I’m due a GP blood test at 8:35am today. Can I have a decaf coffee before???
It’s a waste of time test I think as my saliva test showed the only normal one was the morning but that private test wasn’t good enough! Also my DHEA of less than 10 was completely sidetracked by GP. Very little hope this saliva blood test will be useful.
Grumpy and tired and hungry and fed up.
🥰
Saliva cortisol and blood cortisol don't test the same thing, so getting different results is common.
Hormones of all kinds move around the body attached to transport proteins. In the case of cortisol this is mainly Transcortin and a lesser amount is attached to albumin.
en.wikipedia.org/wiki/Trans...
en.wikipedia.org/wiki/Serum...
When attached to its transport proteins cortisol is inactive.
In order to become active, cortisol must be separated from its transport proteins.
The amount of active cortisol in the body is tiny compared to the amount of inactive cortisol.
The cortisol measured in saliva is active cortisol.
The cortisol measured in blood is mostly inactive cortisol.
Inactive cortisol cannot enter the cells to do its job. Once cortisol and their transport proteins are separated the cortisol can enter cells and do its job.
Although I can give people the above information, one thing I don't know for certain is what causes cortisol to separate from its transport proteins i.e. I don't know how inactive cortisol becomes active cortisol, or what prompts that change to occur. (I'm not a doctor.)
One problem that can occur with cortisol is that a blood cortisol test (inactive ) can show a good ("normal") result while saliva cortisol (active) can be very low. And a doctor usually looks only at blood cortisol.
One member of the forum had rock bottom saliva cortisol but "normal" levels of blood cortisol so her doctor believed she had no problems, despite the fact she felt awful. At some point the member started taking T3 and it solved her cortisol problem. Her saliva cortisol became much more "normal" and she felt much better.
I don't know what other factors might affect the level of inactive vs active cortisol.
When testing cortisol, whether blood or saliva, it is recommended that the patient goes about their day in the same way they would if they weren't testing. So the coffee shouldn't be a problem.
But if you are getting multiple blood tests done from the same blood draw then stick to the methods we usually suggest on this forum and fast overnight and before the blood draw.
I've been reading about cortisol binding to try and find out what causes the cortisol to detach from the transport protein, not found anything yet. My saliva cortisol is rock bottom and my blood cortisol is 383. Same with DHEA. My Dutch test DHEA is rock bottom. I did a blood test which showed top of the range.
Where are you now with your low cortisol and DHEA if I may ask?
I went with recommendations from here to be on safe side thanks for info. I just don’t know. Where I go from here if it comes back as normal which I feel it will. The phlebotomist said she was testing for lots of things so it’s wait and see
Years ago now so if my memory serves me, I had an elevated 24 hour urine result, yet my saliva result was sub optimal. That puzzled me. Seems I was producing enough cortisol, so why wasn’t it showing at cellular level. On looking into it, I found a piece about cortisol binding globulin & wondered if it were possible that CBR level was low. I did mention to Dr P & he said it was possible. I hope my recollection is correct & no idea if helpful at all in mentioning to you. (My thyroid levels were good at the time, so wasn’t considered at uptake issue).
Hey, may I ask how you were feeling when your urine cortisol was high and saliva sub? I am in this position too, my blood cortisol is high in range and saliva low in range on a couple of points. I just can't seem to figure out if this caused intolerance to thyroid hormones in some way for me. Thank you 😊
How you feel depends on cellular level of cortisol doesn’t it, So I felt awful with low saliva results. And for me, effects of high & low cortisol, can be similar. It’s a pity there isn’t a similar saliva test for thyroid levels, i.e. so you could be sure of what was going on at cellular level too. But if your cortisol blood was elevated, with low saliva result, seems you have an cellular uptake issue. For me, I just checked my thyroid & important nutritional levels to see if those needed improving. (As happened in the past before I started thyroid meds, my blood levels of B12, cholesterol, Ferritin were all elevated. But once my thyroid levels (FT3 most importantly) were improved on meds, those other blood levels normalised as they were then being utilised). I’m not medically trained & above is just my own experience & thoughts. Hope you start feeling better soon 😊
How much levothyroxine and T3 are you currently taking
Previous post shows low Ft4
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test
I was on 5mcg 3 x daily and 50mcg thyroxine but that’s when I felt anxious, headache, spaced out etc and felt terrible which is why I did a cortisol saliva test then cut back on the T3 to 2x daily 5 mcg. This helped massively. Now I feel my levels are too low and will test next week. I know if I up my T3 the same will happen. I did the test as per recommendations, she took 4 vials 😮 but GP had said no thyroid as it would only confuse matters as my TSH would be too low because of T3 , best leave that to the private Dr.
Thanks for reply 🥰
Hi Joant24, can I ask which laboratory you used for your Saliva test please? NHS Drs I’ve shown Saliva Test to haven’t been interested, one said he didn’t understand it! But it is a useful test I think.
I had exactly the same response with the first GP and the 2nd said it was controversial!!! They also said they don’t use the saliva test as it’s not as reliable as the blood test. I find this ridiculous as my morning saliva one was fine but all the others were low so the morning NHS blood test showed I was fine 🙄. I used Regenerous and I thought it was useful too. Good luck and let me know how you get on.
The blood test is a result based on that point in time in the day as we all know. And as you say, it doesn’t indicate the pattern or high & lows, which gives a better overall picture. And I wonder how often GPs call for a DHEA test. I’ve not used the Regenerus Saliva test, so will check that out - thanks. Keep well 😊
Salvia test for cortisol
Best initial cortisol test?
Cortisol Results
Test results - low cortisol and DHEA. 
Cortisol Test Results
