I had my cortisol tested but I and confused by the results. why does it go up so high late in the day. I did end up with a migraine that day, which I rarely have , and was violently sick just before the last sample could that be the reason?
can anyone help me make sense of this.
MY last results were a while back in May 2022
B12 and folate: 614 (191-663pg/ml)
Folate(serum) 9.5 (ug4.8-31.3)
Cortisol 622 mol/L.
FT4 12.1 (11-22 pool/L)
TSH 0.07(0.27-4,2 ml/L)
FT3 4.89 (3.1-6.8 pool/L)
I can't find my last vitamin D result
I take a 100mg Levo and 15mcg T3 (Thybon)
I have just started on HRT to help with symptoms but I am now wondering it it is low adrenals that give these symptoms. I was not on HRT when this test was taken. I don't take any steroids.
I supplement on and off with Bit D/B Complex/Vit C/Zinc?Magnesium/ and eat one or 2 Brazil nuts
Written by
Yoll
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Cortisol measured in blood and cortisol measured in saliva are not measuring the same thing. Having a good level in blood and a poor level in saliva is not unknown on the forum.
Cortisol and other hormones (including thyroid hormones) are carried around the blood stream attached to transport proteins. The transport proteins differ depending on the hormone being carried.
Hormones attached to transport proteins are inactive. To become active, and to get into cells and do their jobs, they must be separated from their transport hormones.
You may be familiar with people being tested for Total T3 and/or Free T3. The difference between the two is :
Total T3 = T3 attached to transport proteins + T3 unattached to transport proteins.
Free T3 = T3 that is unattached to transport proteins.
Hormones attached to transport proteins are often referred to as being "bound".
Hormones unattached to transport proteins are often referred to as being "unbound".
On this forum we encourage people to get Free T4 and Free T3 measured rather than Total T4 and Total T3 because it tells you what the body can make use of.
Cortisol transport works in exactly the same way as T4 and T3.
Blood cortisol could be called "Total Cortisol" (but this terminology is never used - it is usually referred to as "Bound Cortisol").
Saliva Cortisol could be called "Free Cortisol" (but this terminology is never used - it is usually referred to as "Unbound Cortisol").
Saliva Cortisol is the one that patients often get tested because it can give you information on the circadian rhythm of cortisol (which is important) rather than blood cortisol which only tells you what cortisol is doing at one point in the day, and tells you nothing about how much active cortisol you have or how levels change during the day.
On the other hand, GPs use blood cortisol because it gives them just one result and is, for them, much simpler.
Obviously there is some biochemical process involved in separating hormones from their transport proteins - but unfortunately I don't know what it is. It is probably because I don't know the terminology to search for.
One member of the forum McPammy had the same problem as you. Her blood cortisol was fine but her saliva cortisol was really low.
If blood cortisol is fine then the adrenal glands are working adequately and the patient doesn't have Addison's Disease or Hypocortisolism or Adrenal Insufficiency.
Unfortunately, doctors don't take the next step and check levels of saliva cortisol and find out that the patient has too little active cortisol.
McPammy found out what improved her saliva cortisol - her Free T3 was too low and when she raised her T3 to much better levels her saliva cortisol rose to normal levels.
The frustrating thing is that I'm sure that there must be several other factors involved in separating hormones from their transport proteins apart from T3 - probably vitamins and minerals must be important. But I can't find out what that process is and what other factors must be involved.
...
TSH 0.07(0.27-4,2 ml/L)
FT4 12.1 (11-22 pool/L) 10% through the range
FT3 4.89 (3.1-6.8 pool/L) 48.38% through the range
It is a common finding that when the thyroid starts to fail the body will frantically convert T4 to as much T3 as possible. This seems to be what has happened with your results, although I could be wrong. I'm not sure what the timeline is of your results and your thyroid hormone intake.
The results you had above are very poor, and improving both Free T4 and Free T3 would probably help your saliva cortisol a lot.
...
Oh, and I forgot to mention... Your migraine and vomiting probably did affect your last saliva result. Being in pain tends to raise cortisol a lot.
Thank you so much, it did wonder if it would affect it, I did raise my T4 intake from 75 to 100 after those results, I'll try and get them retested soon.
thank you for all the info it is all a lot clearer, about how it works. Now I am wondering if I should have address the low cortisol before the HRT. As I had a small breast cancer 10 years ago they are not to keen on me taking it.
I'll investigate, they and work out what I can do to support my adrenals.
The HRT is not been prescribe for low cortisol but for the symptoms I have that are similar to hypothyroid,
I did suggest it could adrenal deficiency to the consultants, she just said "not my domain". Now I have discovered it could also be low cortisol, I feel I need to address this too.
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