Could anyone help please with my adrenal cortisol results?
I posted it recently as part of another thread (healthunlocked.com/thyroidu... but think it might have got lost in the mix.
I have low cortisol, which I’m not surprised at. I have reduced my levo dose from 100 to 50mcg for the last four days and have now put myself on 1 x 50mg Thorne Adrenal Cortex morning and lunch time.
My questions are:
Looking at my results, what is DHEA telling you?
How long should I stay on this dose of Thorne ACE for before raising it?
If I raise it, what should be the next dose?
Is there a protocol members have used which they found helpful? I see STTM, Paul Robinson and Barry Peatfield mentioned but don’t know anything about these.
Anything else such as diet to know?
I plan to go back to 100mcg levo from tomorrow.
Thanks very much for your help.
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Sneedle
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Sneedle Bless you that morning cortisol is low. Do you know your 9am blood cortisol?
As you are 54 with sufficient DHEA my immediate question would be are you supplementing any type of HRT? Have you been through menopause?
My experience with adrenal issues re. Diet is that balancing your blood sugar is non-negotiable. I never eat a carb unless it’s followed by protein and vice versa.
I don’t know how much improvement you’ll get from 100mg Thorne. I have written all of the suggested protocols by those you mention (Barry, STTM and Paul R) in my bio
I replied below to your question about my HRT and various other things, but you may not have seen it.
I've been looking at your Bio and it's very helpful especially the summaries of the various adrenal treatment approaches. And some of your replies in threads too about supplements - I'm so glad you have taken the time and energy to put your experiences on here it's awesome👍😀
I've decided to try the STTM protocol as I like the idea of multiple doses supporting me all the way through the day.
My DHEA seems OK and my AM cortisol blood test also, at 509 nmol (79% through range)- but unbound cortisol is just so low as you say.
Would you suggest starting with the exact same doses of ACE as suggested by STTM ie. first dose 150mg, then 100mg etc.
Or should I go higher? Or is it a low and slow business?
I plan on using up the Thorne ACE I have so will be taking 3 x 50mg first thing, etc.
Do you know if there is a difference in Thorne and the other brands, Adrenavive and Nutricology for example? Other than the size of the dose I mean. Adrenavive gets a lot of mentions here.
I’m so glad you find the bio helpful - it is all the information I wish I’d had 3 years ago!
I also went with STTM for adrenals, it is the approach with the most precision. I would take your waking and 3pm BBT before you start the ACE, so you have a baseline, BP too if you can fit that in. The deal with those brands is that Adrenevive can make people’s tummies funny, Thorne is probably best but is v expensive. You have to play around with them and see how they feel. I believe the lowest ACE adrenevive does is 150mg, so could only ever be used for the morning dose. Ideally you begin on the 150,100,50,50 straight off the bat and use DATS, more information on that here - rt3-adrenals.org/temperatur...
Depending on your current thyroid dose you may experience increased uptake due to the increase in cortisol so watch yourself for overstimulation.
A 509 blood cortisol is good assuming it is the usual range, so at least we know your adrenals are functioning xx
I'll look up the costs and figure it all out. I'm not sure how you go about doing the smaller doses of 100 and 50 with the Adrenavive or any apart from the Thorne - do people break capsules in half and chow down the gland powder euuuuurgh?!
Also have you come across anyone starting the morning with say Adrenavive, then using a different brand eg. Thorne for the smaller doses? Or would that risk great confusion?
I'm not sure about a usual range for the blood cortisol, I guess I'll have to hope it's about 350-550 which seems to be a common NHS range!
Thanks for your help and for using the word 'implore' when urging me to do the Regenerus test - it got through to me 😀 - and you were totally right! X
🤣🤣 oh my god I’m sorry for being such a drama queen 🙈 but I’m glad you did it!
If it were me I would be happy to mix brands as long as I were consistent with it. Small capsules you need to dose on Thorne to my knowledge no one else does 50mg.
No it was all good I appreciated the sentiment and went with it😄
I am thinking to start with Adrenavive first thing and then use Thorne for smaller doses- yes good point to be consistent. As you say, I can only try various brands and see what happens. I'll keep a log and not chop and change too much though.
Special Message for TiggerMe - I didn't reply to myself this time😅
That sounds great Sneedle, I really recommend doing DATS, they’re a drag but as we can’t do adrenal testing when on adrenal supps they are a good way to get a handle on whether you need more or not x
Wow... lowest I think I've seen! You are likely going to need something a little stronger to lift you up! Your DHEA is pretty good which means your other hormones shouldn't have panned as well 😅
Have you had blood serum tests done by your GP? I'm thinking a Short Synathen Test is in order!
I last had a proper period late spring last year. But in between then andnow, I have a few times had spotting or a sort of in between spotting anfd proper period. Very confusing.
I've had the mirena coil for 2 years and 200mcg patches oestrogen since late lasy year. I'm wondering if this is too high?
Two days ago I saw a lovely lady doctor who examined me (because last load of spotting was more than usual and for persistent dragging feeling in lower abdomen) and is asking for ultrasound to rule out fibroids and other things. I'll also be doing swabs and urine testing but she doesn't think there are any obvious issues and all tissues look healthy.
My morning cortisol last wednesday was 509 nmol/L and the note said >450 nmol does not exclude adrenal insufficiency. The GP who ordered it has not got back to me.
Do you think I should try a stronger dose of glandular ie Klaire, Adrenavive or similar?
My blood sugar is generally well controlled - a few years ago I started fasting after about 8pm and don't eat breakfast before 10am, nor do I feel hungry. It works well for me, so that's something I feel I've got right! I do eat protein and carbs together and ususally make sure I have plenty of meat, or I feel dodgy.
I'll look at your bio dontforgetcortisol and choose an approach. I'm a bit sad to find out I'm one of the lowest you've seen Eeyore😔 but to be honest I'm not really surprised as I've lived with relentless stressful family situations with ill kids for about eight years now. Plus my own very wobbly emotional health which pre-dated all that. On an under replaced levo dose I now know. My adrenals are pickled.
My aim is to feel well enough to get to my therapy lady who is very good and I feel I can get somewhere with, I had to stop about two months ago as I was too unwell. I know I need to get back there.
That is quite a big dose of oestrogen... standard patches are 50mcg... though being transdermal it shouldn't effect your free cortisol levels but something is locking it up as your blood serum shows total cortisol is very good? Your morning blood cortisol is twice the level of mine!
You could swap to Lenzetto and then you can control the dosing more easily and experiment?... though you'd need to use something like 7 squirts to get to 200mcg I think and it's only licensed for 3 which is nonsense 🙄
Thanks for that Eeyore, that's very helpful as I've not thought of cortisol being 'locked up'. Hmm.What does hrt do to cortisol I wonder? If anything. 🤔
Or could it be like active and inactive B12, where my early morning cortisol might be high, but the useable part of it is actually very small?
There is certainly some connection with oral oestrogen raising CBG levels in the HPA axis which I think raises serum cortisol but also binds it so presumably this is the difference between 'total' blood and 'free' saliva.... so yes very like B12
But it's beyond my brain capacity, I think I'll tag humanbean as the knowledgeable one on this subject?
Thank you for the thinking, I know what you mean about the Brain not playing along. 🤯A good idea to reduce the dose and see what changes. I can cut up the patches easily to make 150. It was the gp who suggested going up to 200 a few months ago when I was telling her about the fatigue and unwell feeling...but it was possibly low cortisol. Or high, which has now crashed.
😱😬indeed I don't need that locking up and binding shenanigans, I've been wondering for a while about the 200 as I've felt it hasn't helped so the scissors are coming out and I'll have a think about asking for lenzetto.😀👍
oh wow good for you finding this out, validating isn’t it having a test that confirms your symptoms finally! I’ll be very interested to hear what you learn about adrenal support and supplements and what works for you 🤗🌱
It is good finding out, but at the same time a bit scary as I can't change certain contributory factors eg. my daughter's ill health for one (I find it sends my worry sky high which is no good whatsoever for the poor adrenals). But I have to find a way to improve, so I can get to therapy again. You're right, it is validating. Maybe I'll take a moment to let that sink in instead of rushing on to the next thing...I reckon slowing down my fear response to everything and anything is going to be a big part of recovery. 😊🌺🌺
Hi, you haven't replied to samking5 but to yourself so the notification won't flag them up... the tag might 🤗
I seem to remember liquorice root had some downsides... like raising blood pressure, blood glucose and hormone instability off the top of my head... but you'd need to read up on it as I discarded it so have emptied the information out of my head 🙃
hi sorry for delay. I started taking it because I had this issue with getting easily dehydrated which caused ft4 levels to spike making me hyper. I discovered that licorice increases water retention by increasing aldosterone levels. I have found it incredibly effective to that end, been in hot enviroments a lot last month and have found that eating even a quarter stick of licorice (I just bought on amazon) is enough to maintain blood volume even without drinking water + salt like crazy.
However I have also been feeling generally better despite discovering that my results came back quite hypo, and as my cortisol saliva test was low normal, and licorice also increases cortisol levels, I beleive that it is also helping me to feel more energetic and just generally good. still need to play around with thyroid dose, gonna add some t3 now too, but its really been the greatest supplement discovery ive ever made, a truly magic herb for me.
My endo said he wasnt worried about me taking it daily or that it would induce some kind of adrenal issue further down the line, that is it just an adrenal support as long as I keep the dose reasonable.
I’ve been litterally chewing on licorice root ( have to rehydrate in water overnight) or I had a some licorice extract pills but the former is much stronger. For some reason my body doesn’t seem to want to hold onto the correct amount of fluid and the licorice offsets that, I don’t have addisons for sure but I think the thing is related to my hypothyroidism and as I’ve recently discovered low cortisol / adrenals. It’s really the most effective supplement I’ve ever come across, gives significant benifits the same day
For what I understand, if your blood cortisol (total) is normal and your salivary cortisol (free) is low, you have high corticosteroid binding globulin (CBG) or high albumin. Oestrogen increases CBG and the other binding globulins, but there are other causes. Apparently there is a test for CGB, but only a few hospital seem to offer it. Albumin is often listed in regular blood tests. But all this should be confirmed by the appropriate tests, done in the same day.
In theory the body should adapt to the situation and increase the total cortisol production, but this doesn't seem to happen in your case.
DHEA and cortisol are produced in different layers of the adrenal cortex, so they are more like cousins than siblings.
Thanks for your reply. I'm not sure I understand all of it but I do have a serum albumin level as part of the same blood test as the cortisol. It's 39 (35 - 50g/L), so not high- could you explain a bit more what this might mean for me? My body is definitely not adapting at the moment!
So decreasing my HRT to 150 for a trial of a few weeks might be a good thing? I'm pretty sure I'll know the symptoms of not being on enough HRT if they come back.
Cortisol is like thyroid hormones. Part of it is bound to its binding globulin and also to albumin, and is not available for immediate access. The blood test for cortisol measures the total cortisol, while the salivary test and the urinary test measure the free/available cortisol.
If the appropriate tests show that your total cortisol is normal and your free cortisol is low, the only logical explanation is that you have too much cortisol binding globulin or albumin that is hoarding your cortisol. If your albumin is normal, the culprit should be the binding globulin.
It is well known that oestrogen (from pregnancy, pill or HRT) increases the amount of binding globulin(s), but it is also known that generally free cortisol stays stable or increases. Therefore the body usually compensates for the increase in binding globulin by making more cortisol. But this requires that the adrenals and the pituitary are able to do so.
If the adrenals are struggling (or the pituitary-adrenal axis isn't working properly) they will not be able to adapt.
But of corse this NEEDS to be supported by the appropriate tests.
I feel that you should request a synacthen test by your endocrinologist. This test is to check how well your adrenals are responding. You may need some steroid medication. It’s very important to have adequate cortisol.
Speak to your GP and endocrinologist urgently I’d say.
I don't have an endocrinologist (I wish I did...or maybe not!) and the gp will no doubt look at the morning blood cortisol and think it's fine (which I guess it is - I was relieved to see that!). I can try to get a doctor to look at the private saliva results. I have a B12 injection appointment tomorrow with a nurse and I'll ask then the best way to get the attention of a GP.
Has your GP ever offered you a 9am cortisol blood test. If it’s too low he can arrange for a short synacthen test through a hospital. It’s really important to have adequate cortisol.
Yes I did that test last week, it was 509 nmol, no range (v annoying), all it said was 'above 450 does not exclude AI'. don'tforgetcortisol in a reply to me further up this thread suggested that this is a good level and implies my adrenals are working.
I looked up some ranges in the nhs and many are 350-550 so I'm hoping that's ok.
The range at my hospital lab is 155- 650. So if yours is as 509 that is really high. In that case you don’t have a low cortisol issue as I first thought. I recently had a synacthen test that’s why I thought maybe you needed one. But now on flection I doubt you have any adrenal problems.
It's a strange one. The blood test says OK, the saliva test says very low. I certainly have symptoms which is why don'tforgetcortisol suggested I do the Regenerus test. My totally uneducated guess is it's to do with the blood test measuring bound cortisol, and the saliva measuring free.
It’s odd for sure. Maybe you could do with a retest. Phone the saliva test company and explain. They may just send you another test kit out free of charge. Then ask your GP for another cortisol 9am test. Explain that adrenal failure could be life threatening. Mention Addison’s disease to your GP. That should make him/her sit up and listen.
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