I am thinking of having a DUTCH test due to low cortisol and chronic insomnia. I contacted DUTCH but they’re unable to give me a UK practitioner’s details due to date protection?!
Can anyone recommend a UK practitioner please? I assume this can be done with an online consultation, but if not I’d be looking for south Devon/Cornwall. I do not feel confident at interpreting results myself and would need expert help with whatever’s required to sort out my apparent hormone problem. Obviously my NHS endocrinologist is not interested in my dire cortisol level 220 & 245 ish on latest pre 9am tests.
Specific recommendations by PM please to comply with requirements. Any other general comments/ help much appreciated below. Thank you. 😊
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CornishChick
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Have you thought about just doing a Regenerus saliva cortisol test? Don't need a practitioner, and easy to interpret. Doesn't have the full spectrum of things included on DUTCH, e.g. hormones, but that can be covered by a standard Medichecks blood test, for example.
Thank you. I’ve had two saliva tests and I think it was radd who said I’d benefit from a DUTCH. Interpreted by Dr Myhill who said to try Adrenavive but I never felt any better.
Which Medichecks blood test would you do alongside a saliva test please?
Ah fair enough - yes you've got a bit of a complicated picture, haven't you, I remember now. I can see why a DUTCH might be helpful because of all the extras, but I've never tried accessing from the UK and don't know anyone who has managed to. Medichecks does a few hormone tests, main being just female hormone profile. But sounds like you want much more comprehensive. Did you end up trying hydrocortisone? Adrenavive never did anything for me either, so I'm a few months into HC now.
That's good, hopefully hormones can shine some light for you. Re HC, yes and no. I got a prescription from a private doctor just to have a backup/evidence of needing it, but I self-source from an online international pharmacy because it's a lot cheaper. It's also possible to just use 1% HC cream (the kind you can get for skin complaints and insect bites) - I'm trying it now for my evening dose, and so far so good. Everyone responds differently though. All felt a bit scary at first, but actually it's been fine, and I'm slowly improving. I didn't really have a choice though - I couldn't go on as I was and needed T3 badly but couldn't have tolerated it. So I either had to let my cortisol and thyroid completely tank or do it myself (zero help from NHS - wouldn't even diagnose my Hashimoto's let alone refer for SS test, even though morning serum cortisol below range). My cortisol is dire all day, but DHEA just within range. DHEA is a complicated one and seems very influenced by sex hormones in particular.
Thank you. Did the private doctor give it you based on low cortisol? I asked mine and she said she couldn’t if my nhs endo hadn’t suggested it. My nhs endo is absolutely useless and doesn’t seem interested in helping me unless I have Addisons.
Pretty sure that's not true that a private doc can't prescribe if NHS endo doesn't suggest it, but, and it's a big but, there's a lot of reluctance to touch HC even among private doctors because there's so much unfounded fear around it. So technically there's nothing stopping them, but many either don't understand how to prescribe and dose it properly and/or don't want the responsibility for it.
Yep, doc I saw prescribed it based on my low cortisol - they're based in Ireland and I think used a lot among thyroid patients to access HC prescriptions (I found out about them from another member here). I've been a poor sleeper forever, since a kid - very overactive/hypervigilant nervous system. I think I also have an issue with low aldosterone because that can lead to getting up many times a night for the loo. The HC has helped me primarily to tolerate T3 without being a jibbering mess. I'm also just now starting to make it through the day without crashing in a heap in the afternoon. I'm falling asleep more easily, and if I wake up at 3am with low cortisol symptoms (fast heart, slightly wired, can't get back to sleep), I take a tiny HC 'stress dose' and go back to sleep.
I’m glad you’re on the road to recovery. Does the Irish GP to video consults please? If so do you mind PM ing the details please?
Do you think the HC cream would work in the night? I take antihistamine to sleep, but would rather not. If I don’t, I wake at 2am for a minimum of 3 hours. We sound quite similar although I don’t think I need T3 with my blood results, did try it but felt no better.
Yep, PMd Gosh, yes, the antihistamine thing is familiar. I've got histamine issues and kept having to take an antihistamine before bed if I wanted any chance of sleep. I think as a kid, combo of histamine intolerance, high anxiety, tendency for big adrenaline responses, and being autistic and hypersensitive (and not knowing it). But histamine has a relationship to cortisol, so it can actually be the cortisol that's the root issue. If you don't have enough cortisol overnight, your adrenals will produce adrenaline instead to keep you going, but obviously that's not really compatible with sleep!
Well one of the effects of histamine is making you more alert, hence why the prescription anti-histamines make you drowsy, because they switch off the receptors. So taking an a-h can reduce the amount of stimulation going on with your nervous system, sometimes enough to let you sleep. So switching off those receptors will have a similar overall effect on your system, regardless of whether there's any allergic reaction, because it's turning off your response to histamine temporarily.
Hypersensitivity for me is just very sensitive to sensory stimuli, so all of touch, visuals, sound (especially sound) etc. And being overstimulated hikes up your cortisol and adrenaline to try and deal with all the input, and then you're in a hypervigilant/stressed/over-alert state that makes it hard to switch off your brain and relax enough to sleep. As an adult, sleep hygiene helped a bit, and even when I was younger I knew that if I watched TV right before bed, it would take hours to fall sleep. Can't speak to what your daughter might be experiencing, but that's how it was for me anyway. I'd struggle to relax enough to fall asleep, then be awake 2 hours later, stressed and upset that I couldn't sleep, which made it worse. Horrible cycle!
I’m not wholly sure. Several years back I had two DUTCH Complete Hormone Panels which included both sex and adrenal hormones. Since then DUTCH have bought out other tests including the Plus which as far as I can see gives you in addition a CAR reading. There may be other benefits and perhaps others will comment.
I’m sure we’ve been through this before 😁. The DUTCH is a completely different test to the NHS’s measuring of blood serum, and would be like trying to compare apples with pears.
A NHS blood serum test measures the amount of total or free of a certain hormone in circulation at that given time of the blood draw, and offers no indication in how your body is using it.
For that we need investigating into metabolites, methylation/excretion, use of good or unhelpful pathways, the three different oestrogens with phase 1 and phase 2 metabolism, levels of oestrogen harmful substances (cancer risks), oxidative stress markers, neurotransmitters, usage of B vits and loads more … and this is where the DUTCH comes in.
It is an advanced and comprehensive test measuring something like 35 hormones and indicating how they are working. Sometimes hormonal imbalances such as in O, P & T can be easily observed in serum bloods but these can be ‘normal’ and it is the breakdown products causing imbalance and inflammation.
Once imbalance occurs a further cascade can follow over many years that could never be picked up on by the NHS’s measuring of the odd individual hormone level. Off the top of my head, the DUTCH measures something like 35 hormones.
However, DUTCH is unrecognised within the NHS, expensive and requires interpretation by a DUTCH practitioner who will help you correct inefficiency possibly through suggestions of lifestyle/dietary changes and supplements. It is not an overnight fix but a commitment both physically and financially. Here is a sample test report for you to see how in-depth it is … portal-app.inspira-regeneru...
Thank you, it does look very comprehensive. I contacted Regenerus to see if they could advise me if practitioners in my area but they said they couldn’t tell me any due to data protection. Someone has messaged me with a recommendation but I’d like to check out a few before I commit to one. Do you know how to obtain a list of practitioners please or is it a case of googling and checking each one individually?
Sorry, I don't know of any practitioners now as had my DUTCH years ago.
I don't wish to confuse you but if you are going to be investing a lot of money in your health, another option to consider would be the LifeCode GX Hormone Report which analyses genes involved in the synthesis/signalling/regulation/transport of the HPA and HPG axis, oestrogens life cycle and steroid hormones. It is equally in-depth and different practitioners usually favour the DUTCH or the LifeCode. Here is a sample report .... static1.squarespace.com/sta...
Hello, very interesting conversation. But what I don’t get right is how taking a tiny HC makes you to sleep again. Elevating cortisol is not what leads to wake up signal for your body ? Thanks.
So if you have normal or even high cortisol, then yes, taking HC would only make you more stressed/wired etc. But if you have very low cortisol, the body will ramp up adrenaline to compensate, because you need cortisol to live or everything would shut down. I think that's sometimes forgotten because we only ever hear about high cortisol and stress being bad for you. So taking a small amount of HC before bed with low cortisol helps keep the cortisol going through the night so you're not buzzing with adrenaline and can therefore relax enough to sleep.
Thanks seveneleven. I may try to test my cortisol during the day as I feel I have an empty bag the morning and little by little cortisol fills in to be too elevated at the end of the day, that could be the cause of my insomnia. So if it is really the case taking HC before bed would be worst. But maybe what I feel need to be proved by a test to be sure.
Absolutely - best to never take anything for cortisol, low or high, unless you know what's going on with it, because you can end up doing the opposite of what's helpful. Hope you can resolve the insomnia - it's a bugger to have!
I have problems sleeping too, usually wake around 4am & that’s after taking Nytol every night.
I have recently read that low blood sugar at night can cause an adrenaline rush which wakes us. Apparently eating protein without many carbs just before sleep can help.
I also take Berberine to help with blood sugar control.
Thanks. I’ve tried a protein snack but it doesn’t work for me. What’s Berberine please? How has it helped you please if you still wake at 4am? Many thanks
Berberine is a supplement made from plants. It works like Metformin, which people take to treat diabetes. It helps stop high blood sugar readings. I take it to help me with that throughout the day as blood tests show I’m near pre diabetes levels in blood tests.
It may be helping me stay asleep, it’s difficult to know. Magnesium at night as a supplement or in a bath are also supposed to help.
Blood sugar is also a consequence of low cortisol, so it can all be wrapped up together - waking in the night because of low cortisol + high adrenaline, which give blood sugar crashes...rinse and repeat! It's a tricky thing to get right, to be sure.
Thank you for this explanation. As a kid a woke every night to eat sugar/biscuits which sent me back to sleep in minutes, now I know why. Later on I got hayfever but cannot tolerate antihistamines. I did not know they could all be connected. Have you found a way to lower histamine or hayfever reaction? I am going to try MCAS diet and nettle tea good too!
Building up gut health is useful, so taking histamine-friendly probiotics (some common strains can feed histamine). S. Boulardii is a good one, and Symprove is good by very expensive. I'm also taking LDN, which seems to have calmed down at least of my reactivity to high histamine foods, and it reduces inflammation overall. Nettle tea's great! Know some find it really helpful. Everything histamine-y is a long game - won't see results from diet or herbs/supplements quickly.
I take adaptogens, lemon balm tea, high magnesium glycinate 300mg, sometimes CBD oil and sometimes melatonin. They have a calming effect and have helped with anxiety and sleep. Also there are breathing methods on YouTube that are helpful for relaxation and anxiety. These might help while you wait for the tests and HC.
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Gosh, yes, the antihistamine thing is familiar. I've got histamine issues and kept having to take an antihistamine before bed if I wanted any chance of sleep. I think as a kid, combo of histamine intolerance, high anxiety, tendency for big adrenaline responses, and being autistic and hypersensitive (and not knowing it). But histamine has a relationship to cortisol, so it can actually be the cortisol that's the root issue. If you don't have enough cortisol overnight, your adrenals will produce adrenaline instead to keep you going, but obviously that's not really compatible with sleep!
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