Saliva cortisol test

[Mag999]

Got results, a.m ok rest of day cortisol is suboptimal and DHEA is below reference range. Along with rising TSH and T3/4 at bottom end of range, although TSH not over range yet, would this explain the fatigue, muscle cramps and spasms, and can my gp do anything about it?!

[humanbean]

It helps if you give us your results and reference ranges. We need numbers to be able to give any sensible feedback.

You might find this thread of interest :

healthunlocked.com/thyroidu...

[Mag999 in reply to humanbean]

I hope that’s legible, will try and find a better way than taking photo

[humanbean in reply to Mag999]

I've done some analysis of your results.

Your results :

Sample 1) 18 (7 - 30) 47.8% of the way through the range

Sample 2) 2.8 (2.1 - 14) 5.88% of the way through the range

Sample 3) 1.9 (1.5 - 8) 6.2% of the way through the range

Sample 4) 0.63 (0.33 - 7) 4.5% of the way through the range

DHEA 84 (106 - 300) Below range

...

Optimal levels - see example 1 on this link :

Source : rt3-adrenals.org/cortisol_t...

• Morning at the top of the range i.e. 30 with your range

• Noon approximately 75% of the range i.e. 11.025 with your range

• Evening close to 50% of the range i.e. 4.75 with your range

• Nighttime at the bottom of the range i.e. 0.33 with your range

Compare your results to the optimal levels.

Sample 1) Optimal = 30 Yours = 18 --- You produce 60% of optimal

Sample 2) Optimal = 11.025 Yours = 2.8 --- You produce 25% of optimal

Sample 3) Optimal = 4.75 Yours = 1.9 --- You produce 40% of optimal

Sample 4) Optimal = 0.33 Yours = 0.63 --- You produce 190% of optimal

Totals Optimal = 46.1 Yours = 23.3 --- You produce 51% of optimal.

The thread I posted in my previous reply probably contains just about everything I can think of to post.

I looked back at this post of yours :

healthunlocked.com/thyroidu...

and noticed that your cortisol from a blood test is actually over the range when tested first thing in the morning first thing in the morning.

Note that blood and saliva cortisol testing aren't measuring exactly the same thing. Cortisol measured in blood is analogous to measuring Total T4 in blood.

Cortisol measured in saliva is analogous to measuring Free T4 in blood.

Cortisol measured in blood can be thought of as "Total Cortisol".

Cortisol measured in saliva can be thought of as "Free Cortisol".

Free Cortisol which is immediately available for use by the body plus Cortisol bound to transport proteins which can't be used immediately.

This type of result has been posted on the forum before (i.e. low saliva levels of cortisol but high levels of blood cortisol), and it is always difficult to know what causes the differences between saliva and blood results for cortisol. My feeling (but I'm not a doctor or a biochemist so I'm only guessing) is that something is keeping your cortisol bound up in transport proteins as it is carried around your blood stream. You have plenty of cortisol, it just isn't available to your body to use. You wouldn't be diagnosed by the NHS with Addison's Disease or any other form of Adrenal Insufficiency because your blood cortisol is high.

I suspect one thing that might help you a lot is optimising your thyroid hormone levels, but I've got the impression you aren't being treated for hypothyroidism. Am I right?

There are countries where patients are considered hypothyroid and treated when TSH goes above 3, and your level is nearly 4. You might find this thread of interest :

healthunlocked.com/thyroidu...

You are very unlikely to get treated for hypothyroidism in the UK with thyroid hormones and TSH all in range. So if you wanted treatment you would almost certainly have to treat yourself.

From a couple of months ago you were posting results showing Free T4 only 22% of the way through the range and Free T3 only 21% of the way through the range. For people on this forum many of us feel best with Free T4 around 60% - 80% of the way through the range and Free T3 around 50% - 70% of the way through the range. But those suggested values are not set in stone and we all need to find out own sweet spot.

...

As to what you can do about your low Free Cortisol (the saliva test results), the best I can suggest is that you try the options I mentioned in this thread that I gave in my earlier reply and see if any of it helps :

healthunlocked.com/thyroidu...

Other things I can suggest are trying a different kind of diet. The recipes on this website are all gluten-free, and they also include dairy-free recipes too :

dietdoctor.com/

The site also includes vegetarian and vegan recipes.

If you don't need to lose weight then you could just eat bigger portions of the recipes they suggest.

Also make sure to optimise as many of your nutrient levels as possible. It can make a surprising difference to some people e.g. me :

healthunlocked.com/thyroidu...

I suspect that your best bet might be treating your own low thyroid hormone levels. But once you start doing that your TSH may reduce substantially which will freak out a doctor. And then you will never get a diagnosis of hypothyroidism. I'm just speculating, but you could have some degree of secondary hypothyroidism. In this particular type of hypothyroidism the thyroid can actually be completely healthy. But the pituitary can't produce enough TSH for your needs.

[Mag999 in reply to humanbean]

Thanks for comprehensive reply. I’m not being treated for hypothyroid but my Tsh has been rising over past 6 months from 2.4 to 3.6. I am just done with the overwhelming fatigue and muscle problems but getting nowhere with gp as I’m always within range. Will look into the diet option.

[humanbean in reply to Mag999]

By the way I forgot to mention that your results page shows your name at the top of the page. You might want to take the picture again so it doesn't include the bit above the word "Analyte" and shows more of the graph.

[McPammy]

I had low out of range cortisol and low T3. Once my private Endocrinologist put me on a T3 trial my cortisol shot up and has remained good in the range. T3 drives your adrenals/Cortisol. I feel so so much better on T3 medication. It has transformed my life. I have Hashimotos and was on Levothyroxine alone for many years and struggling. My T3 was never checked by my GP. It was only when I became severely ill, found this site and went private that my life turned around. I’d been a poor converter T4 to active T3 snd this was also confirmed by doing the DIO2 gene test through Regenerus Laboratories. If you want my private Endo’s details please just message me. He is in Oxford and not that expensive. I thought it’d be £1000’s I was wrong. All I paid to get well and T3 medication was less than £700.

[Mag999 in reply to McPammy]

Thanks very much, great to hear you have managed to navigate through this. Will message you

[Gingernut44]

I had the same problem, my GP agreed to do a morning blood test which, of course, came back within range and totally dismissed the fact that my cortisol dipped below range by lunchtime, also, no mention of the fact that my DHEA was so low it couldn’t be measured although on my report Regenerus repeated the test several times to make sure. It has also been ignored by NHS and private Endos.Talk to your Doctor about it, you may have more luck than me - we can live in hope 😒

[Mag999 in reply to Gingernut44]

O I’m sorry to hear that, I know the nhs doesn’t use the saliva test although I think research in Sheffield is taking place. It has to mean something in the context of health problems!