What is the best way to decide if you suffer from adrenal fatigue: saliva testing (four times a day), blood, or 24 h urine? I am asking because the Hertoghe doctors in Belgium only use 24 h urine analyses, although I've read that saliva testing is the only reliable way to assess if someone has fluctuating cortisol levels throughout the day, meaning you could have highish cortisol levels in the morning and lowish levels later the same day or the other way around. Supplements such as Nutri Adrenals Extra are said to work only if you have low cortisol levels in the morning, but not throughout the day.
Saw NHS consultant endo yesterday and before he signed me with ‘I’ve done all I can’ , I queried with him why I had a reading of 325 (range 134-537) at 8:15am on one cortisol blood test and 330 at 14:30 blood test - he said nothing remarkable about that as cortisol lower in morning...
That is not always the case. My friend, who is himself a Doctor, was very surprised when his dhea and cortisol readings came back. His rose in the late afternoon. Mixed results are more tricky to fix.
OK, thanks. But I guess a 24 h urine analysis won't show if your cortisol levels rise and decline when they should; I understand not everyone with adrenal fatigue has lower levels in the afternoon/evening, but that they can be higher than they should later in the day, and those people should not be on cortisone for adrenal fatigue? I am asking because the Hertoghe doctors diagnose adrenal fatigue and prescribe hydrocortisone or prednisolone for it based on that test alone. I would have imagined a saliva test would be much more accurate?
Yes saliva are the best. The blood tests can be unreliable plus you need to have dhea results otherwise you’ve only half the picture.
This is a very helpful article.
Www.drmyhill.co.uk and in the search engine on the top right hand corner type adrenal then choose the gearbox.
It explains everything in great details about the combinations of results.
I wish you good luck with your test results. Adrenal fatigue is relatively easy to sort out.
You can monitor your thyroid and adrenals with a basal thermometer. You aim for 36.50 degrees and take 4 readings per day. An average of less than 36.50 is an indication your thyroid meds are too low( under the arm is the easiest place to take readings.) If they vary by more than 0.3 it indicate adrenal issues.
Www.drmyhill.co.uk and search under orchestra for a great article on how to improve your overall health. In this order of importance it’s :-
You are welcome. If you need any help afterwards please do ask.
Helena
Please be very cautious about taking either Hydrocortisone or prednisilone as in time they can shut your adrenal glands down completely, so you will be dependent on steroids to live - adrenal insufficiency is a live threatening condition. I know because I have it! Taking too much when you don't need it will cause Cushing's syndrome. Be cautious.
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Yes, that's what I fear...I spent a few years on 4 mg of Medrol daily (the equivalent of 20 mcg of HC or 5 mg of pred) after being diagnosed with adrenal fatigue based on cortisol levels in a 24 h urine analysis. I managed to wean off it as I felt uncomfortable taking it indefinitely, but I am beginning to suspect it has messed me up and that my own adrenal glands are struggling to start working again...the idea is to order a saliva test before trying a supplement like Nutri Adrenal Extra or adrenal cortex to, hopefully, nurture my adrenal glands back to health.
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Suspected Cushing's: High cortisol levels on saliva test, now low cortisol after 8 months on Levothyroxine. Can this happen with Cushing's?
Help to interpret 24 h saliva test results, please
