A lot of people on here talk about the 24 hour cortisol curve which can be done with the online providers.
I’ve discussed this with a few of my nine different Endos. All have dismissed this test out of hand and would not entertain discussion on its merits.
Has anyone yet found a private Endo who would recommend the test?
I find it odd that what looks like quite a sensible test of a key hormone is dismissed by hormone doctors!
There’s a valid reason for this. Medical doctors look for overt pathology in other words Addison’s or Cushings, because this is what they can treat using the tools and medications they have. There’s nothing they can do with an ASP test so they just dismiss it. That’s not to say that there is no dysfunction in between.
Precision Analytical, makers of the DUTCH test have a lot of educational material on this by Dr Carrie Jones. So this is something that only a functional medicine practitioner can help with not a medical doctor. I have only come across one endocrinologist who did not dismiss the Adrenal Stress Profile test results I already had, but again he referred me on for a Synacthen test.
This explains everything about testing for the HPA axis dysfunction and treatment:
dutchtest.com/video/foundat...
Agree the Synacthen and Insulin Tolerance tests are what Endos prefer but like you say unless you are under/over on these they cannot treat.
Will try out functional med doctor and see what they recommend.
Well I hope you can find a good practitioner in the U.K.
The video explains a lot of the interventions that can be used to address HPA axis dysfunction. A lot of them are things which we can do ourselves to support our circadian rhythm. There’s another video on the Cortisol Awakening Response (CAR) and the importance of this to our sleep and immune response. Again doctors may scoff at this, but it’s documented in scientific literature.
It’s lifestyle medicine rather than taking the approach to treat a specific disease.
Indeed.
I remember a BBC health show about 10 years ago. They actually looked at morning cortisol (blood test IIRC) and how what you did the day before impacts it.
Really simple experiments but just goes to show your level of diet, sleep and exercise all impact the next day’s cortisol level.
Doctors are so worried about disease but never focus on simple interventions like this to help patient outcomes.
I’ve had chronically low morning cortisol and struggled to wake no matter how much I slept. No doctor was prepared to admit anything was wrong as my blood results weren’t low enough.
Synacthen and ITT were normal-ish so I wasn’t offered any treatment.
A brain MRI was also conducted.
No solutions or advice offered.
However:
Since adding T3 to my T4 I have never struggled to wake in the morning no matter how little I sleep. Morning cortisol is also slightly improved per blood tests.
There is a difference between serum and saliva testing. If I remember correctly serum only measures total cortisol and not free and unbound cortisol.
To me this just highlights that health is something we should take personal responsibility for and how the current medical system doesn’t work for chronic long term issues. However, due to a lack of education most people simply don’t have a clue. Why would they? We’ve been conditioned to think that we don’t need to think about our health. The medical establishment is based on the drug treatment approach which in most cases is there to suppress symptoms and not address the root cause. We expect our GPs to give us a solution in the 10 minutes but nobody knows our bodies better than we do.
Thankfully the internet and social media are helping increasing our awareness and highlighting the importance of functional and root cause medicine. People like Dr Tim Spector and Dr Rangan Chatterjee are medical doctors who are advocating for change. I think it’s those doctors that are personally affected by disease who realise that the current model has failed patients and are saying something about it. The current system is only lining the pockets of big pharma.
Private Endocrinologist
24 hour saliva test 
Private endocrinologist 
Private GP or Endocrinologist?
