Medichecks Cortisol saliva tests back - advice ... - Thyroid UK

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Medichecks Cortisol saliva tests back - advice please

Anniejw profile image


I wonder if anyone can help please. I am trying to get to the route of my problems and so far ruled out Hashimotos so I must be in the 10% that doesn't have Hashimotos. My insulin levels are slightly raised (last medichecks test last November) but I had a lot of symptoms that indicated adrenal dysfunction (anxiety, fatigue, insulin raised, crave carbs, stressed, put on more weight (even though have a balanced diet), memory loss, blurred vision, water retention, hump on.back of neck, bruise easy). My test results are as follows;

Adrenal Hormones

Cortisol - Waking 18.700 nmol/L (Range: 6 - 21)

Cortisol - 12:00 4.720 nmol/L (Range: 1.5 - 7.6)

Cortisol - 14:00 4.050 nmol/L (Range: 0 - 5.5)

Cortisol - 16:00 4.710 nmol/L (Range: 0 - 5.5)

Cortisol - 18:00 2.810 nmol/L (Range: 0 - 4.5)

Cortisol - Before Bed 1.910 nmol/L (Range: 0 - 2)

My thyroid panel blood tests last Oct was all okay too.

I am so frustrated as to what tests to have now? Any advice or anyone who has experienced this I would be so desperate.

Thank you.


15 Replies

Your results look well within the normal limits.

Anniejw profile image
Anniejw in reply to

Thanks PaulineS,

I was surprised for them to be in a normal range, why would I have these symptoms...has anyone else had normal tests back but still have symptoms?

What is classed as optimal cortisol please? I have had flu 6 weeks ago now and my immune system is very low as still recovering from reoccurring sore throat/cough (GP has advised)...I feel exhausted still and feel my adrenals are out of rhythm/whack even though they have come back "normal".

I'm confused. Any one else who has experienced similar I would be interested in hearing about.



in reply to Anniejw

A normal blood cortisol around 8-9am should be between 400-550nmol/Ls. Below 400 it needs further investigating for adrenal insufficiency. Above 55 it needs investigating for Cushing's.

Anniejw profile image
Anniejw in reply to

I had saliva cortisol test not blood test would it be useful to have a blood test? Sorry but confused as getting to understand all this.


in reply to Anniejw

A GP could do the blood test which is always the first point of testing for adrenal/pituitary issues, rather than saliva.

Anniejw profile image
Anniejw in reply to

Ok many thanks for your advice which has been helpful.

mischa profile image
mischa in reply to Anniejw

Anniejw: You have given little information other than a saliva test.

Can you post your latest thyroid blood tests. Your symptoms can also be due to being under medicated.

You could also be low on iron, B12, D3 and folate. Hypo's generally are.

Doing an early morning blood test for cortisol is fine but it only shows you what your cortisol level is at that moment in time - between 8 -9 a.m. It does not show you how your levels are during the rest of the day. Your cortisol levels are good except that they could be lower towards the end of the day. Cortisol follows a curved pattern throughout the day - being highest in the morning and gradually decreasing until they are at the bottom on the range towards to end of the day.

Despite being recognised by NASA (astronauts are given saliva tests for cortisol) and are used quite widely, they are not recognised by GP's unfortunately.

A cortisol blood test will test the whole cortisol - bound and unbound, whereas a saliva test only tests unbound cortisol which is what is needed for thyroid medication to be used by the body. Most cortisol in the blood is bound and therefore unusable.

When I had a blood cortisol test some years ago it was within range despite being very ill. A saliva test showed my levels of unbound cortisol was flatlining throughout the day. It was a truer picture of where my cortisol levels were.

You need to look at other factors which could be contributing to your symptoms.

Anniejw profile image
Anniejw in reply to mischa

Hi Mischa thanks for your reply which was interesting to know.

My latest results (by Medichecks private testing ) were taken in Nov last year I was on Naturethyroid (NDT) daily ... 2 grains and supplementing with Vit D 2,000iu with K2 (my vit D been severely deficient in the past ...blood test of 20) Magnesium (150mg), 15mg Zinc, B12 plus B Complex.

Since Feb this year I purchased WP Thyroid (I used to be better on this previously but then it wasn't available for over a year so took Naturethyroid instead). Currently on 1 and three quarters of a grain of WP Thyroid daily.


- Oct 2018

Thyroid Function


FREE THYROXINE 13.400 pmol/L 12.00 - 22.00

FREE T3 6.32 pmol/L 3.10 - 6.80


<10 IU/mL 0.00 - 115.00




ACTIVE B12 113.000 pmol/L 37.50 - 188.00

FOLATE (SERUM) 14.74 ug/L 3.89 - 26.80

25 OH VITAMIN D 69.1 nmol/L 50.00 - 200.00


Inflammation Marker


3.38 mg/l 0.00 - 5.00

Iron Status


79.5 ug/L 13.00 - 150.00

Not sure I break down carbs checked insulin. I crave carbs over proteins.



5.15 mmol/L 4.10 - 5.90

INSULIN *28.37 mIU/L 2.60 - 24.90 (too high)


*5.84 0.00 - 1.00 (too high)

Since I've had flu I have suffered with anxiety and to be honest haven't taken the vit d daily as get fed up with taking supplements together with timings...this went out of the window with recovering with flu. I'm now back on all vitamin meds and wanted to see if Rhodiola would help get my adrenals in balance (if this is what I have slightly) and take the anxiety down - I am thinking about purchasing a book by Alan Christiansen about resetting adrenals to see if this helps?

Previous to that ...NHS thyroid blood tests were ..taken at GP

TSH 0.01 ..Range 0.35 to 5.00 mu/L

Free T4 10.3...Range 9.00 to 22.00

Free T3 3.7...Range 2.60 to 5.70

Sorry a lot of information to read but I just want to feel better. My GP not really interested and don't seem to know about this subject unfortunately.

Thanks 😀

mischa profile image
mischa in reply to Anniejw

I wouldn't do anything about your adrenals at the moment as they are quite good apart from being a little high in the evening and this could be due to the high CRP you have. High CRP indicates inflammation in the body and you need to find what is causing this. My guess it could be your high insulin levels.

Your thyroid blood tests are good. Were they done first thing (8-9 a.m.) in the morning on an empty stomach and after a 12 hour gap between last dose of thyroid and blood test?

Your blood tests were done in October of last year - nearly six months old and ideally they need revising. Those figures for vitamins are low particularly ferritin. You need to bring levels up if you haven't already done so. Good cortisol and ferritin are essential for thyroid medication.

Your insulin is high and you need to work on this. It indicates insulin resistance. Pre-diabetes. Insulin resistance has a negative effect on hypothyroidism. Eating the wrong foods contribute to this.

You really should change your diet to low carbs, some protein with good fats, i.e. avocado, olive oil, etc. and plenty of plant foods. Cut out sugar altogether and sugar laden foods, refined and processed foods. Reduce to the absolute minimum bread, potatoes and pasta - any starchy foods. Try and leave 4 hours between meals and don't snack between meals. High insulin leads to weight gain. And above all exercise - for example 20 minutes of walking twice a day is good but stay away from aerobics or energetic exercise. And monitor your glucose and insulin very closely. It will lead to diabetes if you don't. I have to watch my blood glucose too.

The Diabetes Code by Dr Jason Fung and/or Dr Bernstein's Diabetes Solution - two very good books on controlling pre-diabetes and blood sugar levels.

Anniejw I hope this is of help for you.

Anniejw profile image
Anniejw in reply to mischa

Hi Mischa

Thanks for your reply which is really helpful. I suspected this was to do with carbs and your advice makes a lot of sense. Yes my thyroid blood tests are always done early with 12 hour gap. I will take on board about the pre diabetes ...change my diet and limit carbs. I have just got an allotment which I am enjoying so it's good exercise.

I will get some more thyroid tests done soon to compare.

Thanks again for your time ...most appreciated as this endocrine system is so complex but I am positive I will get to the route cause which is pointing to insulin resistance at the moment.


mischa profile image
mischa in reply to Anniejw

The allotment sounds perfect.

SeasideSusie profile image
SeasideSusieAdministrator in reply to Anniejw


"What is classed as optimal cortisol please?"

According to:

Optimal levels

• 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

That's based on the 4 point saliva test. So yours are:

Morning - 85% through range

Noon - 53% through range

Evening - this is difficult to comment on. First of all, Regenerus (4 point test) classes their "evening" test as from 4pm but before dinner, and Genova (4 point test) says between 3-5pm.

Also, I'm not sure that a range can have 0.00 as the low limit, if you have no cortisol for these samples - which is possible according to their ranges - you'd be in big trouble! This applies to the nighttime sample too.

So there are 2 possibilities for your evening sample, either of which are higher than optimal:

1) - 4pm - 86% through range

2) - 6pm - 62% through range

Nighttime - 95% through range

Anniejw profile image
Anniejw in reply to SeasideSusie

Hi Seaside Susie

Thanks for your time and would you suggest I can correct my ranges? Sorry just learning about cortisol and the swerve. Any advice would be appreciated.

Many thanks

SeasideSusie profile image
SeasideSusieAdministrator in reply to Anniejw

I only know a little bit about how to try and correct either all low levels or all high levels, I don't know what one should do when one has a mixture of some normal, some high. My own experience was firstly I had all high levels, was recommended a supplement, then no longer consulted with the practioner but continued supplementing for too long and ended up with all low levels, so now I am trying to improve those, without too much success at the moment.

Anniejw profile image
Anniejw in reply to SeasideSusie

No worries and thanks for your help....all the best Susie.

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