Regenerus cortisol results - help interpreting

[seveneleven]

Hi, got my Regenerus cortisol and DHEA results back (only took a week so very quick). I'd expected low cortisol, but it's a bit more than I thought. DHEA just in range. Surprised that night cortisol was in range, but then it probably used to be very high. I had a period of about 7 years of extreme stress and anxiety for various reasons, undereating, etc. and had insomnia for a long time.

I've seen a Chinese doctor for the last year and had acupuncture and herbs, and sleep is a lot better now than it used to be, only rarely getting that night-time 'high'. I'm a bit of a zombie in the mornings and afternoons though (which I guess is all day really..??). My herbs usually have liquorice in them, which I understand is sometimes used in adrenal treatment, so maybe why it's helped?

Can anyone help me make sense of this? I have Hashimoto's but not yet on Levo yet, hopefully starting next week after seeing doctor. What might the results mean for how I go ahead with thyroid treatment? Adrenal cortex supplementing? Could there be conversion issues if I don't address cortisol first?

[SeasideSusie Remembering]

seveneleven

I would take these results to your GP, they are very low and maybe suggest testing for Addison's disease. I don't think this is a DIY fix by self supplementing.

[seveneleven in reply to SeasideSusie]

Thanks, think I was under the impression all readings would have to be low to suggest Addison's. I have an NHS blood test (repeat test for thyroid) on Wednesday morning, so I'll try and get the GP to add serum cortisol to it.

[FancyPants54 in reply to seveneleven]

Serum cortisol is not the test you need. You need to persuade your GP to test you for Addisons properly.

[seveneleven in reply to FancyPants54]

What test would I need? Judging from how the thyroid non-diagnosis is going, she'll only follow the guidelines, which seem to say serum morning cortisol first, then refer to endo for further testing if below range.

[FancyPants54 in reply to seveneleven]

Well perhaps that's how she will do it, but I've had the dexamethasone test to rule it out. You have a blood draw one day, take some medication at a specific time and then have another blood draw the next day so that they can see if you have a response. I see an endo. privately and he asked the GP to run that test, so perhaps you will have to go the long way around. Shame.

I'd avoid starting thyroid meds until you know what's going on with this cortisol. I think you will really struggle if you start it.

[seveneleven in reply to FancyPants54]

Mm, she's not inclined to pay attention to private tests, so don't even know if she'll agree to add serum cortisol to be honest, but I've sent them and requested. I wanted to start thyroid meds asap, but tested cortisol because I suspected it would be low-ish given what adrenals went through, and read the two together can go badly. Based on how I've felt, I've probably been in this stage of dysfunction for a good couple of years since the extreme stress lifted.

[SlowDragon Administrator]

Request referral to endocrinologist for testing for Addison’s disease

Or self refer

Email Thyroid U.K. for list of thyroid specialist endocrinologists and doctors

[e-mail]

Meanwhile presumably you are working on improving low vitamin levels

[seveneleven in reply to SlowDragon]

Thanks, will look into private endo . If serum cortisol is also low, GP will probably agree to refer, but wait times are usually insane here, so would likely go private anyway just to get the right test done. I did have an appointment booked at the private thyroid clinic next week but have postponed as she doesn't do endo testing, and seems like this all needs sorting out before thyroid meds. Yep, on supplements trying to improve low vitamin levels.

[humanbean]

In your shoes I would be worried about Addison's Disease.

Just so you can compare, this thread discusses the results of someone who got a saliva cortisol test and it led on to her getting a diagnosis of Addison's Disease. Note that her GP thought initially that her saliva results "weren't that bad", which I still think was shocking.

healthunlocked.com/thyroidu...

If your results aren't as bad as the author of that thread it doesn't mean that you shouldn't be tested, because your results are awful.

[seveneleven in reply to humanbean]

Thank you humanbean, that's a really useful thread. Yes have asked GP to add cortisol to bloods already booked in for early Wednesday morning. Probably it's just chronic HPA dysfunction because I don't have a lot of the symptoms of Addison's, just exhausted and dark circles under eyes, but that overlaps with thyroid. I do eat a lot of salt though because I have POTs so struggle to hold onto water. So we'll see. Really hoping it's not AD...was saying to someone this morning it would be great if the body could just stick to one thing wrong at a time!

[humanbean in reply to seveneleven]

If it turns out you definitely don't have Addison's then some generic info about how to improve the health of the adrenals can be found in this thread. I wouldn't start doing any of the things suggested until you get properly tested for Addison's :

healthunlocked.com/thyroidu...

It is an old thread and some of the links may be broken.

For future reference, this document - the Endocrine Bible - is well worth knowing about.

imperialendo.co.uk/Bible201...

It gives info on all the testing - preparation, methods, interpretation of results etc - that a hospital endocrinology department is likely to do.

The Short Synacthen Test (SST) is described on pages 68 - 70.

Be aware that doctors often only do a partial SST. They don't bother measuring ACTH. This means, as far as I know, that they can only reliably diagnose Primary Adrenal Insufficiency, but not Secondary or Tertiary. The different types are described here :

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

Good luck.

[seveneleven in reply to humanbean]

Thanks, will keep all this in mind. I am curious about cortisol being so low but DHEA being 'normal'/in range (albeit lower-middle) - it seems to be more usual to have both low? Only info I've found is a vague thought from Dr Myhill that maybe it means adrenals/HPA axis is starting or trying to recover, but nothing to support that or what it would mean. Have you come across any resources on this combo? Obviously still getting tested for Addison's, just curious.