I am reposting a new photo as suggested, in the hope that someone with knowledge can interpret the results please
If you can’t read the figures they’re:-
5.46 (2.68-9.3)
2.23 (0.75-2.93)
2.10 (0.36-1.88)
0.61 (<=0.94)
DHEA 0.21 (0.25-2.22)
DHEA:cortisol ratio 0.04 (0.05-0.32)
The handwritten figures are my results 19 months ago
Many thanks in advance.
Hi,
I'll respond in a couple of hours. I have to go and get dinner. I couldn't read the numbers in your previous post, but I can read this one very well. 
Your results :
(1) 5.46 (2.68-9.3) 42% of the way through the range
(2) 2.23 (0.75-2.93) 68% of the way through the range
(3) 2.10 (0.36-1.88) 114% of the way through the range
(4) 0.61 (<=0.94) 65% of the way through the range
Optimal results from this link (Example 1) :
rt3-adrenals.org/cortisol_t...
(1) Morning at the top of the range i.e. 9.3 from the range you quoted
(2) Noon approximately 75% of the range i.e. 2.385 from the range you quoted
(3) Evening close to 50% of the range i.e. 1.12 from the range you quoted
(4) Night time at the bottom of the range i.e. 0 (!!!) from the range you quoted
Clearly the range provided for sample 4 is not a sensible or believable range. I simply don't believe that any cortisol sample from a healthy person would ever show a result of zero. The idea is absurd. But I will carry on as if the bottom of the range for sample 4 is zero.
Compare your results to optimal results :
(1) Optimal = 9.3 --- Yours = 5.46 --- You produce 59% of optimal
(2) Optimal = 2.385 --- Yours = 2.23 --- You produce 94% of optimal
(3) Optimal = 1.12 --- Yours = 2.1 --- You produce 188% of optimal
(4) Optimal = 0 (!!!) --- Yours = 0.61 --- I can't divide by zero!
Totals : Optimal = 12.805 --- Yours = 10.4 --- You produce 81% of optimal.
---
Looking at the totals, your overall daily production of cortisol is not as bad as I thought it might be before I did the arithmetic. It could certainly be better though.
Your biggest problem is that the distribution of your cortisol production is poor. You produce too little cortisol earlier in the day and too much later in the day. This is going to lead to dreadful fatigue in the morning and it will be hard for you to get going. Your higher cortisol later in the day will make insomnia a problem. Your below range DHEA makes these issues more obvious. The fact that your previous DHEA result was slightly better than it is now shows that the direction is down and things are only going to get worse unless you stop the rot now.
Just with a visual inspection your previous cortisol levels were noticeably better than they are now, and the distribution was better, with more cortisol being produced earlier in the day and less being produced later in the day.
I'm going to post this now, but I'll add some more stuff in another post.
Trying to improve (i.e reduce) the last cortisol result of the day won't improve (i.e. increase) your first cortisol result of the day.
Your plan should be to improve the first result, which is low. This will have knock on effects on later results, and with luck the later cortisol levels will sort themselves out to some extent.
At the moment your body is trying its best to produce enough cortisol first thing in the morning. It fails to do so but it keeps trying. Your second sample makes a good stab at producing almost an optimal level of cortisol (for the time of day), but it isn't quite there and also it doesn't make up for the earlier poor result for sample 1, so the adrenal glands keep on trying.
Sample 3 is still trying to make up for the earlier poor cortisol output and goes way over the top.
Sample 4 is a bit of a last gasp, and is possibly a bit high - I can't tell for certain because of the stupid reference range.
If you do nothing then samples 1 and 2 will continue to get lower, samples 3 and 4 will probably get higher. Over time sample 3 will eventually start to drop and sample 4 will shoot up. Eventually all four samples will be very low, and you will be very unwell.
...
So, how can you improve your cortisol levels first thing in the morning?
The first thing that comes to mind is...
One person on the forum ( McPammy ) had poor cortisol, added T3 to her thyroid hormone dose and her cortisol improved immensely, very quickly. I don't know what you take and what your latest thyroid results are like, and obviously there is no guarantee this improvement will happen to everyone. Read McPammy's responses in this thread :
healthunlocked.com/thyroidu...
...
The second thing that helps some people with low cortisol are adrenal glandulars.
I've never needed to take these, so I'm not particularly knowledgeable on them. The most popular ones I know of are the ones shown on this site :
procepts.eu/adrenavive-i-bo...
Click on the three little bottles to see details for each product.
Adrenavive I is an adrenal glandular that includes the whole adrenal gland. These may cause problems for some people because they contain adrenaline.
Adrenavive II and III are made from adrenal cortex only and are probably the ones I would go for in your shoes, but I have no idea how to choose. Do a search on the forum for "adrenavive" and read the comments. You can buy Adrenavive from here :
the-natural-choice.co.uk/En...
I think SeasideSusie takes adrenal glandulars and may be able to help.
...
There are various ways of improving cortisol without taking an adrenal glandular, mostly based on lifestyle improvements which will improve health and reduce physical and mental stress. I would suggest that you try these lifestyle changes if you ever want to help your adrenal glands to recover. You may want to try these first before trying a glandular, or in addition to a glandular, its up to you.
Bear in mind that stress can be caused by all sorts of things - poor sleep hygiene (interrupted sleep or not getting enough sleep or sleeping at odd times or getting up at lots of different times), being bullied at work, grieving, chronic pain, being ill, being malnourished or nutrient deficient, eating too little or too much, exercising too little or too much, not having enough fun and relaxation, eating erratically, eating poorly (e.g. too much sugar and carbs and not enough fat and protein - fat and protein are both essential, carbs and sugar aren't).
Specific suggestions :
1) Drink an adrenal cocktail every morning, and maybe later in the morning or lunchtime too, its up to you. There are lots of recipes on the web but they are all similar - they all contain sodium (or salt), potassium, and vitamin C. For more info :
therootcauseprotocol.com/fa...
stopthethyroidmadness.com/a...
2) Eat breakfast every day, and make sure to include a decent portion of protein and some healthy fats and oils. Healthy fats and oils are things that people would have eaten 200 years ago, somewhere in the world. If they were invented and are made in a lab then they aren't healthy.
3) Exercise : Marathons are out, walking, swimming and yoga are in.
4) Try to go to sleep and wake up at the same time every day.
5) Eat enough and eat varied foods. Slimming world, weight watchers and very low calorie diets are out. Avoid sugar and junk food.
6) Have some fun and relax.
7) Take care of your gut. Some people find natural probiotics and fermented vegetables very helpful :
traditionalcookingschool.co...
users.sa.chariot.net.au/~dn...
8) If you have problems with low stomach acid and/or acid reflux and/or heartburn then there are lots of posts on the forum you could search for help.
I'm running out of steam now, so I'll just chuck a few links at you that you might find of interest or useful (they are not in any particular order). Before spending money on anything or trying something you think might be strange always do your own research and/or seek other opinions :
functionalmedicine.net/pdf/...
adrenalfatiguesolution.com/...
stopthethyroidmadness.com/s...
In the link above, go down to the adrenal section of the site map and read some or all of the links that could be relevant to you.
stopthethyroidmadness.com/s...
rt3-adrenals.org/does_it_af...
In the two links above, they both miss out whether the things they mention lower or raise cortisol. Always research anything either of the links mention if you take it or want to try it out.
drlamcoaching.com/adrenal-f...
You'll come across adaptogens a lot in discussions about adrenal health. This thread may be of interest :
healthunlocked.com/thyroidu...
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Please note I have no medical training of any kind whatsoever.
Wow thank you so much for your extremely comprehensive reply. I shall re read a coupe of times again tomorrow and come back, if I may, with any queries. It is very kind of you to spend so much time trying to help. Thank you.
You're welcome.
Yes, I take adrenal glandulars. I started off with Adrenavive - just the cortex so Adrenavive ll, then increased to Adrenavive lll. Then it became unavailable and when it reappeared it had increased tremendously in price. During the time it became unavailable I tried a different brand and I ended up on the whole glandular rather than the cortex only and I've found that the whole glandular suits me better. It's an individual thing, some do best on cortex only, some need the whole gland.
Thank you so much humanbean and SeasideSusie for all your help. It’s so kind to take the time to help others.
I am pretty much following all your recommendations Humanbean with regards to rest, sleep, yoga, gluten free etc. I did try a very low carb diet, but it didn’t help, so I admit I don’t worry too much about that now. I should also make more effort to take probiotics and I’ll look into the adrenal cocktail (I do have Himalayan salt).
My thyroid bloods last month were
FT4 15.2 (9-19)
TSH 0.004 (0.35-4.94)
FT3 5.4 (2.9-4.9)
My blood cortisol went up from around 200 19 months ago to 292, although I realised afterwards that I’d had a cup of tea prior to my test, so maybe that was the ‘improvement’.
I used to take Adrenavive 11 and 111 following my last cortisol saliva test 19 months ago. I was advised by a well known thyroid female dr located in Wales to take this although seasidesusie didn’t think I needed it. I have to agree now I know more. There was a huge question mark over my results because you cleverly spotted loads of coincidences with the figures, so they may in fact have been incorrect. I stopped taking it after several months because I suspected it could be causing the headaches, but I was wrong. I stupidly retested with Genova again this time, I got mixed up over who I used, but I shall not use them again after their unbelievable results in my last test, and lack of customer service.
I should also say that when I did my third Saliva test, I was a bit stressed out, and I do wonder if this could’ve caused my cortisol to rise sharply? In fact I used to get an afternoon slump at this time, although this has stopped now I take antihistamine for sleep and since being on LDN.
It is odd that my morning result is not great. Yes you’d think I’d feel dreadful but it’s strange in that I’m at my best in a morning. That’s the time I can do all my chores or some gentle gardening, but come the early evening, I am shattered. I even unbelievably (with two young children) managed 10 hours solid sleep Friday and Saturday, but then by Sunday evening, I was still shattered and was desperate for bed by 9pm. I daren’t drive in an evening and I avoid going out. If I do, I dread it because of being so tired after 9pm. I miss out on seeing friends who can only see me in evenings.
I am currently on 125mcg levo and 17.25mcg T3. I appreciate this is a low dose, but I am already over range and I have to pay for it myself, so I can’t afford much more.
Sorry if this is a bit long, but just wanted to give you all the info in case any of it is relevant. Thank you in advance if there is anything you can glean from this.
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