Help to interpret 24 h saliva test results, please

In January ´20, I ordered a 24 h saliva test kit from Genova Diagnostics (overnight delivery using DHL, samples kept refrigerated at all times). The results showed slightly elevated cortisol levels throughout the day. I´d really appreciate comments on the results (reference ranges in brackets):

Drugs taken at the time: NDT, Oestradiol, Utrogestan (cyclically).

Diagnosis: Hashimoto´s (2001).

Results Jan´20:

DHEA 0.55 (0.25-2.22 nmol/L)

DHEA/cortisol ratio: 0.05 (0.05-0.32)

morning 30 mins after wakening (7.30am): 11.15 (2.68-9.30)

noon : 3.51 (0.75-2.93)

4 pm: 4.84 (0.36-1.88)

11.30 pm (bedtime): 1.25 (<0.94)

[SeasideSusie Remembering]

Anncats70

According to rt3-adrenals.org/cortisol_t...

optimal levels are:

• 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

As you know, yours are all high. Your DHEA is low.

According to the same link your results seem to fit with

Example 6

High levels at most or at all times

• Frequently a precursor to low levels

• From stress, internal and/or external

• Can be caused by systemic conditions such as

• long-term hypothyroid

• high glucose

• gastrointestinal issues

Dr Sarah Myhill has articles about adrenal testing which you may find helpful :

drmyhill.co.uk/wiki/Common_...

[Hidden in reply to SeasideSusie]

Thank you so much for replying and the link!

It´s worrying because I suspect my highish cortisol levels caused insulin resistance and recent weight gain.

I recently read that the body can use progesterone to make more cortisol if needed, and this in turn results in estrogen dominance. I used an online calculator to find out my E/P ratio, and it was 27....and should be >100. Anything below 100 means E dominance. E dominance can also cause symptoms such as hot flushes and night sweats. My doctor of course only tells me to take more estrogen for symptom-relief, but I will try weaning off it and take progesterone only to see if it makes a difference. E dominance also raises thyroid binding globulin (which my doctor never tests) and that could explain why NDT has worked less well for me lately...the problem might not be the drug itself but rather high TBG levels.

Even so called "hormone doctors" don´t pay attention to things such as the ratio between sex hormones, but only look at each individual lab result. One thing is certain - going from two to three pumps of Estrogel daily (as recommended by doctor) has not done anything to help with hot flushes and night sweats, but rather made things worse...the doctor suggested I could go up to four pumps daily if symptoms persisted, but instead I will go off estrogen completely and see if that might help. More is not always better...

Of course, my cortisol levels are not high enough to suspect Cushing´s, so the only way to lower them will be using supplements...but which one(s)???

[SeasideSusie Remembering in reply to Hidden]

When I had high in range cortisol (but only one sample was very slightly over range) the practioner I was seeing at the time put me on Adreset by NutriAdvanced. It's a combination of adaptogenic herbs - cordyceps, Asian ginseng, rhodiola root. This brought my levels down. Another member has done well with Holy Basil.

These are not recommendations, I am not medically qualified so can't advise you what to take, just passing on what has worked for me and another member.

[Hidden in reply to SeasideSusie]

OK, thanks for the tip, I´ll look into Adreset!

[SeasideSusie Remembering in reply to Hidden]

Whatever you choose to do to try and reduce your level, please remember to test regularly. This is something that my practioner didn't tell me. I stopped seeing her due to a number of issues, but just continued with the supplement and it occurred to me about 2 years later that I ought to test. My levels had plummeted to very low across the board and now I've been working on raising them again and it's been a long, hard slog. So I would test at 3 monthly intervals to see how things are going.

[Hidden in reply to SeasideSusie]

Yes, that´s a good idea as I would not want to end up with too low levels either...I just read that the DUTCH (dried urine) test is the best one to measure cortisol and sex hormone levels, not saliva...so I have been thinking about trying that next time.