Saliva Cortisol DHEA Test Results , how do they look?

[Caroline369]

Hi guys, so my saliva cortisol dhea results came back from Regenerus, any thoughts on them ??

[humanbean]

Sample 1 : 18 (7 - 30) 48% through range

Sample 2 : 5.7 (2.1 - 14) 30% through range

Sample 3 : 5.5 (1.5 - 8) 62% through range

Sample 4 : 1.1 (0.33 - 7) 12% through range

DHEA : 266 (106 - 300) 82% through range

...

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 = 18 --- You produce 60% of the cortisol you should.

Sample 2 : Optimal = 11.025 -- Yours = 5.7 --- You produce 52% of the cortisol you should.

Sample 3 : Optimal = 4.75 --- Yours = 5.5 --- You produce 116% of the cortisol you should.

Sample 4 : Optimal = 0.33 --- Yours = 1.1 --- You produce 333% of the cortisol you should.

Totals : Optimal = 46.33 --- Yours = 20.3 --- You produce 44% of the cortisol you should.

...

Given that the graph you've posted shows your results being almost completely within the green portion I thought the results would be quite good, but your overall cortisol level is surprisingly low. However, your results don't suggest Addison's Disease or Adrenal Insufficiency (also known as Hypocortisolism) :

en.wikipedia.org/wiki/Addis...

en.wikipedia.org/wiki/Adren...

There was a member on the forum who was diagnosed with Addison's Disease after a saliva cortisol test, and you can see her results here, just for comparison :

healthunlocked.com/thyroidu...

Your results are more suggestive of Adrenal Fatigue (AF). What this means is that your adrenals are not working terribly well but they can recover with the correct help. [In Addison's Disease the adrenals will never recover.] Don't mention AF to your doctor. They "don't believe in it", which I personally find ridiculous.

I wrote a huge amount of info for another member in a similar situation to you that you might find helpful.

healthunlocked.com/thyroidu...

The fact that your DHEA is still quite high in range makes me think that your cortisol has possibly only started deteriorating fairly recently. But the likelihood is that your DHEA will drop eventually, possibly quite a lot. Note that DHEA drops as people get older, even if they are perfectly healthy.

Note that the link above needs updating, and some of it is out of date...

NutriAdvanced no longer sell NutriAdrenal or NutriAdrenalExtra.

Be careful with anything described as an adaptogen and do lots of research before even considering them. Most of them reduce cortisol rather than raise it. Licorice gets a mention as an adaptogen too, and for some people (e.g. me) it raises my blood pressure quite alarmingly.

healthunlocked.com/thyroidu...

[Caroline369 in reply to humanbean]

Hi Humanbean

Thank you so so much for your detailled and comprehensive reply. I read it last night but was so tired i could not reply.

Thank you for breaking it down as even though i didnt really know how to interpret the results - i kinda thought it maybe wasnt too bad becuause like you saw it was all in the green. So thank you again for working out the percentanges.

So basically my overall cortisol actually is low then? So i had posted here i was going to give NDT a try based on my symptoms and lower end FT3 and FT3 so based on my cortisol results would this be a bad idea until i got the cortisol sorted?

What do i take to sort the cortisol ??

I am going to order another thyroid blood test from medichecks today as it was 5 months 4 months ago since my last test.

[humanbean in reply to Caroline369]

I think it is unlikely that you will get your thyroid sorted while cortisol is low. There is a strong relationship between thyroid and adrenals, and they affect each other. Delaying fixing one while waiting for the other to improve won't really work in the long term.

I would suggest that you start taking thyroid hormones (assuming you need them) and start experimenting with supplements to improve your adrenal health. Many supplements for adrenal fatigue will also help your thyroid hormone levels. Go slowly and don't assume you have to take everything that is suggested. Use this thread for suggestions :

healthunlocked.com/thyroidu...

1) Adrenal cocktail. They are cheap as chips to make at home. Standard recipes contain sodium, potassium and vitamin C. If I take one early in the day I use this combination. If I take one at night I drop the salt and include magnesium. But that is what works for me. Experimentation is key. Note that healthy adrenal glands need salt to work effectively - low salt diets aren't a good idea.

2) You might benefit from an adrenal glandular, such as Adrenavive. I'm not knowledgeable about these because I've never needed them. You could write a post asking people their suggestions and opinions on good adrenal glandulars.

3) Start optimising your basic nutrients - Vitamin B12, folate, ferritin/iron, vitamin D. They will help the adrenals and the thyroid, and will improve conversion of T4 to T3.

4) There are a ton of other supplements that are recommended by various websites, but I'm not going to suggest that anyone takes all of them - there are so many that it would be ludicrous. I would suggest starting any new supplements one at a time, not all at once. If something doesn't work you won't know what it is that is helping and what is making you worse. You will have to do your own research on these :

drlamcoaching.com/adrenal-f...

Note that many of the suggestions in the above link are found in good quality B Complex products. And I would also suggest doing some research into what can be found in your diet.

Avoid Phosphatidylserine - it reduces cortisol, it doesn't raise it. Research the effect on cortisol of any supplements you think might be helpful before purchase. You should also look up side effects.

[June25 in reply to humanbean]

humanbean I'm not sure that your analysis of this Regenerus result is valid and here's why. You are taking your standards for optimal from a website which applies these standards to the adrenal test from ZRT. They can't just be lifted and applied to another provider which designs and draws its graphs differently.

Regenerus is very clear on its graph that anything within the green zone is considered optimal for its test. It gives optimal ranges and reference ranges. Green means optimal. An orange mark means within reference range but not optimal range. So Caroline is optimal except for a slight jump higher than optimal for the evening sample.

Well that's how I read it anyway.

[Caroline369 in reply to June25]

Hi June

Thanks for adding your thoughts. So u think my results are actually OK?? I dont have low cortisol that needs raised ??

Just wondering if that is the case why Regenerus say it shows HPA dysregulation ?? Would that not suggest there is an issue of sorts ??

Bear in mind I am new to this so all advice welcome.

[June25 in reply to Caroline369]

In a perfect world, cortisol starts high in the morning and gets lower as the day goes on. Yours doesn't do that, it has this little jump for your evening sample. I think that's what Regenerus is pointing out. It's not a lot, just a tad over the green area. If I had these results I wouldn't worry. Maybe I'd look at your lifestyle around that evening sample and if it involves an unusual amount of stress that you could reduce.

[humanbean in reply to June25]

They can't just be lifted and applied to another provider which designs and draws its graphs differently.

That would be true if I was looking at results as raw numbers, but I'm using percentages.

Suppose I have a saliva sample I want to test for cortisol. I divide it into 4 and send one sample to each of Labs A, B, C and D.

A, B, C and D don't all use the same type of machine, so they have different reference ranges.

A : Ref range = 10 - 20

B : Ref range = 14 - 30

C : Ref range = 6 - 18

D : Ref range = 2 - 10

Suppose the result was 12 from all of the labs.

Lab A would have produced a result which is low in range.

Lab B would have produced a result which is below range.

Lab C would have produced a result which is mid-range.

Lab D would have produced a result which is above range.

This would give completely different interpretations of the result and so comparing the actual number when the reference ranges are different produces a nonsense result.

But, suppose the results were all different and came out as follows :

A : 15

B : 22

C : 12

D : 6

Each of the above results is 50% of the way through the range for the lab that did the test. The results are comparable because they are independent of the reference range.

If one result is 75% of the way through the range and another one is 5% of the way through the range then they can be realistically compared and would be interpreted as the first result being much, much higher than the second.

If we couldn't compare percentages of the way through the range, and can't compare the actual numbers when reference ranges were different, it would mean that no two results could ever be compared. Instead you'd have to insist that all results for a particular person were done on the same machine with the same reference range with the patient in exactly the same condition at every test.

[Caroline369 in reply to humanbean]

Thanks humanbean for contributing again.

[June25 in reply to humanbean]

Hi Humanbean,

I'm not trying to rain on your parade, honestly. I always like your posts. It's just that I don't think this is sound statistics.

The flaw in your argument is the assumption that all providers fix their reference ranges at the same place on the bell curve of results that they expect. They don't.

For example, lab A uses reference range 12 - 22 and the top of the bell curve that they have designed for is 17 or 50% through their range.

Lab B uses reference range 12 - 56 and the top of the bell curve that they have designed for is 17 or 11.36% through their range.

Both Lab A and Lab B use the same units, do the same test, and get the same result but Lab B is choosing to represent the results with the bell curve at the front of the horizontal axis and with a long tail off to the right. In this case you can't compare percentages. Lab B is free to do this and might think that the numbers it derives fit better into the graphical representation of the results that it wishes to demonstrate.

I know that traditionally we compare percentages of our thyroid results to get over the different ranges that they come in, and generally it works. But statistically speaking, assumptions are being made about how the providers are determining the ranges for their tests. Essentially, they could choose any range they want. I think that Regenerus have determined their ranges in such a way as to produce this nice graph with the green area down the middle to give us a visual representation of what is optimal in their view. I looked at the ZRT website but they don't give a sample graph to compare with. I hope this makes sense, otherwise we might have to draft in a statistician to settle it.

[humanbean in reply to June25]

As far as I'm aware the usual way of setting a reference range for any blood, urine or saliva test is something like this ...

a) Take a sample from a group of (allegedly) healthy people. Let's say there are 200 of them, for ease of arithmetic.

b) Do a test for cortisol. Assume the machine used is calibrated correctly for measuring cortisol. If the test group is large enough and the results were graphed I would expect the shape of the graph to be roughly similar to a normal distribution, but one tail of the distribution might well be longer than the other.

c) Put the results in order of magnitude. Discard the bottom 5 (2.5%) of 200 results and discard the top 5. The remaining 95% (190) of the 200 results should represent the reference range for the ferritin test.

d) Someone - I don't know who decides - sets what the optimal is that companies like regenerus quote. I have never trusted the optimal results for cortisol (quoted by Genova or Medichecks or Regenerus etc) because I don't know who makes the decision and how optimal was determined. So I've always used the whole range, and taken the optimal levels to be the ones described in Example 1 of this link :

rt3-adrenals.org/cortisol_t...

Optimal levels

• 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

The suggested levels in the above link come from a group of people who are knowledgeable thyroid patients. And of course, the circadian rhythm has been graphed many times and I know that how it looks depends on whether you graph from midnight to midnight or 3am to 3am or whatever.

For example, lab A uses reference range 12 - 22 and the top of the bell curve that they have designed for is 17 or 50% through their range.

Lab B uses reference range 12 - 56 and the top of the bell curve that they have designed for is 17 or 11.36% through their range.

I can see what you're getting at. I know the TSH range is very skewed for example. The peak of the graph that I've seen for TSH was at 1.25 with a reference range for the testing kit used at 0.2 - 4.5. But doctors pay no attention to that at all. They will look at that reference range and many of them won't care if most of their hypothyroid patients have a result for TSH between 4.0 and 4.5 because that is in range.

I'll give you an example of why I think uses percentage through the range is well worth doing even with widely differing reference ranges, and even if those results don't take any notice of possible skewing of the actual results within a range.

I have three ferritin test results from several years ago, and they all took place over about 13 months. I was actively supplementing iron to raise my ferritin throughout the time the tests were done.

Test 1 (NHS) : 21 (Range 13 - 150)

Test 2 (Blue Horizon six months after test 1) : 67.7 (Range 13 - 400)

Test 3 (Blue Horizon six months after test 2) : 51 (Range 13 - 150)

So if one ignores the ranges my ferritin went up a fair amount and then dropped again, but if you look at the percentage through the range there had been steady progress.

Test 1 : 6% through range

Test 2 : 14% through range

Test 3 : 28% through range

If you can think of another way of analysing results that doesn't require a computer, and doesn't require anything other than basic arithmetic, then please describe it.

Do you believe that the analyses being done on the forum (for anything) are actively dangerous? If it isn't dangerous, and people feel comfortable with what is being done, and they understand it, then I can't see a problem.

[June25 in reply to humanbean]

"Do you believe that the analyses being done on the forum (for anything) are actively dangerous?"

Let's not try to widen my comments out. I have referred specifically to the analysis of the Regenerus saliva test in this thread.

It is only potentially dangerous if the interpretation of the results is wrong and a course of action is taken based on that interpretation.

Regenerus has clearly specified that it considers the green area of its graph to be the range of cortisol that is optimal.

You and your knowledgeable thyroid patients are free to have a different opinion on what is optimal. What is less than honest is for you to present that opinion as the correct interpretation of the Regenerus result when it is actually an alternative interpretation based on unrelated standards that you have chosen to adopt.

I suggest that it might be more helpful if you were to explain to those seeking help what Regenerus is actually presenting in their graph, ie. the meaning of the green area and their opinion on what is optimal. You might then give your own opinion on what is optimal and your reasons for differing with Regenerus. That way people could make up their own minds about which interpretation they felt was valid.

[humanbean in reply to June25]

This reply has been delayed because I have not been very well for the last week.

If we are going to talk about honesty, perhaps it would be more honest for all companies who supply optimal ranges for any kind of test to explain how they calculated them, whose data they are using, how healthy those people are, what health conditions they have, what conditions were used to get their saliva results. Did they take thyroid hormones? Supplements? Medicines for other conditions?

If I can briefly go off at a tangent, in hypothyroid patients anyone with a TSH in range - anywhere in range - is considered (by most doctors) to be healthy and their result is optimal, but in reality it leaves many patients feeling very unwell with low levels of Free T3.

How can any company setting optimal levels ever know that the ranges they set for healthy people will also apply to unhealthy people with permanent thyroid problems? Has the research been done?

Trying to squeeze thyroid patients into the same reference ranges for TSH that work for healthy people doesn't end up with everyone feeling well, no matter how much doctors might assume it does. Similar arguments could apply to anything that is being tested.

If I test a group of 200 people for saliva cortisol using Regenerus machines and testing protocol, and then I compare the results to the same test done with Genova Diagnostics UK and then I compare to Medichecks or any other company that does saliva testing for cortisol, the general distribution of results will be exactly the same shape in every company. It might have a different mean and standard deviation from one from Regenerus, but if it is positively skewed from one company it ought to be positively skewed from every other company too. If the shape of the distribution changes with every company, from say, a positive skew from one company to a negative skew from another company and a completely normal distribution from a third company then it says something shocking about the accuracy of testing for anything.

Another factor... In my hypothetical group of 200 people being tested for saliva cortisol the 10 people with results that are closest to the mean ought to have results that are closest to the mean from any company. If a completely different set of 10 people have results closest to the mean in company A to those in company B that makes no sense whatsoever, and suggests that Companies A and B aren't even testing the same thing.

Going back to the actual optimal results from Regenerus, the first sample has an optimal range of 14 - 25 nmol/L and a standard reference range of 7 - 30.

The optimal levels quoted in Example 1 of this link, which is the one I use, :

rt3-adrenals.org/cortisol_t...

suggest that having a result at the top of the range first thing in the morning is likely to be optimal for the majority of patients.

I have doubts that a result of 7 or 14 (bottom of the standard and optimal ranges) first thing in the morning would feel good for anyone. But I might be persuaded if I knew how the optimal range was calculated.

I also have doubts that people would bother spending money on a saliva cortisol test if they felt well. I have suggested that since changing thyroid hormone intake and changing nutrient levels and changing diet and exercise levels are likely to alter cortisol that cortisol should only be tested after as many other things have been optimised as possible.

Another issue is that cortisol is difficult to change deliberately unless someone has a proven case of Hypocortisolism or Cushing's and is being treated medically by a qualified doctor.

If levels are shown to be low (in either range) in the morning and someone wants to raise it without medical help how do they do it? It isn't easy. Ditto with people who have very high cortisol. Lowering it isn't easy either.

It seems to me that you are suggesting that anyone with results that are "all in the green" on the graph should be told their results are all optimal and if they have any health problems they aren't caused by cortisol. I don't believe that is always going to be true. But without any info on how the optimal ranges are created by testing companies I can't say more than that.

[June25 in reply to humanbean]

I mostly agree with all that you have said.

I did contact Regenerus who said :

"These ranges are proprietary to Labrix and not shared information. However, in general they are based on a healthy, symptom free patient population."

I have no problem with debating whether the optimal AM range for cortisol is at the top of the range or the top of the green zone or somewhere inside the green zone, but I think that the debate should be had, and crucially with the individual who is seeking guidance on their results. What I was not agreeing with was your imposing your own set of standards on the results and presenting that as the only correct way to interpret them.

You just have to look at the mistakes that have been made with thyroid treatment whenever a one-size-fits-all approach has been taken. I think it is most likely the same with cortisol, that there is no one right answer and that it varies from person to person. Much progress has been made since the debate on optimal thyroid results has opened up to basically admit that widely differing results can still all be optimal if the person involved is thriving. Along the way we have also learned that signs and symptoms trump reference ranges. These have been valuable lessons that have advanced thyroid care, and I would like to see them also applied to cortisol.

"It seems to me that you are suggesting that anyone with results that are "all in the green" on the graph should be told their results are all optimal and if they have any health problems they aren't caused by cortisol."

I wasn't saying that and I'm sorry if I gave that impression. That would be regressing right back to the one-size-fits-all approach. I was saying that people seeking help deserve to get that help in reading their results as presented on the graph they have received. That is their starting point. From there, hopefully meaningful dialogue can take place about the interpretation of the results and any health problems that they may have.

[humanbean in reply to June25]

The interpretations that I do of results in people who have done saliva cortisol testing have been based on this link which I have already given :

rt3-adrenals.org/cortisol_t...

Similar results are discussed on the STTM page :

stopthethyroidmadness.com/l...

where it says :

ADRENAL RELATED

24-HOUR CORTISOL SALIVA

Here are the consistent results of people who do not have an adrenal problem, which is also your target when on adrenal cortex or hydrocortisone:

8 am (or when you normally wake up): at the tip top part of the range (if top of range is 9.5, people are right there, or 9.4, 9.3.

11 am-noon (or approx. 4 hours after you woke up): in the upper quarter, closer to the bottom of that upper quarter

4-5 pm (or approx. 4-5 hours after the above): right “around” mid-range

Bedtime: at the very bottom (Literally. So if range is 1-4, people are at 1, not even 2)

There are also many, many graphs on the internet showing what should be expected from the cortisol output of healthy people during the period waking to bedtime. These graphs often look different from one another because they don't always use the same start point for the graph, or they don't cover the full period from waking to bedtime, or they use an entire 24 hours including nighttime.

The fact that Labrix considers its standard and optimal ranges to be proprietary to them just makes patients' lives more difficult. So we have to get our understanding from elsewhere. I work on the assumption that the standard ranges are more reliable than the optimal ranges, because standard ranges are worked out via a common method, as far as I can tell. But the optimal ranges are just a big black hole in terms of how they are worked out, so I always work from the standard ranges. They may not be perfect but at least their derivation is more likely to be understood.

In reference to your point in bold in your previous reply...

I'm not imposing my own standards of what cortisol should be on other people's results. I'm giving links to a set of standards given by a website (RT3-Adrenals) which has been set up by people who seem to know what they are talking about and also have thyroid problems.

STTM uses similar suggestions of what cortisol levels to expect from healthy people.

The graphs on the internet covering the period from waking - bedtime also suggest that healthy people have a pattern of cortisol results similar to those listed by the two websites I've given.

When I got my first ever set of saliva cortisol results, nearly 10 years ago now, I really had no idea how to interpret the results I got and what healthy results ought to look like. (A common rookie mistake.) I did a lot of research at the time, and have continued looking for good links on the subject every so often.

When someone comes to the forum and asks for help on what their saliva cortisol results are telling them I often spend a long time on my answers. I don't want to add another enormous screed to that on top of what I already do. And I don't want to have a debate on something over and over again. People can do their own reading and research and hopefully will ask for more info when they feel they need it.

A couple of years ago I wrote a lot of replies to someone whose cortisol was on the low side (but nowhere near Addison's) and I threw everything into my answers that I could. I now refer people to that thread when it is relevant rather than write it all out again.

healthunlocked.com/thyroidu...

In future I will refer people to this thread in the case of any issues with my interpretation.

[Caroline369 in reply to humanbean]

Thanks Humanbean for your thoughts and interpretation.

As my low in range cortisol is morning and midday I was thinking of trying Thorne adrenal cortex to try and raise my cortisol levels.

I also bought some selenium and biocare oral iodine.

I was also recently starting taking magnesium glycinate at night and noticed it was making me more tired and read that it lowers cortisol . Have you or anyone else read this ??

[humanbean in reply to Caroline369]

I've just read that magnesium lowers cortisol today, and only because you mentioned it.

It would be worth a try for you to take an adrenal glandular.

Other ideas on getting cortisol right can be found on Paul Robinson's website :

paulrobinsonthyroid.com/

His main method (I think) is to use T3 dosing at certain times of day. I've never studied his methods because my cortisol has always been high rather than low.

[Caroline369 in reply to humanbean]

Thanks Humanbean for reminding me of Paul Robinson and T3, I briefly stumbled on his website about 2 weeks ago and read a little but not enough as I though it was just for hypothyroid but after you posted about him I had another quick look after you mentioned that T3 is also for raising cortisol!!! How exciting!! Thanks do much for this so think I will order the book and read up on this.

I had booked a telephone endo appointment for today based on my potential central hypo bloods but I cancelled (might actually loose the cost of consult 😭😭😭, though hope I get something back) but he only prescribes T4 and I read horror stories of levo and I dont care if I need T4 I will not take in Levo form, my anxiety would be through the roof worrying about all the side effects and that would be before I even took it !! I am very sensitive to medications.

But I also cancelled because of your insight into my adrenals and cortisol and think I need to try to get my cortisol raised first before trying anything else.

I know your cortisol is high but do you think for me you would steer first towards the Adrenal cortex (I could not take glandular as I read it had adrenalin in it and I would mot be able to handle that, i read the cortex is less stimulating) or would you be thinking T3 ?? What would you try first??

I know I have to buy Paul Robinsons book first to read. I am glad I have another 2 options now so thank you.

Yeah bummer about the magnesium, it cost me £20 for that bottle too 😭😭

[humanbean in reply to Caroline369]

In your shoes I would take adrenal cortex rather than glandulars too. But bear in mind I have no long-term experience of glandulars or cortex products. I think SeasideSusie takes adrenal products of some kind. Perhaps you could search her replies to other members :

healthunlocked.com/user/sea...

...

Levo shouldn't scare you. The majority of thyroid patients do well on it as far as I can tell. The people on this forum are the ones for whom standard diagnosis and treatment hasn't worked well - but there are millions of people around the world taking Levothyroxine successfully.

I couldn't take anything containing T4 for about 8 or 9 years. It made me feel extremely ill. But reducing my high cortisol and improving my nutrients eventually allowed me to tolerate Levo, and I started taking it successfully (for the first time) in 2020/2021. I do need a smallish dose of T3 on top, but my treatment and my blood test results are now far more "ordinary" than they've ever been before, which makes my life easier if I have to deal with doctors. Also, relying on T3-only might work for some people (and it did for me for a few years), but there is always the danger that an accident or stroke could leave someone needing T3 and not getting it, and they have no T4 in storage. I wouldn't feel great on Levo only, but I would survive.

I don't think you should stop taking magnesium. When you find a method/treatment for your cortisol that works for you, definitely add in magnesium again if you choose to stop taking it.

[SeasideSusie Remembering in reply to humanbean]

I've just read that magnesium lowers cortisol today, and only because you mentioned it

I didn't know that either (thanks for the heads up), now that's a problem because I need magnesium citrate to get bowels moving and I also take magnesium taurate as it's beneficial for heart and I have problems there. No wonder my saliva cortisol level always shows low and doesn't seem to improve

[Caroline369 in reply to SeasideSusie]

Yes i am disappointed for same reason! The magnesium glycinate helped my bowels too !!

[Eton in reply to Caroline369]

Same here! And I also have a history of low cortisol and constipation. If you come up with an alternative to magnesium please share with me.

[Staffsgirl]

Could you explain how you copied the relevant parts of these results please? I’m trying to post mine, but can’t see how to avoid my details being there!

[Caroline369 in reply to Staffsgirl]

Hi Staffgirl

I took a screenshot and then cropped it and screen shot it again and then uploaded it.

Hope that helps.

[Staffsgirl]

Thanks…sounds a bit clever to me! I must learn how to crop.

[Caroline369 in reply to Staffsgirl]

Lol no it's not clever honestly, actually I might have worded wrong. Take a screen shot. Go to the picture and start enlarging / making it bigger until the details are off the screen and then take another screen shot and upload. Does that sound OK or easier?

[Staffsgirl]

I did manage it with your first instructions, so thanks.

[Caroline369 in reply to Staffsgirl]

Oh excellent!

[AS14]

I followed Paul Robinsons CT3M to raise my very low in range cortisol, I used ndt. It worked well and in just a few weeks.

Any change in time or dose is reflected in results.

When Ive changed a time or dose I give it a few weeks and do both a blood cortisol and saliva cortisol test. The blood is always as expected a bit higher than than the saliva but responds just the same as the salvia test to a change in dose or time.

I should add Im not well yet, still working on iron ( serum iron) as that too either prevents T3 working or provokes bad reactions when trying to increase T3.

Ive still a way to go yet but just using a little ndt this way has proven to be excellent for cortisol.

Its important too know that too much cortisol isnt great either.

I have tried adrenal supplements several times and they made me feel even worse.

T3 in the cortisol production window ( the four hours before you get up), will improve low cortisol, cortisol needs T3 and T3 needs cortisol.

Highly recommend Paul Robinsons book Recovery with T3, I bought mine from Amazon.

[Caroline369 in reply to AS14]

Hi AS14

Thanks for replying and for saying u have had good results so far with Paul Robinson protocol, that gives me hope for another option. I am defo going to buy the book now. 😀

[AS14]

Its a great book, everything about using T3 you could possibly need is this book. Dont skip any parts and be sure your nutrients are optimal, its vital for any thyroid meds to work and T3/ndt is even more sensitive especially iron and cortisol levels. Ferritin is talked about a lot but serum iron crucial for T3/ndt to work, its explained why in Pauls book.

Stop the thyroid madness also talk about how important cortisol and serum iron is to T3/ndt, it seems to be very common problems for us hypos.

However when reading stop the thyroid madness it will describe this problem as”pooling”, as in T3 pools in the blood and doesn’t get into the cells properly. This term is a very out dated and has proved to be inaccurate, but what ever term they use it basically means T3 wont work with out good cortisol and iron.

Sorry if this might confuse things but speaking from experience I found Regenerus to be inaccurate, greatly so in my case.

My first ever test was with them, bottom of the range cortisol, I also had bottom of the range blood cortisol at the same time.

I then followed CT3M for several months and felt some subtle improvements, slept better and bit less sleepy in general. So then I tested with Regenerus again and this time result had dropped even further, by quite a way. I also did a blood cortisol on the same day as the saliva test but only this time it was right at the top of the range.

Something wasn’t right, I was feeling a little less sleepy, I was sleeping well, blood cortisol had improved dramatically yet saliva was saying it was far worse.

Thoroughly confusing and disheartening and it just didnt make sense.

So I decided the only thing I could do was test again with zrt labs and medichecks.

Both zrt labs and medichecks saliva test showed high in range, the complete opposite to Regenerus.

All these tests were done close together, no changes to any meds or timings that could potentially explain these differences.

I now use only medichecks for saliva test.

There are people who like Regenerus but from experience they are inaccurate.

I hope I havent confused things just telling you what Ive found.

[AS14]

I should add be thorough in your testing, all the key nutrients as discussed on this forum as well as the full iron panel and cortisol. Any issues in any of things can make the process of getting well very confusing.

I failed to test iron ( full iron panel) until well into “ figuring it all out”, lost a year missing iron, Im still trying to get iron right over another year later.

Had I tested nutrients properly in the first place it would of saved me a lot of time, confusion and feeling dreadful.

Dont make the same mistake.