Any comment on cortisol/aldosterone results please

[PotatoFan]

Hi all, I've just received my results of a private blood test from Inuvi. Could anyone comment as to if they look like a problem I need to attend to or not? Thanks in advance.

Aldosterone Serum/Plasma # * 156.0 pmol/L

Cortisol (Serum) ** 147.0 133 - 537 nmol/L

Cortisol Reference range

6-10am: 133 to 537 nmol/L

Midnight: <150 nmol/L

[humanbean]

Aldosterone Serum/Plasma # * 156.0 pmol/L

Cortisol (Serum) ** 147.0 133 - 537 nmol/L

Cortisol Reference range

6-10am: 133 to 537 nmol/L

Midnight: <150 nmol/L

I've never seen a test result for aldosterone, so can't make any comments on that.

The cortisol test has different reference ranges depending on the time of day. What time was the blood taken?

Just want to check... Was this a straightforward blood test? Nothing injected beforehand?

[PotatoFan in reply to humanbean]

Hi humanbean,

the test was taken at around 2pm, nothing unusual taken beforehand.

Thank you!

[humanbean in reply to PotatoFan]

There isn't a reference range applicable to tests done at 2pm, so I'm not sure what level is considered to be "normal" by whoever did the test.

The reference ranges for the last (and only) blood cortisol test I ever had were :

6am - 10am : 166 - 507 nmol/L

4pm - 8pm : 73.8 - 291 nmol/L

I've never been quite sure what the range is for blood cortisol between 10am and 4pm i.e. between the two reference ranges. I've seen other people quoting blood cortisol reference ranges with that big gap. But I've always thought that blood cortisol tests are rather a waste of time because of the stupid reference ranges. The saliva cortisol test is a better one because each saliva sample has its own reference range, and it usually includes more than one test, and instead is usually four tests.

As a complete guess I would say that your result is actually okay, but I don't think you should rely on my guesses.

Cortisol should usually be measured around 9am when cortisol is usually at its highest . Cortisol is at its lowest at around midnight (ish). If you have severe insomnia or work shifts those times might be quite different to those in a healthy person.

One thing you can try as a cheap and easy experiment is an adrenal cocktail. You can make them at home.

stopthethyroidmadness.com/a...

therootcauseprotocol.com/fa...

If you get no benefit from them then the chances are good that your cortisol isn't low. But again, the info you have is too sparse to be sure of anything.

[PotatoFan]

Thanks for all that info humanbean, I think my trouble is too many symptoms & not enough knowledge! You've given me quite a bit to go on there tho', it's all helpful.

I've had dreadful sleep for the last couple of years now, since my hypo symptoms started, or even before. I can drop off ok, if I'm lucky I'll get around 4 hours, but then spend the rest of the night restless. I've considered getting a job with a 4am start, but I'm exhausted again by 9.30 am. I figured that my cortisol was maybe peaking too early, but I'll explore this more.

The test was taken 3 weeks ago now, and I have in fact been sleeping a bit more soundly since I took the advice on vitamins. I now have added B12 & magnesium, and I had D insufficiency. Hard to know exactly what did the trick, but there is a definite improvement so I'm happy with that.

I decided this new year that I can't wait around for my GP to understand that despite my minimum thyroid bloods being within the NHS 'range', that my symptoms are worsening rather than improving, and keeping me from working. I had private tests for all thyroid and related vitamins, allergy bloods, & the cortisol/aldosterone, to see if anything turned up. My GP actually took some notice when I emailed the thyroid panel & has agreed to checking for other autoimmune disease 'next time'. I'll find out if she knows anything about cortisol/aldosterone too!

The adrenal cocktail links are interesting, I shall try them as they look simple enough, and I feel nowadays that I've nothing to lose & everything to gain.

Thanks again for taking the time to make your detail reply, I very much appreciate it 😊

[radd]

PotatoFan,

Aldosterone helps keep electrolytes and indirectly BP stable. Have you had electrolytes tested? They normally measure renin too to get the aldosterone/renin ratio, and there are ‘erect’ and ’supine’ ranges .

Several years back all my adrenals hormones were low/under range including aldosterone, DHEA and cortisol. Conns and diabetes insipidis was eliminated and hormone levels eventually improved after hypo-hashi was better controlled.

Why did you have aldosterone tested? Have you increased thirst/urination?

[PotatoFan in reply to radd]

Hi radd,

thanks for your reply.

I got the aldosterone tested because, according to the symptoms check list for low aldosterone in the book 'The thyroid patient's manual' by Paul Robinson, recommended on this forum, I have light headedness on standing, high heart rate, dizziness & feeling faint, thirst, cognitive fuzziness, amongst other symptoms. I know that there is symptom overlap with a number of other possible causes but I thought if I had some test results, at least to show my GP, I could start to eliminate possible causes and maybe get some treatments to deal with everything. I've had worsening symptoms since hypo/hashi diagnoses last June, and the levo is not improving anything much at all. Levo was increased 3 weeks ago to a more suitable level to weight ratio.

No, I haven't had electrolytes tested.

The aldosterone test was just as the nurse found available and I had no advice at that time as to what might be recommended. Unfortunately, I've got no background medical knowledge and am rather groping in the dark to find solutions. I'm probably jumping on anything that appears possibly relevant. I'm trying to arm myself with evidence to present to my GP at my next appointment, and hoping she will fill some gaps.

[radd in reply to PotatoFan]

PotatoFan,

Yes, it can difficult to assess what symptom relates to what until we are optimally medicated for thyroid hormone deficiencies for several months/years. Low aldosterone is associated with adrenal insufficiency or HPA dysfunction, which is very common with years of undiagnosed or badly managed hypo-hash (hence the thirst and salt cravings).

If your blood was drawn at 2pm I think your cortisol levels looks fine, as is supposed to be highest in the morning with a gentle decline throughout the day. Aldosterone is effected by the sleep/wake cycle but I'm not sure about your result as there is no range.

Both my results were low but they were testing for high levels and when results weren't high, I was discharged as they don't provide treatment unless low enough to diagnose Addisons.

Don't expect your GP to know much about cortisol and its behaviours. Members here are far more knowledgable and some even self medicate cortisol steroid replacements.

[PotatoFan in reply to radd]

radd,

If nothing else, it's reassuring to be able to ask others and get a sensible reply. My GP has been really 'cross' with me, saying my symptoms are not hypo symptoms, as if I'm not allowed symptoms outside of my diagnosis. I'm not sure I would still be functioning if I hadn't found this forum.

Many thanks for your input 😊