Cortisol results

[Laundretta]

Endo has run a pretty comprehensive set of tests including a serum cortisol test for the first time ever for me. It has come back marginally low at 397 nmol/L. The result sheet says "adrenal insufficiency is unlikely if >430 nmol/L."

Test was taken fasting at 9am, and I don't take any medication other than Levo. I take some supplements too, but I'd been off of them for 2 weeks prior to this test. (details and other test levels in profile if relevant)

Interested in your thoughts! X

[Hidden]

Unfortunately many Endo's would take this result as being okay, however they should do further testing as your blood test was done at 9am which is the correct time for the test to be done. You really need to have a Short Synacthen test done to see how you respond to the ACTH stimulation. They would like your results to double within an hour. If you do then it shows that your adrenal glands are working okay, but with a slightly low cortisol it could be a pituitary issues. If you don't respond to the ACTH & your levels stay the same then you have an adrenal problem. Your cortisol should be around 500 at 9 am so yours is a bit suboptimal. If it is a pituitary problem then testing TSH is irrelevant as it's a pituitary hormone & they need to test T3 & T4 which I think they have done. Hope that helps?

[Laundretta in reply to Hidden]

Hi, Thanks for the reply! So you're saying that the cortisol result potentially puts a new slant on reading the Thyroid function tests, but that marginally low cortisol in itself isn't a big drama?

[Hidden in reply to Laundretta]

It really depends on why you are having low cortisol, if it is pituitary problem then that affects the Thyroid, if it is adrenal then TSH is fine. You do need further testing to establish why your cortisol levels ae not as high as they could be. Sadly many Endos don't have experience with pituitary/adrenal issues, they are more used to dealing with diabetes or thyroid problems.

[G2G2]

Saliva testing is the most accurate way to test cortisol. It's four samples taken at different times of the day to get more data. There's also the DUTCH test (Dried Urine Test for Comprehensive Hormones), which is also four or five samples.

[Angel_of_the_North in reply to G2G2]

But unfortunately, most GPs and endos don't take any notice of saliva tests, so if you want a diagnosis it has to be short synacthen test

[G2G2 in reply to Angel_of_the_North]

True