to show that they are just as good as blood tests for cortisol. in fact they are better because they show the cortisol levels at 4 times of the day not just one day, which is better for analysis as you have found out on this forum.

They may be "confused" by salivary tests for other hormones, but the salivary test for cortisol is a good test.

Evidence:

Salivary cortisol--an alternative to serum cortisol determinations in dynamic function tests.

Aardal-Eriksson E1, Karlberg BE, Holm AC. ncbi.nlm.nih.gov/pubmed/963...

Salivary cortisol for assessment of hypothalamic-pituitary-adrenal axis function.

Törnhage CJ1.

ncbi.nlm.nih.gov/pubmed/195...

Salivary cortisol determined by enzyme immunoassay is preferable to serum total cortisol for assessment of dynamic hypothalamic--pituitary--adrenal axis activity.

Gozansky WS1, Lynn JS, Laudenslager ML, Kohrt WM.

ncbi.nlm.nih.gov/pubmed/161...

[Sally56 in reply to holyshedballs]

Thanks Holy,

I really appreciate the time you took to try to help me. I'm in Australia. I have already shown previous results to my GP and she said she couldn't understand them. My adrenals Doctor is the same. My overall cortisol through a 24 hour urine test and from early morning blood tests of course show me in range. So I was hoping to get advice from other patients. I have done this before with excellent advice and results.

I guess I'm saying I cannot show them to my Doctors, I have no thyroid and have to take medication. T4 gives me some relief but brain fog is unbearable. T3 was great but I couldn't get up to a therapeutic level and crashed after 3 months on 15mcgs and a TSH of 71. My adrenals churning out adrenaline rushes for 5 weeks. I think NDT's small amount of T3 is skewing my adrenals again. I just don't know what to do. I took Jarrows Adrenal support last night and today I am worse. Thanks.

[holyshedballs in reply to Sally56]

I really don’t know that much about dosage etc. but my view is that if you don’t have any Thyroid gland at all then 15mcg of T3 per day is no where near enough.

Other people on the forum have a better understanding of dosing but if I was in your position I would want to take 10 mcg of T3 x 3 times a day as a start and see how that felt.

It may be wrong for me to say it though with my limited knowledge

I would look at changing doctors to someone who know what they are doing

[Sally56 in reply to holyshedballs]

Hi Holy,

Unfortunately the 3 months I was on T3 only, I couldn't get over 15mcgs without having adrenaline rushes, so I couldn't get to a therapeutic level. So upsetting because I actually felt fabulous until the crash. So on NDT now and am hoping to get some advice on getting my adrenals up to speed. But thanks so much for answering. Getting a Doctor who knows/agrees with anything to do with adrenals is very hard. I have a good Endo who has been liberal in his approaches, but I seem to be the exception to the rule all the time. I have ordered some Adaptogens today. Rhodiola and Ashwandga (?) something like that!

[holyshedballs in reply to Sally56]

I’m sorry I can’t help you further, it is beyond my knowledge!!

Just remember that you are in charge of your body and simply there are no rules about your health

Good luck, I’m sure that with the help of the forum and good doctors you’ll eventually regain your health

[Sally56 in reply to holyshedballs]

Thanks Holy.