Saliva test results

[Maya_83]

(Repost)

Hi guys.

Can I please get some advice on what my results mean as i have no idea.

I'm on t4/t3, don't feel any better and feel rubbish all the time. And what I should do next??

(I'm also 6weeks pregnant)

Any advice highly appreciated

[MaisieGray]

Ideally your results (the black line) should be within the optimal green area; but not just anywhere within it - the morning level should be near the top; the noon level a little lower; the evening level lower still, and the night-time level towards the bottom. Apart from your evening level which is too high ideally, within the optimal area of the range, the others have unfortunately dropped low, especially your morning level which doesn't even make it to the bottom of the reference range. It's no wonder that you feel "rubbish", as your results indicate you to be at what's known as adrenal stage 3 - this link will tell you more about each stage drlam.com/adrenal-fatigue/a... However, there is newer/different thinking that challenges the "adrenal fatigue" nomenclature, that of HPA axis dysregulation. Chris Kesser says that many, if not most, people with so-called “adrenal fatigue” don’t have low cortisol levels. Their free cortisol, when measured in saliva, may be low, as is yours, but their total cortisol production (including cortisol breakdown products measured in urine) is often normal or even high.

Hence why we often see people reporting that their Dr-tested morning cortisol blood test is often at odds with their saliva test results. Even when cortisol is low, it is rarely because the adrenals are “fatigued” and unable to produce it; but that cortisol production is governed primarily by the brain, central nervous system, and tissue-specific regulatory mechanisms - not the adrenal glands themselves. So the vast majority of people with low saliva cortisol levels will have normally functioning adrenal glands; and the problem is further “upstream,” in the brain and central nervous system. Chris Kesser describes it thus: "Stress activates the HPA axis and sets off a cascade of neuroendocrine signals that ultimately leads to the release of hormones and neurotransmitters like cortisol, norepinephrine (noradrenaline), and epinephrine (adrenaline). Over time, the chronic activation of our stress–response system erodes resilience and depletes metabolic reserve. Resilience is the immediate capacity of cells, tissues, and organ systems to respond to changes in physiological need. Metabolic reserve refers to the long-term capacity of our body to respond to these changes. The loss of resilience and the depletion of metabolic reserve lead to changes in cortisol output (most commonly too much, but sometimes too little), disruption of the diurnal cortisol rhythm (too little cortisol in the morning or too much at night), and changes in the production of other hormones and neurotransmitters related to the HPA axis, such as DHEA, melatonin, and epinephrine."

[MaisieGray in reply to MaisieGray]

What to do? Address the stressors in your life, which might be things such poor diet/nutrition/absorption; allergens; poor sleep; chemical sensitivities; pain; anxiety; worry; and of course chronic illnesses such as thyroid disorders. Also, pregnancy is a major drain on the thyroid especially in the first trimester, so for both reasons, and for the proper brain development of your baby, you need to ensure you are optimally medicated, which probably means a thyroid dose increase of at least 25 mcg, always supposing you were optimally medicated before becoming pregnant. Some people take adaptogens but obviously you need to ensure that anything you planned to take was absolutely pregnancy-safe.

[Maya_83 in reply to MaisieGray]

Thanks for replying ☺

I had a morning cortisol blood test done at 8:15 am on 9th Nov,

563 nmol.

I've been feeling rubbish for two years now.

[MaisieGray in reply to Maya_83]

I see that your thyroid levels were low last week. Have you asked your GP for an increase, and is your Gynae:Endo appt arranged?

[Maya_83 in reply to MaisieGray]

Are you referring at the TSH of 1.16?

If so ,

I upped my dose of Levo to 50mcg monday and Friday only. Anymore and I get racing heart and insomnia plus head pressure. I kept T3 6.25mcg daily the same.

[MaisieGray in reply to Maya_83]

No, your TSH is a pituitary hormone aka 'Thyroid Stimulating Hormone'. You wrote that your FT4 was only 13.6 ( 10.5 - 25.5) which is not even midway in the range, so very low even if not pregnant, but especially so as you are. A foetus needs an adequate source of thyroxine from its mother in the first trimester as it cannot make its own at that stage, and it is critical for its brain and other development.

[Maya_83 in reply to MaisieGray]

Oh I see..

Do you think 50mcg alternate days would be Ok, as I can't take it every day

X

[Marymary7 in reply to MaisieGray]

Great answer! I want to save it. My brothers saliva tests looked similar. Thanks 😀

[Mary-intussuception]

Have you seen your GP since results?

Reading under:

'Hormone Comments ' it says . . . consistent with adrenal dysfunction . . '

Also comments that there should be further tests including Vitamin D.

Have you had a blood test to check Vitamin D level? If not ask GP.

Also suggests hemaglobin Alc test. Ask GP?

There is also a note at the bottom about ' . . not intended to be used as the sole means for clinical diagnosis or . . '

I would see your GP in the week to discuss result and ask about the other tests.

[Maya_83 in reply to Mary-intussuception]

Thanks Mary.

I have an appt on Monday but doubt my doc will take me seriously and dismiss it. They've already diagnosed me with chronic fatigue syndrome 🙄.(because of all these problems)

My vit d level, ferritin, folate and b12 are all optimal now and I keep an eye on it. So I knew something else was up hence the cortisol test.

Are there any supplements I can take to help with the symptoms?

[Mary-intussuception in reply to Maya_83]

I don't know anything about this, sorry.

But I would see a different GP and make sure you are fully tested.

What about showing these results to whoever you see in Ante-natal clinic?

When did your GP last do the HbAlc test?

[Maya_83 in reply to Mary-intussuception]

HbA1c? About 6 months ago which was normal.

I guess I can speak to midwives at the hospital when I get referred.

[Mary-intussuception in reply to Maya_83]

Do you have the actual HbA1c result?

[Maya_83 in reply to Mary-intussuception]

Yes, I do.

I will post back when I find them

Thank you so much

X

[silverfox7]

Congratulations!

Ask your doctor to refer you now and to say you need to see someone re your thyroid and adrenal problems asap. Baby needs must come first so that means getting help for both of you.

[Maya_83 in reply to silverfox7]

Thank you.

I have an appt tomorrow. Hopefully doc will take my adrenal issues seriously.

[Maya_83]

I've been trying for a long time now, so was over the moon when I found out. With my 1st pregnancy I was kept on the same dose of levo which was 50mcg throughout , docs never increased a single dose at all. Glad to say my son turned out Ok, only issues was with reflux.

[helvella Administrator]

Two out of three of their vitamin C products are exactly what you say not to take - ascorbic acid. The other one is simply calcium ascorbate.

pure-encapsulations.co.uk/p...

[Maya_83]

Yes I agree..

I didn't know much about thyroid issues back then about 5yrs ago..

Now I also get private bloods done as well as getting a print out from Gp every time and posting here for help.

[Maya_83]

Thank you.. I already take vit c (wonder if I take enough)

But I will look into the ones you suggested x

[helvella Administrator]

Apologies - yes - I took the link from my search and went to the wrong place.

[Maya_83]

Oh thank you.. can you kindly link it please, as I can't find it x