Hello lovely people
I have consistently high cortisol. It stops me from sleeping and make me really anxious. Any ideas on how to reduce this?
I have changed jobs to reduce stress, taken up yoga, drink herbal tea but still 😞
Any ideas please?
Thank you!
PixieElv
You have an endo who has prescribed DHEA. I would be showing him these results and see what he says. With levels that high Cushings disease comes to mind, but I am not medically trained so you need to discuss this with your doctor.
hi Seaside Susie
Yes, I will show this to him. He previously didn’t have much advice, but he may change his views?
Hi PixieElv,
Do you have any problems with high blood pressure/hypertension? I realise you're reducing stress through changes that you've made but sometimes blood pressure can be high without having any obvious symptoms.
If you've not had a pituitary MRI scan it might be an idea to ask your GP or endo about it.
Best wishes.
Hello,
Luckily I don’t have high blood pressure.
I had an MRI scan and that was fine as well. But i do have central hypothyroidism, so my pituitary gland (or hypothalamus?) is not working properly, without any obvious damage.
I am at a loss of what causes this and what I can do lower it 😞
Best wishes
hey, did you ever take anything for low cortisol? What is your thyroid treatment? Sometimes thyroid treatment can send cortisol very high.
hello
I take NDT 3.5 grains and DHEA but my cortisol has always been high. DHEA has been low, so I’ve been prescribed DHEA.
ah Ok, maybe worth asking if your DHEA needs reducing? Otherwise seriphos & PS100 are very good at lowering cortisol x
Hello
My DHEA is 250 (105-300), so that should be ok?
What are Seriphos (not the Greek island, right 😂) and PS100 please?
Never heard of them
you can Google them 
they lower cortisol
Are they herbal? Or hormonal? Sorry I can google them 😆😜
tbh I have never had to research them as my cortisol has always been deathly low, but a quick search said the following about seriphos -
Seriphos encourages your pituitary gland to stop sending the order to your adrenals for more cortisol production. After a month or so, this normalized message should be permanently re-programmed, and you should not need any more Seriphos. Caution: Do not take Seriphos for more than three months total.
I tried Seriphos quite a few years ago. My cortisol was high (over the range for 1st, 3rd, and 4th saliva samples, 2nd sample was 90% through range), but nowhere near as high as yours. I have read a lot of people think Seriphos is wonderful, and I found it enabled me to get to sleep for a while. But I had many health problems with tolerating lots of things at the time, and Seriphos made me feel like I had the flu all the time. It is also expensive, and I couldn't afford it more than a couple of times.
In the end I tried Adaptogens (there are quite a lot of them) to lower my cortisol :
healthunlocked.com/thyroidu...
I eventually settled on Holy Basil in about 2015. This is the one I take.
dolphinfitness.co.uk/en/swa...
The dose mentioned on the bottle was 2 capsules a day, which did nothing for me. I was so desperate that I took more than recommended. I increased my dose until I was on eight capsules a day, which was too much. I eventually spent a few months on six a day, then when it became counter-productive I gradually reduced to 4 per day, then 2 and now 1. I was spreading out my doses for quite a while because my cortisol results were high throughout the day, but eventually I concentrated on taking them about an hour before bed. It is worth experimenting with the timetable you need to get the best benefit from them. I've been on it for seven years, and I am now a much less anxious person than I used to be, although I think there are multiple reasons for that, not just the Holy Basil.
I have very recently been able to get to sleep very occasionally without any at all. But I'm not quite there yet and might try alternating for a while.
Holy Basil should never be taken by anyone with low or acceptable levels of cortisol. Anyone trying it should always be sure they do actually have pronounced high cortisol, not just "a little bit high".
You could try what I did. But seriously, I think you need to get tested for Cushing's Disease or Cushing's Syndrome (I always forget the difference between them.) Your saliva cortisol results cannot be classed as normal by anyone with a brain. It would appear that your endo doesn't know what he is talking about when it comes to the adrenals.
my pituitary gland (or hypothalamus?) is not working properly
Ditto. My pituitary is squashed flat in one direction and stretched in another. This showed up on an MRI. I don't know if my hypothalamus is normal looking or not. Nobody has ever tested the output of my pituitary, but my TSH has never been above about 5.7 despite Free T4 and Free T3 being very low in range sometimes. (Having Free T3 only 8% through the range makes me feel dreadful, surprise, surprise.) I was first told my thyroid was "borderline underactive" in 1990(ish). I got my first prescription for Levo 23 years later. My doctor was extremely reluctant to prescribe because my TSH was only just over range. I decided then that I didn't want to spend the rest of my life fighting with doctors so I decided within about three or four months that I was going to treat myself.
...
Have you ever had cortisol tested via a 8am - 9am blood test? If yes, what was the result?
If you are ever given tests by the endocrinology department of a hospital you should read up on the tests they do beforehand. The "Endocrine Bible" is well worth keeping as a reference to preparation, timing, testing protocol, and result interpretation of every test they are ever likely to do in an endo department.
imperialendo.co.uk/Bible201...
Wow! Thank you. so much information.
I tried Holy Basil and (like you at first) it did nothing. But I never went over the allowed dosis, so might be worth a try to up the dosage to see if it works?
I read up about Cushings, and I seem to have very few symptoms (other than fatigue and irritability, but then I have hypothyroidism and am peri-menopausal, so it could be anything, But it sounds like i should make sure I have a test and rule it out for sure!
I did have the 8am cortisol test and that was well within range, ie normal. I also had the ACTH test and that was normal. It just seems that the saliva test is sky high, and getting worse.
Problem is that the saliva test isn’t recognised by the NHS… i wonder if they will do any tests… with central hypothyroidism, it took my 4 years and a private Endo to make a diagnosis. (No I am not depressed, I wasn’t menopausal, i am not a hypochondriac etc etc,)
I think I’ll ask my Endo for an appointment and get him to try some of the tests tests in the Endocrine Bible (what a great link, thank you!)
I did have the 8am cortisol test and that was well within range, ie normal. I also had the ACTH test and that was normal.
Okay, so if your saliva cortisol is very high, and your blood cortisol and ACTH are in range and apparently normal, have you had a Short Synacthen test? Is that what you mean by the ACTH test?
According to pages 68 - 70 of the Endocrine Bible which discuss the Short Synacthen Test both Cortisol and ACTH should be tested during the Short Synacthen test. But many hospitals/endos don't bother with the ACTH part of the test.
METHOD
1. 0900h: take 7 ml blood for cortisol (red or yellow top Vacutainer) and ACTH (purple top, on ice to lab immediately).
2. Give 250 micrograms tetracosactride i.m. (ideally) or i.v.
3. 0930h: Take 3 ml blood for cortisol.
4. 1000h: Take 3 ml blood for cortisol.
5. For the diagnosis of congenital adrenal hyperplasia the samples taken for cortisol are also analysed for 17-OH progesterone to exclude 21-hydroxylase deficiency. In some cases 17-OH pregnenolone is measured to differentiate between 21-OH and 3ß-HSD deficiency.
Note : tetracosactride is an artificial version of ACTH.
bnf.nice.org.uk/drugs/tetra...
en.wikipedia.org/wiki/Adren...
If you look at this link :
en.wikipedia.org/wiki/Adren...
Primary Adrenal Insufficiency is caused by malfunctioning adrenal glands and that is tested by checking cortisol.
Secondary Adrenal Insufficiency is caused by a malfunctioning pituitary or hypothalamus and is tested by checking ACTH. (The patient may have perfectly healthy adrenal glands).
Tertiary Adrenal Insufficiency is caused by a malfunctioning hypothalamus and is tested by checking corticotropin-releasing hormone. (The patient may have perfectly healthy adrenal glands).
If doctors do the SST without checking ACTH then they can't diagnose secondary adrenal insufficiency. And the reason they don't test it is (apparently) because "Oh, its very rare", with the implication being that the patient either isn't sick enough to have this problem or they just aren't interesting enough. And of course they want to reduce the number of tests they do to save money. (My cynicism about doctors knows no bounds.)
Since you have a dodgy pituitary your ACTH might not be normal - but who knows.
Hello Humanbean
Very good prompt! When they did the Synacthen test, they couldn’t do the ACTH test as the technicians had ‘gone’ home for the evening. 🙄 so I will get them to do that.
I am with you re doctors. Spending 4 years on HRT and having antidepressants pushed on me when I didn’t need either, overweight with brain fog, having to give up my job and find another one, and generally being miserable, have taught me to question them at every stage!
Thank you so much!
Are you telling me they did an SST late in the afternoon? And thought that was a good idea? That sounds weird and pointless to me. According to the Endocrine Bible it should be done as close to 9am as possible. So, do you know why they did it late in the day?
You said your SST test result was normal. But how can they tell if it is normal if they did it at completely the wrong time of day? Do you know the actual result for your cortisol.
I'm just baffled. I really don't understand what their plan was and what they were testing for.
This is simply a wild guess, so take it with a pinch of salt. But if your blood cortisol levels are really, truly "normal" (but I'm not sure how you would know if it was tested at the wrong time of day) and your saliva cortisol is far too high, then it suggests to me that you have the right amount of cortisol, but it is getting separated from its transport proteins in greater quantities than is healthy.
Since another member had the opposite problem - "normal" blood cortisol but very low saliva cortisol - and fixed it with T3, I wonder if your problem might be fixed with T3 too? It's a very long shot, so you might want to ignore it. And I don't even know if you've ever had T3 measured.
Hello
re the timing of the synacthen test, I had no idea about timings etc! And by the sounds of it, neither did they 😱
My Endo has come back to me and said:
“Synacthen test is to look for low cortisol levels or adrenal insufficiency. Will not be useful when cortisol levels are high. Tests that may be needed are dexamethasone suppression test, pituitary function test and 24 hour urinary cortisol”
What are your views on this please?
I hear you re T3, but I really didn’t get on with T3 only and am much better on NDT (Efra), which I am on now.
Best
Synacthen test is to look for low cortisol levels or adrenal insufficiency
I agree with that.
If your GP (not the endo) had just done a simple blood test for cortisol between 8.30am - 9am it ought to be at or close to the highest level it ever gets to.
This is worth reading :
labtestsonline.org.uk/tests...
If the result was low in range or under range then testing for hypocortisolism or Addison's Disease with a properly carried out SST would be worth it. i.e. Testing at the right time, and also testing ACTH as well as cortisol.
If the blood cortisol result was well within range, it probably wouldn't be justified to do an SST or test for Cushing's. But the saliva test is justified because it can find problems that a "normal" blood cortisol test result doesn't show up.
According to the Endocrine Bible on the Short Synacthen Test :
CONTRAINDICATIONS
Definitely not required for assessment of hypoadrenalism if random cortisol >450 nmol/L.
If a random cortisol >400 nmol/L, patients are very likely to pass the test, and some feel that in this circumstance, the test is not usually warranted.
If the result of an ordinary cortisol blood test is high in range or over the range then it suggests that testing for Cushings may be justified.
The Endocrine Bible describes the testing required for Cushing's and various other related tests from pages 25 to 34, and some of the things that the endo has mentioned [Tests that may be needed are dexamethasone suppression test, pituitary function test and 24 hour urinary cortisol] will be described in that document somewhere I'm sure.
I hear you re T3, but I really didn’t get on with T3 only and am much better on NDT (Efra), which I am on now.
I wasn't suggesting you go on T3 only, just that you might need to include some T3 in your thyroid treatment. But if you are on NDT you already take some T3, so that is the end of that idea.
thank you.
I will read up on the tests for Cushings. The symptoms just don’t chime with me. But then it does say that many sufferers don’t have many symptoms…
hello human beanI won’t be able to see my Endo until after Xmas, and any tests will be even further away. I’m keen to get started on the Seriphos or try Holly basil again. Do you know long it takes to leave your system, if I have to stop taking that before a test?And do you know if you can take that and DHEA?thank you!
Licorice Root is meant to be very good at reducing cortisol.
It also raises blood pressure in some people, so anyone taking it should be cautious.
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