I ordered a saliva cortisol/DHEA test from Regenerus but am sending it back as I can't use it - mouth to dry despite using every trick in the book to improve it enough for the test.
A kind member on here mentioned the dry urine test - DUTCH - and I went back on the Regenerus site and found they have 2 on there, and Regenerus agreed to refund the saliva test so I can buy the DUTCH one.
However, the DUTCH one is VERY expensive and there are 2. I asked Regenerus which to go for, as I thought, considering the cost, I would do the most comprehensive one. This is because, as well as testing cortisol and DHEA, it also does melatonin and sex hormones. Being a women who's been through menopause and also has Hashi's (which must be linked to female hormones at least slightly, given the hugely disproportionate women to men ratio that get it), I thought I'd pay a little more and go for the lot.
Regenerus sent me an email saying the results of that would be extremely complex and would take a qualified and experienced healthcare professional to interpret.
I was wondering what members on here think. Are there members who would be able to have a go at interpreting the results? Or would an NHS endo - if I ever get an appointment - or GP be able to do it?
Your thoughts on this would be much appreciated, as I keep ordering the wrong damned tests and would like to get this right second time round.
Cheers.
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Nico101
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Should also have mentioned Dr P told me he expected I would have a few issues with female hormones almost 2 years ago and recommended a progesterone cream, which I was taking. I stopped taking that about a month ago in preparation for taking thyroid and adrenal tests.
"Or would an NHS endo - if I ever get an appointment - or GP be able to do it?"
Last year member stav01 posted "My wife and I did the DUTCH test and our endos in the UK looked at it like it was from another planet. Ended up having a consultation with a great functional hormone doctor in the USA."
I did this test last year and it was interpreted by my nutritionist, who also had to phone the company to find out more. I doubt an endocrinologist would be able to interpret it. I'll see if I can find the file mine is in and how comprehensive the lab's report was, and I'll let you know.
Actually, I downloaded an example copy - it is is VERY complicated. But the endo could always phone the company if I take the phone number with me, although it's would probably be on the report.
Not sure which DUTCH tests you are looking at. The DUTCH Advanced Adrenal (HOR32) consists of urine samples, but does not include sex hormone metabolites. The DUTCH Complete Hormone (HOR 30) consists of urine samples and includes sex hormone metabolites. Don't order the DUTCH Plus test (HOR 43), as it utilises both urine and saliva. In addition to the urine samples, you need to collect 5 saliva samples. So it is similar to doing their saliva cortisol test with an extra sample to document the cortisol awakening response (CAR).
You said you've tried every trick in the book, so this probably won't help, but just in case...
I was going to buy the HOR32, but then thought it might be a good idea to go for the DUTCH 30 and get my melatonin and sex hormones looked at, too, since I expect they are far from perfect and it's all interconnected. Just to check -the HOR32 and 30 don't require saliva, do they?
Oh, and I did all of things mentioned on those links with no result whatsoever. I was considering acupuncture, as it's meant to work for severely dry mouths, but I haven't the time to spare - or the money. Others on here have said the DUTCH test is superior to the saliva test, anyway, aside from the cost.
Mmm... they do seem quite similar, don't they? The main difference seems to be the cost. But since I can't physically do the saliva test, it looks like I have no choice.
Thanks. I was beginning to get very upset about not being able to do it - not to mention feeling time-pressured so I can get back on my Adrenavive. I can't go on my thyroid meds until after a couple of weeks back on cortisol and Adrenavive, so you can imagine I was starting to get VERY stressed about this until I found out about the DUTCH test.
I've found mine and it's not the comprehensive one, it's the creatinine, cortisol, cortisol metabolites and DHEA one, so simpler. It looks easy to understand, has the pathway diagrams, the results in a chart, then a report explaining everything, comparing the differences and suggesting what has gone wrong and what needs to be addressed, but not how to do it.
The sample report for the comprehensive test, which I've also looked at, is more complicated but you can see what I mean about it - If you look at pages 8 - 13, the important explanations of the actual test results are those parts written in bold. Those are really the only things you need to know.
The result of mine was elevated HPS-axis activity due to long term stress, which the nutritionist phoned the testing lab in the US about, and between them - their knowledge of the testing and hers of my medical history - they decided it was due to inflammation. I probably wouldn't have come up with that reason, and would simply have thought "stress" and wondered why.
I think both tests are very good, and reading just the report you would know what was going on, but not necessarily why or what to do with it. I doubt most endocrinologists would be interested unfortunately. However, the testing lab Precision Analytical in the US has phone numbers for help (although they keep mentioning practitioners) and lots of videos to explain the results. You could find a nutritionist here who would order it and explain it, but it would probably involve several appointments and cost more than just buying the test from Regenerus and then emailing the lab in the US to ask for help interpreting it. In fact you could email the lab before buying the test, to check if they would help once you'd done it.
Thanks for that. Maybe I could get the full test and then hang on to the sex hormone stuff until I find someone who can decipher it - it can always be done a bit later. Normally, I would have gone to Dr P, but that's no longer an option. In the meantime, I could try and find a decent functional Dr near me.
I did a lot of research into inflammation, and it appears it is the root cause of everything bad in our bodies. It worries me (having an inflammatory bowel disease and now Hashi's), as chronic inflammation over a long period can cause cancer.
In recent years I've worked really hard to eat anti-inflammatory foods and take anti-inflammatory supplements, etc. But with the constant exhaustion from adrenal and thyroid issues, as I'm sure everyone here knows, sometimes it's a take-away or I don't eat. Of course I can't exercise, either, which I find stressful, as I used to live in the gym.
Looking at that example test result, you're right. I think I could have a stab at interpreting some of it, as they do seem to guide you and explain quite a lot. It just looks so daunting at first glance. The Medichecks thyroid result fit on one page. If I got stuck, I'm sure there are a few people on here who could give guidance on the more complex bits.
I have done the comprehensive DUTCH a few times. It consists of four urine collections dried on special paper at specific times over approx 14 hours (or five if including an overnight wee)
(Dinner time, Bed time, At waking, 2 hour after waking) (+ overnight if necessary).
There is absolutely no saliva involved, and it is thought to be superior over saliva, blood serum or 24 hour urine collections because after measuring free cortisol, it combines those four samples to investigate the metabolites. Also of oestrogen, androgen, progesterone, etc ... .
The results are immensely complicated to interpret but they can reveal not only production levels but how hormones are metabolised and excreted. ie if cortisol levels are inadequate, these would be seen as low in a saliva test or blood test but what is not seen is the total of the metabolites which gives an indication of true production levels. If production were high with low levels, this would mean a high clearance which might be useful in evaluating other hormones.
Also genetic defects are considered if known. ie people with the genetic defect related to methylation (MTHFR) may have more trouble turning a 2 hydroxy oestrogen into a 2-methoxy oestrogen, identifying the cause isn’t wholly that deficiency of the next hormone up the line.
So each result can only be found by considering all others, and enables better clinical decisions regarding supplements to help the issues.
Thanks. I thought there was no mention of saliva on the website - but I get confused easily. Not to mention I keep ordering the wrong bloody tests! Luckily, both Medichecks and Regenerus have agreed to take them back.
I haven't had one done but I can interpret my sex hormone blood test results without a problem. I doubt a GP could do it and an NHS endo (it would probably need to be a gyno anyway, as "women's issues" are hived off into another specialism) probably wouldn't as NHS don't approve of urine and saliva tests
I'm starting to wonder what the NHS Drs actually do - besides dishing out antibiotics and anti-depressants.
All this has been a real eye-opener about the NHS. I thought it was rubbish over 20 years ago - which is why I left England for Spain (Spain is much better, BTW - although Drs are still extremely pompous there and think they're gods and hate foreigners because they "ask too many questions").
I used to think poor care was just down to the gastro department. Now I know different. It's truly terrifying stuff. One the positive side, it's made me take responsibility for my own health, and I no longer take a Dr's word as gospel. Just wish I'd done it decades ago, but better late than never, eh?
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You got me curious about the difference between urine and saliva cortisol assays. I found this. 
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