Hi AllIm wondering if any of you knowledge people can interpret my recent Regenerus Lab saliva adrenal hormone report and give me advice on way forward. Sorry I can't upload copy of report as I only have my mobile so please bare with me as I type results:
8am result 3.7nmol (Low)
( Optimal range 14-25)
(Ref range 7-30)
Noon result 2.5nmol (Borderline)
(Optimal range 5-10)
(Ref range 2.1-14)
Evening result. 2.8nmol
((Optimal range 2-5)
(Ref range 1.5-8)
Night result. 1.2nmol
(Optimal range 1-4)
(Ref range 0.33-7)
DHEA 144pg/ml
(Ref range 106-300)
Report Comment:
Diurnal Cortisol pattern is consistent with established (phase 3) HPA axis adrenal gland dysfunction.
The 8am result contradicts a recent medichecks serum cortisol result which was shown to be high which I found difficult to believe given my morning low moods and complete lack of energy so glad I got this test done to clarify this as saliva result is more in keeping with my daily symptoms.
Any advice on way forward and possible supplements would be much appreciated.
I'm having first endo appt in a few days so want to be prepared to discuss results.
Other factors
I have hashimotos and sjogrens syndrome.
Currently doing MMA test for possible B12 deficiency
Many thanks for help
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Hollybushroad
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If you can see the graph on your mobile then you just need to learn to do a screenshot with your phone. Well worth getting to grips with technology little by little.
I would take this along to your first meeting and hopefully they will organise a Short Synacthen Test, they might dismiss your results if you have a recent Blood Serum Cortisol on record as some are very resistant to acknowledge the saliva test even though serum cortisol is total rather than free🤷♀️
I've been trying to send the screenshot of my results but don't know what I'm doing wrong as they won't come up on my post.As I previously mentioned I done a medichecks blood cortisol test 2 weeks prior to saliva test. It showed contradictory result:
The blood test shows 'total' cortisol and the saliva test show 'free' which is the available bit.
It is being a bit temperamental, are you trying to add as a comment?.. this is usually easier than adding to main post... I usually use the snipping tool rather than adding a photo 🤷♀️but just tried adding a snip of it and it binned me out 😬
From what I gather the NHS don't tend to treat you unless your adrenals stop working well enough ( Addison's Disease Primal Adrenal Insufficiency/ Hypoadrenalism)... your's does seem very low so aught to investigate..... but you can get help from a functional Dr or self treat... plenty of rest, glandular support / hydrocortisone etc
Need to treat both thyroid and adrenals really, lets hope you have found a good one! I've done the exhausted, apathetic phase I'm getting along well with a little dose of hydrocortisone having been using glandular to start with 🤞he might prefer Pregnenolone, at least your DHEA isn't too dire 😅
I've used Thorne Adrenal Cortex, Klaire Labs and Adrenavive, the suggestion is to go for a cortex only one as Whole Adrenal contains the medulla and adrenalin which suits some and not others, avoid the ones that add adaptogens or other things 😉
I'd also recommend Vit C and salt which is what the adrenals run on, an adrenal cocktail with orange juice, salt and potassium (cream of tartar) is surprisingly nice when you start to flag
Worth having a look back at your records to see what your sodium and potassium levels are like
Thank you so much for your very helpful advice. Think I will order the Thorne brand as they have a good record for quality supplements.Never heard of the adrenal cocktail 🤔.....can you buy cream of Tartar?
Sorry for all the questions but I really didn't expect for Regenerus test to flag up anything major and now I'm really concerned 😟
Thanks will have a look out for it.....was hoping I could buy it...thought possibly you meant me having to make it up myself as I can barely cook the basics lately😀Just feel so exhausted 🥱
If I started supplementing now would it skew further testing by endo? Think you said next step could possibly be ACTH test?
Yes, I did the same test, if you click on my name it will take you to my home page and all my previous ramblings... I bought my own HC having read Dr Myhills and Dr Peatfields books
In the past 4 or 5 days there have been multiple glitches with making a basic post and also adding an image/photo of whatever type. The powers that be are onto it but no solutions yet so just keep trying.
Thanks jaydee will keep at it😁 just anxious about my results because I was assuming alot of my symptoms were related to my hashimotos but this result is making me question if the thyroid is really the root cause of my symptoms ???
The 8am result contradicts a recent medichecks serum cortisol result which was shown to be high which I found difficult to believe given my morning low moods and complete lack of energy so glad I got this test done to clarify this as saliva result is more in keeping with my daily symptoms.
I described the difference between blood cortisol and saliva cortisol in a reply to another member earlier today, which might help you.
Another member of the forum McPammy had dreadful saliva cortisol results but good results for blood cortisol. Improving her T3 fixed her cortisol problem, but I don't know enough to say what might be causing the issues of low saliva cortisol if it isn't low T3.
and I think her issues with low saliva cortisol and okay blood cortisol happened four or five years ago - but it may be a bit of a hunt to find where she discussed it.
It's possible your low in range T3 is causing issues with your cortisol. But be careful. You can't say to a doctor that you have "adrenal insufficiency" based on a saliva test, even though I can see how awful your saliva cortisol is. But you do need to be tested (urgently in my untrained, non-medical opinion) for Adrenal Insufficiency.
The likely sequence of events if a doctor did that is :
a) Do a blood cortisol test at 9am. If it is low they should refer you urgently to endocrinology for a Short Synacthen Test (SST).
b) If you failed the SST i.e. you don't produce enough cortisol in response to the ACTH you get injected with during the test then you will be given further tests and may be given a diagnosis of Addison's Disease, and would need to be treated with steroids for the rest of your life.
or
c) If you passed the SST i.e. you do produce enough cortisol in response to the ACTH you get injected with during the test then you will probably be discharged.
The problem is that "HPA Axis Dysfunction" as mentioned on your results is actually a description used in alternative medicine or functional medicine, and ordinary doctors in the NHS don't take it seriously. They don't care if your active cortisol levels are really low. They only want to know if your adrenal glands produce enough (inactive) cortisol to satisfy their tests.
Read these links that describe "HPA Axis Dysfunction" and how to treat it :
They are absolutely typical of "blame the patient" "you're stressed" stuff you get from non-doctors. The first one is involved in supplying "beauty treatments" and isn't a doctor. The second and third links come from someone who is an MD but her links still blame the patient for being "stressed" and not getting enough sleep, and she gives "Natural ways to cope with stress". It's utterly useless for many people with severe cortisol problems.
Since your problem is severe enough that it is unlikely to respond to all that "blame the patient/you're stressed stuff", you may need to find a doctor who will prescribe you T3 or you may need to buy it yourself from abroad.
My reply above started glitching as I was typing so I posted it before I was finished to stop it from disappearing.
There is another possibility to help with your cortisol, but it is a terrible idea in my opinion. People who can't create cortisol because of Addison's Disease have to be supplied it in tablet form.
However, body builders buy and take steroids illegally. This is a very, very bad idea in my opinion. Steroids are controlled drugs in the UK. Anyone who takes steroids reduces the output of their own adrenal glands. And once the output has reduced it never comes back again. So please don't take steroids unless they have been prescribed by a doctor after proper testing.
Hi Humanbean thanks again for your detailed reply and links....I'm still working my way through them....hard going with all my brain fog and poor focus😭Re my private endo appt tomorrow......surely if they use saliva cortisol testing in NHS would he not take some notice of my Regenerus result???
If he decided to do a blood Cortisol test it may very well come back high as happened with my medichecks test:
607nmolL (166-507)
I understand what your saying about the active and inactive blood Cortisol and makes total sense (bit like the the serum b12 not giving a true picture and
active B12 test being more accurate I suppose)
Just worried I won't get the treatment I may (or maybe not) need but will see what he has to say.
He comes highly recommended...sounds nearly too good to be true as far as endos go..... apparently he treats patients and their symptoms rather than just solely relying on lab results which is encouraging but will see what happens tomorrow.
I dare say on reflection I have had adrenal problems for over 30 years. (I'm 56)
I have had unexplained horrendous night sweats since my early twenties.
Also awful morning depression as I call it😟 although it's not a clinical diagnosis in itself ....just my own wee term. Awful hard time getting out of bed....brain fatigue and low mood and energy however once I got up and going after about a couple of hrs or so the feeling would lift and I would be okay and ready to face the day ahead. Would never say I was just being lazy cos once I got going I would feel motivated and would be "on the go" for rest of day. So very much diurnal in nature.
However since 2017 things have deteriorated and I have been constantly depressed to the point I took early retirement from my work. I am totally treatment resistant as far as antidepressants go and always felt there was a big biological component to my depression.....I'm also really concerned that all the various trials of antidepressants have had a further negative impact on my adrenals.
However I find my symptoms confusing as some are suggestive of low cortisol but others point towards high🤔
Low morning cortisol would possibly explain my morning depression as I have called it for years😀
However to me the night sweats are more suggestive of high cortisol??
I can't get over to sleep at night.....( I have become totally addicted to zopiclone). It's not that I feel mentally stressed....it all feels very physical.
I have pounding heart although my pulse is usually a steady 70bpm. My BP is fine also 120/70.
Terrible muscle tension.
My body feels generally "reved up" most of the day but my mind is anything but "reved up"....infact I feel " nothing" completely apathetic about life in general and devoid of any emotion. I don't worry about anything even things I should be genuinely worried about eg paying the bills; mortgage etc.
So in summary as I mentioned my body feels physically under great stress but my mind is saying I feel anything but stressed if that makes sense.....sorry I'm going of a tangent here😁I'm just so confused and fearful of not getting treatment.for my adrenals...not saying I definitely do but my symptoms do feel very physical as opposed to putting it down to stress and him possibly patronisingly telling me to make lifestyle changes....have done the whole yoga mindfulness meditation and gluten free diet stuff with not much benefit 😞
I wouldn't even consider self medicating with steroids.... although i am desperate for help that would be definitely a step too far for me!!
However I'm not totally ruling out self medicating with T3 if endo dismisses it as an option.
I'm sorry my post is so lengthy....I'm not very good at bullet points and tend to waffle 🧇
My endo appt is for 30mims but I reckon I should have requested a double hour long slot as I have so many questions written down🤣
Thank you so much again for all your very helpful advice😊
Hi Human BeanThanks for your reply a few days ago. I have since had my first endo appt and whilst he did make a comment about my Regenerus saliva cortisol test being an almost flat line he was quick to say syncathen test was gold standard test for adrenal insufficiency . I have since had the sync test done but won't get results until I see him again 8 wks time. He also started me on 5cgms T3. Do you think I could start on an adrenal glandular supplement now that sync test is done and awaiting results? It's probably not ideal starting glandular and T3 at same time but due to just recently receiving my Regenerus results it's just been bad timing. Some books say you need to work on your adrenals before starting T3 and others seem to suggest that T3 can help the adrenal problems. It's all very confusing.
I have since had the sync test done but won't get results until I see him again 8 wks time.
I think that suggests that you aren't likely to get a diagnosis of adrenal insufficiency. If it was a possible diagnosis they ought to have started treating you immediately because AI is potentially fatal. But the fact they've left you to rot for 8 weeks suggests your results from the SST were acceptable to the doctors.
Do you think I could start on an adrenal glandular supplement now that sync test is done and awaiting results?
Yes, I think you could.
I only know about Adrenavive, but I'm sure there must be other options. You'd have to shop around for the best prices but it would be a good idea to ask the forum for any other suggestions.
There are some suggestions for adrenal support on the following link but I think several of them would only be available from the USA - but take note of the warnings about things that lower cortisol that you should avoid e.g. avoid adaptogens :
iron saturation has to be at 30% to successfully treat with T3, but only 25% if your dose of T3 is low. I don't know anyone who has ever mentioned this before in relation to T3, and I didn't know it when I first started taking T3. My saturation was 23.8% when I started taking T3 it but admittedly I had other health problems besides thyroid issues at the time, and I was just desperate.
Yes I'm assuming they would have contacted me if it was life threatening ( however it's still no comfort to me when I have to wait 8 wks for result) it was done privately but I assume they would act as promptly on results as NHS would (or should hopefully 😕)
In hindsight I think my adrenals have been very slowly packing in for yrs ( probably made worse by a very stressful life event in 2014) I worry also that with being on different antidepressants over recent yrs has actually worsened my adrenal function ie in that they reduce norapenephrine or noradrenaline ( not sure which🤔) maybe I'm wrong about that?
Re supplements:
Yes I will post on forum re adrenal supplements. I know Dr P used to recommend the Nutri brand.
Do you know if the adrenavive 1, 11 and 111 are selected on the basis of what stage your adrenal dysfunction is at ( I'm phase 3) it confuses me when advertising supplements some mention "balancing adrenals" surely they either increase or decrease cortisol production🤔? I certainly don't want anything that's gonna decrease my cortisol levels further.
Re iron sats: my last results weren't great in June . I inadvertently overlapped on my tests but medichecks said they were 28 % however Monitor My Health showed 18% ....both done same week so suppose I'm not quite the best candidate for T3 at the mo.
But I've waited so long to get it prescribed so have to go with it.
I haven't actually started it yet as still waiting on endo organising private script with Roseway Pharmacy.
He advised taking the 5mcgms in The Morning before getting up. I was thinking perhaps I should split it into doses of 2.5mcgms to start with just to see if my body can tolerate it. Would you have any advice on this?
Can I take it at same time as my levo which I also take an hr before getting up in the . morning?
Sorry for all the questions and I really appreciate your guidance
I'm not sure if you personally have had syncathen test done but do you know if turnaround time for results is same as routine bloods or does it take longer?
[ Image removed by admin as it had personal identification details visible. Please cut off or blank out name, address, etc. Would also probably be better split across two replies. ]
Hi EeoyreYes I made a terrible mistake with that. I had terrible trouble getting graph posted in the first place and think I lost concentration and my poor brain function just took over 😞
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