Cortisol Saliva test results

[Denny39]

Hi,

I’ve done the cortisol saliva test result shown in the photo below.

it advises adrenaline fatigued stage 2.

Has anyone been at this stage before and what did they do to help it heal? Thanks

[Denny39]

reference ranges

Photo

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[humanbean]

I'm going to use the standard reference range provided rather than the optimal range given because I don't know how the optimal ranges were arrived at.

Your results:

Sample 1) 8.2 (7 - 30) --- 5% of the way through the range

Sample 2) 3.5 (2.1 - 14) --- 12% of the way through the range

Sample 3) 1.3 (1.5 - 8) --- 3% Under range

Sample 4) 1.2 (0.33 - 7) --- 13% of the way through the range

...

Optimal results for saliva cortisol are given at this link (see Example 1) :

rt3-adrenals.org/cortisol_t...

• Morning at the top of the range --- 30 with your range

• Noon approximately 75% of the range --- 11.025 with your range

• Evening close to 50% of the range --- 4.75 with your range

• Nighttime at the bottom of the range - 0.33 with your range

...

We need to compare your results to the optimal results and see what comes out of it.

Sample 1 : Optimal = 30 --- Yours = 8.2 --- You produce 27% of the cortisol you should.

Sample 2 : Optimal = 11.025 -- Yours = 3.5--- You produce 32% of the cortisol you should.

Sample 3 : Optimal = 4.75 --- Yours = 1.3 --- You produce 27% of the cortisol you should.

Sample 4 : Optimal = 0.33 --- Yours = 1.2 --- You produce 364% of the cortisol you should.

Totals : Optimal = 46.33 --- Yours = 14.2 --- You produce 31% of the cortisol you should.

DHEA 136 (106 - 300) 70% through the range

Your DHEA is actually pretty good - I've seen far higher and far lower results. At the moment I wouldn't worry about it. DHEA reduces with age, but hopefully doesn't reduce below the range.

...

Although I think it is unlikely that you have Addison's Disease or some other form of hypocortisolism (too little cortisol) I think your results are definitely bad enough to ask your doctor to arrange a blood cortisol test. The blood should ideally be taken at 9am which is the time doctors always assume the highest level of cortisol is produced.

If your blood cortisol result is low enough your doctor should refer you to an endocrinologist, possibly as an urgent referral. You would need an SST (Short Synacthen Test also known as the ACTH Stimulation Test) which is always done in hospital as an out-patient.

Info on what is involved in this test can be found here :

See pages 68 - 70 : imperialendo.co.uk/Bible201...

en.wikipedia.org/wiki/ACTH_...

If you have an SST done, ask the endocrinologist before the day of the test, if an ACTH test could be included. Normally only cortisol is tested which means that only Primary Adrenal Insufficiency can be definitively diagnosed. If you have Secondary or Tertiary then that's just tough luck apparently. *rolls eyes*

If cortisol is too low it leads to a diagnosis of Primary Adrenal Insufficiency.

If ACTH is too low it leads to a diagnosis of Secondary Adrenal Insufficiency.

If corticotropin-releasing hormone (CRH) is too low it leads to a diagnosis of Tertiary Adrenal Insufficiency.

See more info on the different types of Adrenal Insufficiency here :

en.wikipedia.org/wiki/Adren...

...

It is possible to have low saliva cortisol while blood cortisol is "normal". In one member of the forum her problem was cured by taking T3 to improve her very low Free T3 levels.

There will be other causes of low T3 and low cortisol besides under-medication in someone with hypothyroidism, but optimising your T4 will help, and so will optimising nutrient levels.

...

The reason I think it is unlikely that you have Addison's is because there are still signs of a curve in the graph of your results. In true Addison's the line on the graph would be almost completely flat right at the bottom of the graph. (In Cushing's - having far too much cortisol - the line on the graph would be right at the top and almost completely horizontal.)

Some links you might find of interest - check your symptoms against what is given here :

en.wikipedia.org/wiki/Addis...

en.wikipedia.org/wiki/Adren...

Adrenal Insufficiency is another name for hypocortisolism.

One member of the forum was diagnosed with Addison's Disease a few years ago - you can see the saliva test results she got before proper diagnosis by an endocrinologist in this thread :

healthunlocked.com/thyroidu...

...

One member of the forum had to fight to get properly diagnosed with Sheehan's Syndrome - a form of Secondary Adrenal Insufficiency - but she got there in the end.

...

If your cortisol is deemed (by your GP or Endo) to be high enough to not need more testing, then this thread discusses ways and means of improving cortisol in a much more long-winded way than actual replacement of the missing cortisol.

I dumped everything I could think of about improving cortisol (when Addison's or Adrenal Insufficiency isn't involved) in this thread :

healthunlocked.com/thyroidu...

It is an old thread now, so there could be some broken links.

[Denny39 in reply to humanbean]

Thanks for replying.

I had a synacthen test early 2022 and baseline cortisol was 194, 30 minute reading at 516 and 60 minute at 716. And they said not Addisons. ACTH was not included as I didn’t know about that at the time.

After that meds were stopped and restarted but that is another story - I bet that didn’t help my adrenals.

I’m on 87.5 levo and 15 T3 and bloods are TSH <0.02 T4 19.6 (10-22) and T3 6.6 (3.1-6.8)

Blood Cortisol on 5/8/22 was 207 (172-497)

Recent blood cortisol in 2023 was 196 (172-497)

[humanbean in reply to Denny39]

Given your cortisol results of 516 and 716 I think it is clear that you don't have Addison's Disease. Your adrenal glands are pumping out plenty of cortisol when they are stimulated.

It is shocking, in my opinion, that ACTH is not routinely measured during an SST. They can't diagnose Secondary or Tertiary Adrenal Insufficiency without it.

You could write a new post asking if anyone has been diagnosed with Secondary or Tertiary Adrenal Insufficiency and how they wangled it.

Do you know what the reference range was for the baseline cortisol result of 194?

[Denny39 in reply to humanbean]

Sorry forgot to say before I took meds when I was first diagnosed in October 2021 my cortisol was over the range - would need to dig out my numbers but the endo said blood cortisol was high. I think the range was 13-150 and mine was 300 ish. That and a TSH of 4.9 was why he started me on meds.

After I took the meds my cortisol went low.

I read Paul Robinson took t3 only to improve cortisol.

[Denny39 in reply to humanbean]

I have skin pigmentation on both my eye lids but I’ve had that since 2004 which is when I first become hypo but GP said anxiety. Looks like I have eye shadow on 😂

[humanbean in reply to Denny39]

I have skin pigmentation on both my eye lids ... but GP said anxiety

Words fail me. That is absurd.

[Denny39 in reply to humanbean]

I also had anxiety symptoms - adrenaline releasing in my body since 2004 and to be honest it’s not been nice.

Now I’m on thyroid meds that anxiety feeling has gone and I know now it was thyroid all along. No one in my family had thyroid and I knew nothing about thyroid myself. When I got my old records TSH was only tested back then and it was 1.21.

[Denny39]

Hi, the test was £88 but I was then charged £4.20 shipping fee.

[QUE6T-33 in reply to Denny39]

Ah, ok. Was that with Genova Diagnostics?

[Denny39 in reply to QUE6T-33]

it was with regenerus - link below if that helps.

regeneruslabs.com/products/...

[QUE6T-33 in reply to Denny39]

Thanks Denny

[humanbean]

I've started replying to you on your thread here :

healthunlocked.com/thyroidu...