Hi all I have No idea what these results mean and Would really appreciate some help interpreting them as I plan to use adrenal supplements to support, and hopefully correct adrenal problem. What would be the most advantageous adrenal supplements to use considering my result?
Kind regards
I'm going to use the standard reference range rather than the optimal result given because I don't know how the optimal results were arrived at.
Your results:
Sample 1) 16 (7 - 30) --- 39% of the way through the range
Sample 2) 3.2 (2.1 - 14) --- 9% of the way through the range
Sample 3) 4.7 (1.5 - 8) --- 49% of the way through the range
Sample 4) 2.5 (0.33 - 7) --- 33% of the way through the range
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Optimal results for saliva cortisol are given at this link (see Example 1) :
rt3-adrenals.org/cortisol_t...
• Morning at the top of the range --- 30 with your range
• Noon approximately 75% of the range --- 11.025 with your range
• Evening close to 50% of the range --- 4.75 with your range
• Nighttime at the bottom of the range - 0.33 with your range
...
We need to compare your results to the optimal results and see what comes out of it.
Sample 1 : Optimal = 30 --- Yours = 16 --- You produce 53% of the cortisol you should.
Sample 2 : Optimal = 11.025 -- Yours = 3.2--- You produce 29% of the cortisol you should.
Sample 3 : Optimal = 4.75 --- Yours = 4.7 --- You produce 99% of the cortisol you should.
Sample 4 : Optimal = 0.33 --- Yours = 2.5 --- You produce 758% of the cortisol you should.
Totals : Optimal = 46.33 --- Yours = 26.4 --- You produce 57% of the cortisol you should.
DHEA 86 (106 - 300)
...
The fact that your DHEA is under range suggests that your cortisol is probably on its way down and it ain't going to stop unless you do something to stop the rot.
Based on your results, I suspect that you can't get moving in the mornings because your cortisol is too low, and you are wired but tired later in the day. Your night time cortisol is probably causing insomnia.
I'm going to post this to stop me losing it. I'll add more info in another reply.
A couple of useful links :
functionalmedicine.net/pdf/...
I think you may need to take an adrenal glandular first thing in the morning, and you may need to take another dose around late morning, or early afternoon. Don't take glandulars after 1pm - apparently they can cause insomnia if taken later in the day.
There are various popular glandulars e.g. Nutri-Adrenal and Nutri-Adrenal Extra (NAX).
nutriadvanced.co.uk/nutri-a...
nutriadvanced.co.uk/nutri-a...
Adrenavive glandulars are also popular.
procepts.co.uk/adrenavive-m...
the-natural-choice.co.uk/do...
And of course there are other brands, but I don't know which ones are good. Search Amazon for "adrenal glandulars" and read the reviews. One thing to be aware of is that some glandulars may contain adrenaline which causes a problem for some people.
If you want to try taking a glandular you should ask for advice about them in a new post. I took a glandular several years ago, and it turned out I never needed it so my experience of them is of no value.
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You may find suggestions around the web that you take steroids. I strongly suggest you avoid them. Your current results don't suggest adrenal failure - if they did you would need to see a doctor or endocrinologist to get tested for Addison's Disease and you would need prescribed steroid medications.
If you take steroids inappropriately you could cause your adrenal glands to shut down completely, and you'll be fifty times worse off than you currently are.
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A good B Complex is essential for good adrenal health. The ones suggested on this forum are
1) Thorne Research Basic B (normal dose = 1 a day)
2) Igennus Super B (normal dose = 2 a day)
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Salt is essential for good adrenal health too. In connection with that you might want to try an adrenal cocktail - you can easily make them at home. For more info on those :
stopthethyroidmadness.com/a...
therootcauseprotocol.com/fa...
I sometimes make myself a cheap adrenal cocktail with a glass of water and quarter of a teaspoon of sea salt, and for potassium I use quarter of a teaspoon of food grade potassium bicarbonate which I ordered off Ebay (or Amazon, I can't remember exactly), and I also take a vitamin C supplement at the same time.
In fact, you may want to try the adrenal cocktail first before trying an adrenal glandular because if it helps a lot you could save money.
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You should also be aware of what drugs and supplements can affect cortisol levels :
stopthethyroidmadness.com/s...
rt3-adrenals.org/does_it_af...
Be aware that neither of the above links tells you whether the substances listed raise cortisol or lower it, so if you take any of the listed drugs or supplements you need to find out for yourself what effect they have on cortisol.
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Look for links on the subject of adrenal fatigue supplements.
adrenalfatiguesolution.com/...
You really need to take a substantial amount of vitamin C per day, preferably a minimum of 2g per day, but more if you can cope with it without getting diarrhoea.
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It is essential to reduce stress as much as possible and that includes physiological stress. So, keep nutrients optimal, but also work on getting your gut working as well as possible. Probiotics work well for some people. You can make your own probiotics with food - things like water kefir, milk kefir and sauerkraut, for example.
traditionalcookingschool.co...
users.sa.chariot.net.au/~dn...
Eat regularly, don't miss breakfast, eat enough protein and fat, and drink an adrenal cocktail every day (if you can).
Avoid big spikes and drops in your blood sugar, if at all possible. Cutting down on heavy sugar and simple carbs intake would help.
...
Go to this link : stopthethyroidmadness.com/s...
scroll down to the section on "Adrenal Information" and read the links.
...
You might find something of interest on this site :
Hello HB and thank you most sincerely for such a detailed and comprehensive reply to my post. You are a very knowledgeable and kind...bless you. It's going take me some time to read links you sent me as my comprehension and mental processing is quite compromised. I can only try.
In my present, hypothyroid\undermedicated state, along with hypertension, high cholesterol, pre-diabetes which is getting worse, I stopped taking levo (75mcg) three days ago (before I got cortisol results above). In replacement of levo I dosed with half grain of NDT...thyroid S. I just had to do something to help get hypertension etc sorted. Day 1 of NDT I was ok....Day 2 was a bit of a disaster: hour an half after dose of NDT i experienced persistent fast heart rate, so in desperation and ignorance took one capsule of Thorne Adrenal Cortex (first time ever) and ended up with still fast heart rate, along with agitation and anxiety that lasted all day. Late afternoon took 5mcg of valium (from a friend) to calm heart rate which helped. Did not sleep well at all. This morning dosed with 75mcg levo in place of NDT.
I have No thyroid after thyroidectomy in 1992, As already mentioned I am hypothyroid and under medicated on levo. I dose daily with all the appropriate minerals and vitamins to aid conversion of T4 to t3. Have a reasonably healthy diet with moderate exercise. (BP goes too high when I exercise too much). Weigh 58 kilos. It's not my lifestyle causing additional health problems it's hypothyroidism \adrenals but NHS docs just won't listen.
After my experience yesterday taking one capsule of adrenal cortex I feel apprehensive about adrenal glandular. Can adrenal glandular make one feel anxious and agitated?
Sincere thanks HB...you are a tressure
If you've never taken T3 in any form before it will often cause the heart to speed up temporarily, and since NDT contains T3 it would have been what caused it to happen. If you didn't know what to expect and had been nervous of taking the NDT it would have made things worse. But the speeding up of your heart rate would have worn off eventually.
For someone without a thyroid your current 75mcg dose of Levo is shockingly low and you must feel terrible. And it almost certainly explains why your adrenal function is deteriorating.
As far as I can tell you haven't posted any thyroid function test results or nutrient results for vitamins and minerals. If you have those, you should post them in a new thread and ask for feedback on those too.
Optimising nutrient levels (vitamin B12, folate, ferritin, iron and vitamin D) makes people feel a lot better and also makes changes to thyroid hormone levels and the addition of T3 (either separately or in NDT) easier to tolerate.
Which Adrenal Cortex product did you buy and what dose is it?
Some glandulars are made from all parts of the adrenal gland and that means they contain adrenaline too. Other glandulars contain just the adrenal cortex which doesn't contain adrenaline. For example :
procepts.co.uk/adrenavive-m...
Adrenavive 1 will contain adrenaline, which I would avoid, personally. But Adrenavive 2 and 3 contain adrenal cortex only.
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I'd also like to know which NDT you bought and what dose it is.
I thought NDT was usually sold in tablets rather than capsules, and of course tablets can be cut up into smaller doses, whereas capsules have to be opened up and the powder inside has to be divided, which is a lot harder to do than cutting a tablet.
Hello HB once again thank you for your most welcome reply. Sorry for delay in reply....been caught up in a mental meltdown.
In response to your last reply, without going into lengthy details, I trialed NDT...Thyroid S 60mg April 2020. Starting dose half grain, worked up to 1 grain over few weeks. Had no problem with T3 at all.
However at back of my mind I was aware that I had not sorted adrenals issue out before trailing NDT (ducks in a row) and I suspected there would be consequences further down the line. Hence, stopped taking NDT went back on 75mcg of levo in order to get adrenals checked out.
First saliva\cortisol testing with Regenerous went wrong. My fault not theirs.
Second saliva\corisol...results above which you so kindly replied to in such detail and knowledge.
In all honesty when I first received the results they looked fine to me. I just thought the noon cortisol level was a bit low. So in my ignorance, but with great optimism decided to trial NDT again. Which only lasted for two days.
Day 1 NDT. Dose half grain 6am. Went back to sleep until 8am. Posted saliva\cortisol results on this site.
Day 2 NDT. Dose half grain NDT @ 6am. Went back to sleep but fast heart rate woke me up @ 7.10am. Like yourself I put this down to T3 and fully expected heart rate to drop its normal level but it persisted in going fast. At this point I had no agitation or anxiety.
While waiting for heart rate to drop, and perhaps looking for answers, I came to this site and read your brilliant reply to my initial post (adrenal results) ....!
9 20am took one capsule of THORNE ADRENAL CORTEX...thought the might help alleviate fast heart rate? Sadly it did not help reduce fast heart rate it made things worse with agitation along with anxiety. TAC does not contain adrenaline.
HB NDT tablet form can be split. The capsule was the adrenal cortex.
Am reading links you sent me...also having adrenal cocktail.
Dread the very thought of being stuck on levo for test of my life.
Thanks HB have a rewarding and prosperous day.
Fast heart rate can occur when people have too little T3 OR too much T3.
Fast heart rate can also occur in people with low nutrient levels. And having low nutrient levels when also taking T3 can magnify whatever effect occurs on the heart rate.
Fast heart rate may occur when people have too little cortisol OR too much. (Although I suspect low cortisol is more likely to make the heart too slow than too fast - but we don't all react the same.)
Take this with a pinch of salt - it's based on my personal experience - but it seems to me that my heart responds to T3 more dramatically if my T3 levels have been too low for quite a while. And if I then take the T3 away again my heart really won't like that either.
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A single tablet of Thyroid-S contains approximately 38 mcg Levothyroxine (T4) and 9 mcg Liothyronine (T3).
If we assume that T3 is three times as potent as T4 then a single tablet is roughly equivalent to 65mcg Levo.
If we assume that T3 is four times as potent as T4 then a single tablet is roughly equivalent to 74mcg Levo.
Personally, I would go with T3 being three times as potent as T4.
So, taking just half a tablet of Thyroid-S is like taking approx 32mcg or 33mcg of Levo. And you don't have a thyroid, so this very low dose is dangerous.
Do you have any recent tests of TSH/Free T4/Free T3 when you were on the 75mcg Levo? It would be helpful if you could post them.
It would also be helpful if you had any recent test results for nutrients.
...
I'm going to assume that your TSH is high, and that your Free T4 and Free T3 are both too low - but I'd much prefer it if I knew for certain.
This is just a suggestion for what you should do.
1) Go back on 75mcg Levo for one week to try and regain some stability.
2) Stay on the Levo and ADD quarter of a tablet of NDT to your Levo dose. Add the NDT at the time of day when you normally feel at your best. You may have to experiment with the timing, but don't change the dose - yet. Keep strict records of dose, timing and symptoms, so you don't keep re-inventing the wheel.
I use a scalpel to cut my tablets. Something like this :
amazon.co.uk/Amtech-AM-S049...
Other people prefer pill cutters. It's a personal choice.
3) Assuming that your heart behaves in a way you can deal with, two weeks after adding the first quarter tablet add another quarter tablet. You can take the two quarter tablets at the same time or at different times. Don't be afraid to shift your dose(s) around to find what suits you best. And don't be scared to change what isn't working for you.
4) By this stage, you are probably still on a total dose that is barely adequate for someone without a thyroid. You really need some testing done, but when you do that really depends on how you are feeling. If you could hold the dose where it is and wait 6 weeks to test it would be great.
5) Note that when adding T3 for the first time that not only does the heart speed up after taking the T3 but it will almost certainly speed up as well when the T3 gets used up.
6) While all this is going on you should also be trying to optimise your nutrients too. But they need to be tested first.
7) I would hold off with the adrenal glandulars for now. Instead try an adrenal cocktail. Experiment with the timing of when you take it - and you can take more than one a day if you find it helpful.
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Doctors frighten the life out of patients on the subject of taking thyroid hormones in any form. I don't know why. They don't frighten the life out of diabetics (as far as I know) when they have to take insulin.
For future reference...
Do you know how many people have been reported to have died as a result of taking T3 in the UK over the last 53 years (i.e. since records began)? None, nada, zero.
Do you know how many people have been reported to have died as a result of taking NDT in the UK over the last 53 years? None, nada, zero.
Do you know how many people have been reported to have died as a result of taking Levo in the UK over the last 53 years? 19. In 53 years.
For the source of the above data - a government website :
I would also suggest using the above link to find out how many deaths there have been reported for other commonly prescribed drugs e.g. blood pressure pills, statins, blood thinners, diuretics. It puts the data on thyroid hormones into perspective and gives you some context.
I am aware that adverse effects data on the Yellow Card site is sparse for almost all prescribed drugs. Few doctors and patients report adverse effects. But it is the only place that I know of where any data is available to the public.
Ohhh HB I just want to give you you the biggest hug ever for all the time you have taken explaining things to me and for all the links you have sent. Where there was darkness and despair you have given me hope. I can't put a value on that...It's priceless. To say thank you is not enough but still this thank you comes truly from my heart.
Regarding your last post, mostly concerning T3, where you stated: " Fast heart rate can occur when people have too much or too little T3", (first sentence of your post) opened up my mind and I recalled how I have harped on to NHS endocrinologist and private cardiologist over past months about my low level of T3 as a possible contribution\cause of my health problems. Both of these so called professionals took no notice of me.
Endocrinologist reduced levo from 100mcg to 75mcg (jan this yea) despite FT3 being low in TFT test for October 2019!!! Would FT3 drop even lower with a levo reduction?
TFT October 2019. NHS endocrinologist
Levothyroxine dose: 100mcg
THS 0.31..................0.30 - 6.00
FT4 20.2.................10.0 - 22.0
FT3 4.2.....................3.6 - 6.4
TFT March 2020. Medichecks
Levo dose: 75mcg
THS 2.69...................0.27 - 4.2
FT3 3.44...................3.1 - 6.8
FT4 16.4....................12 - 22
VITAMINS March 2020. Medichecks
FERRITIN 98.7..................13 - 150
FOLATE. 10.74...............3.89 - 19.45
B12ACTIVE 150...............37.5 - 187.5
VITAMIN D 97.................50 - 175
My nutrient level via diet and supplements should be ok but I will get a full panel done soon. Have got DI02 test kit in the post to explore conversion issue.
Re: adrenal issue have added probiotics, zinc, omega 3, selenium, more vitC, magnesium complex plus adrenal cocktail 😁 to daily supplements. Stopped my one daily mug of coffee and the occasional gin an t with daughter. Not going to dose with adrenal glandular just yet. It's a work in progress.
I like your suggestion of moving towards introducing a very small amount of NDT alongside my 75mcg of levo. I also thought about this prior to recent dosing with half grain of NDT, due to being undermedicated with levo, so it is an great option which I intend to move towards.
Going back to your opening sentence I really do suspect that low T3 is affecting my heart so I am going to make another appointment with private cardiologist specifically to discuss the effects of low T3 on the heart.
Also got an appointment with a private endocrinologist on Monday based here in the North West who actually got NDT for a patient via the NHS. However, she (the patient) has to pay £50 for monthly supply of NDT. Seems to me this endocrinologist is willingly to work with his patient's rather than dictate to them. Will see how it goes but again I fully intend to focus on the issue of T3.
HB your input has been amazing an I ever so grateful to. Sorry for the lengthy posts.
Have a wonderful rewarding day.
Humble thanks
Would FT3 drop even lower with a levo reduction?
Yes, usually. But there can be exceptions. Lowering dose leads to higher TSH, and raising TSH may lead to better conversion of T4 to T3. But your results make it clear this hasn't happened for you.
TFT October 2019. NHS endocrinologist
Levothyroxine dose: 100mcg
THS 0.31..................0.30 - 6.00
FT4 20.2.................10.0 - 22.0 --- 85% of the way through the range
FT3 4.2.....................3.6 - 6.4 --- 21% of the way through the range
People who have a thyroid get some T3 produced by the thyroid itself. I've read that about 20% - 25% of all the T3 someone has with a healthy thyroid is produced by the thyroid itself. You no longer have any contribution to your T3 from your thyroid so low T3 is very common in your situation. And clearly your conversion rate from T4 to T3 is abysmal.
It obviously varies from person to person but many people need a Free T3 which is 50% - 70% of the way through the range and need a Free T4 which is 60% - 80% of the way through the range. But there are others who do well with almost zero Free T4 and a T3 level 90% of the way through the range or even higher, possibly even a little above range. Nobody can guess - it is really just trial and error.
TFT March 2020. Medichecks
Levo dose: 75mcg
THS 2.69...................0.27 - 4.2
FT3 3.44...................3.1 - 6.8 --- 9% of the way through the range
FT4 16.4....................12 - 22 --- 44% of the way through the range
Clearly the reduction in your dose was absolutely disastrous. Your Free T3 is never going to be sufficient to make anyone well and looks to be in danger of dropping out the bottom of the range, and your Free T4 isn't even mid-range. Clearly your endo/GP will be happier with your TSH being higher, but who cares about them? It is your life and your health that matters, and why should you feel dreadful just to make them feel happy?
VITAMINS March 2020. Medichecks
FERRITIN 98.7..................13 - 150
FOLATE. 10.74...............3.89 - 19.45
B12ACTIVE 150...............37.5 - 187.5
VITAMIN D 97.................50 - 175
Your nutrient levels are good and you should try to maintain them roughly where they are, rather than allowing your levels to drop then start supplementing again to raise it. Finding a maintenance dose can take a long time but it's worth the effort. Don't assume you have to find a maintenance dose to take every day. Maintaining levels can be done by taking supplements only at weekends or just on weekdays or three times a week or ... It usually saves money if you can take a maintenance dose for fewer days a week.
The only one I would want to increase is the folate, up to about 15 - 20, but the change required isn't great so I would suggest just adding some folate-rich foods to your diet.
For future reference :
chriskresser.com/folate-vs-...
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Regarding your dose of Levo/NDT... There may come a time when you might start to feel over-medicated. When that happens you should reduce your Levo dose by about 12.5mcg or 25mcg - cut your tablets rather than asking your doctor for a decreased dose, because if lowering your dose makes things worse then you want to have the option to go back up again without begging for help from your doctor.
Depending on how you feel, and using test results to guide you, you could gradually add more NDT, quarter of a tablet at a time, and then reduce your Levo by 12.5mcg or 25mcg at a time, to finally switch over to NDT completely. Some people do very well on NDT and Levo though, so don't assume that you must end up on all NDT because you don't know whether it will suit you or not.
There is also the possibility that NDT won't suit you and you need to take a combination of Levo and T3.
If you get to a point where any changes to your dose make you feel worse, but you still don't feel good, then you may need to start treating your adrenals.
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I'm glad you're finding my posts helpful. 
Hi dizzy D. I have been reading your posts and finding them interesting. Would you be able to send me the name of your Endocrinologist in a private message please? I am currently seeing an Endo who is unhelpful thank you.
Hello DizzyDI am looking for a new endo for my thyroid and adrenal issues and am wondering whether you can recommend the one you use?
Many thanks
Jane 😊
The USA has a site where you can check for adverse events. I have hardly looked at it - seems to work as far as I have gone.
fda.gov/drugs/questions-and...
After a very quick glance it's much less intuitive to use than the UK site. I managed to find out that in 2019 there were 240 adverse events reported for T3 alone - I didn't check the Levo/T3 combos - which included 2 deaths. But I couldn't find out what the deaths were caused by.
Hello Humanbean, do you know which Adrenal saliva tests are the best?
Thank you
For a saliva cortisol test there are two good ones :
1) thyroiduk.org/help-and-supp...
regeneruslabs.com/products/...
2) thyroiduk.org/getting-a-dia...
gdx.net/uk/product/adrenal-...
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Personally I would use the first one because Regenerus Labs will deal directly with the public. Genova Diagnostics won't, and there is a bit of a palaver involved in getting your results because they use Thyroid UK as a middleman.
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