DHEA/Cortisol

[pj16]

Hi all. Following my recent post regarding my soul destroying visit to A&E and all the wonderful replies I received I’m working out what tests to order for daughter number two and myself. I’m definitely re-checking full thyroid and vitamins but am also considering DHEA/Cortisol testing. Are there any special instructions I should follow before testing? Any recommendations for a company to use? My fatigue levels and crushing morning depression are a big problem currently. TIA 💐

[Sneedle]

Hi pj16,

A lot of people on here use Regenerus or Genova Diagnostics (4 saliva cortisol samples obtained during one day).

When you get the test package it has detailed instructions. You need to pay attention to menstrual cycles. And take samples at specific times of day, freeze them and send all off next day (best done Mon tue wed for belt and braces approach).

I've just taken the Regenerus one and am trying to figure out how to get a gp to take notice of my apparently rubbish low cortisol. Good luck and keep at it 💪 😊

[seveneleven in reply to Sneedle]

Ditto - I did Regenerus, and it's straightforward and relatively quick for results. It will give you a good picture of any cortisol issues and the stage of HPA dysfunction, if any. Good luck!

[SlowDragon Administrator]

suggest you get thyroid and vitamins tested first

Fine tune thyroid levels and improve low vitamins

Optimal thyroid should improve cortisol

Perhaps consider cortisol and DHEA testing 2-4 months later

[seveneleven in reply to SlowDragon]

Why? There's no good reason to put it off when they have clear concerns and reason to think it's a problem, including the visits to A&E and awful morning fatigue. They have also said they will re-test thyroid and vitamins in any case. Optimal thyroid levels are not possible without decent cortisol levels, and vice versa - it's not a cycle that can be broken by exclusively addressing thyroid.

[SlowDragon Administrator in reply to seveneleven]

Well many members find that cortisol levels stabilise and cease to be a problem when on optimal thyroid replacement and optimal vitamin levels (and gluten free/dairy free if these are issues)

[seveneleven in reply to SlowDragon]

If it's only mildly raised or lowered cortisol, for sure, things like adding T3 or optimising T4 could stabilise, but if there are serious symptoms, it needs to be investigated properly. It could be that someone has dangerously low cortisol or even Addison's without knowing it, and adding or increasing thyroid meds could lead to a crisis. Unlikely, yes, but possible, and I find it troubling that someone on here would be discouraged from testing a really important hormone that could have huge bearing on their treatment, like it has on mine and others. The answer isn't always going to be thyroid, vitamins, and gluten.

[SlowDragon Administrator in reply to seveneleven]

if symptoms are worse in morning and improve significantly by afternoon/evening this suggests adrenals

If yes get tested now

Personally I was tested repeatedly for Addison’s, Cushing, pheochromacytoma, pituitary tumour, MS, MND etc

NHS Adrenal Levels were never off enough to warrant treatment

And cortisol levels on Regenerus test always looked reasonable ….still good diurnal rhythm.

Like many when under medicated I had slightly high cortisol

Regenerus test showed low DHEA …but supplementing DHEA made situation worse

[seveneleven in reply to SlowDragon]

OK, but, you're saying that you had lots of testing, presumably to rule things out. So by testing, you were able to get a good picture of your cortisol and see that it wasn't dangerously low, and being slightly raised, then yes, optimising thyroid levels helped. Your first suggestion of holding off on testing and only doing thyroid and vitamin levels makes even less sense given your own experience.

[Hidden in reply to seveneleven]

In January this year I swear I was in the brink of adrenal crisis. I was following well-meaning advice if raising NDT at a snail’s pace as I wasn’t able to tolerate, but felt so poorly. I was having to pull over my car to wretch regularly, my whole body was full of fluid and my feet in particular couldn’t bare my weight it seemed they’d burst, I had chest pains, and was increasingly hypo in spite of raising meds. Luckily I got my hands on STTM and Barry Peatfield, went to a private endo and persuaded him to test me - adrenal insufficiency was tested and diagnosed. On hydrocortisone I can now tolerate and raise T3 and T4! 🎉

[pj16]

Thanks everyone. Lots to mull over 🤔. For sure I wake up every morning feeling sluggish, filled with dread, mood through the floor and feeling unable to face the day. This improves usually within a few hours. I suppose there are many things which could be causing this.

With regards to vitamins I decided in March this year to stop all supplements as my thyroid results and gut symptoms had improved with gluten/dairy free diet. Also I figured summer was coming so I’d get natural vitamin D ☀️. I’m thinking I might have made the wrong decision. I’ll get all the bloods done and see where I’m at. Definitely feeling grim recently.