Cortisol, Adrenal & Hypothalymus Testing Recommendstions

[Curious123]

Looking for recommendations of best self tests for cortisol levels. Also information on what other parameters I should be testing for adrenal function and hypothalamus, pituitary and parathyroid function..

Finally, any recommendations for how to raise a low adjusted calcium level?

[greygoose]

hypothalamus, pituitary and parathyroid function..

As far as I know, you can't test any of those yourself. You need an endo.

Finally, any recommendations for how to raise a low adjusted calcium level?

How is your vit D? Low vit D will cause low calcium. Raise the vit D and that will increase absorption of calcium from food.

[Curious123 in reply to greygoose]

vitamin D is ok 118 (50-174).

[radd]

Curious123,

The DUTCH gives a comprehensive look at adrenal hormone levels and how they are being utilised, also hypothalamus melatonin and other neurotransmitter metabolites which offers a good overview of how the HPA axis is working (hypothalamus - pituitary - adrenals). It is done via dried urine strips. However it is quite expensive and you'll need an experienced practitioner to interpret the results.

A cheaper and more popular test is the saliva stress test that measures "free' cortisol in four or five samples given over 24 hours. If you do this you will need a test that measures DHEA as well for a more complete picture. For 'total' cortisol and DHEA you can have a serum blood test with blood drawn before 9am when levels should be highest.

For self assessment of the pituitary you could blood test hormones such as prolactin, growth hormone together with the gonadotropins but realistically if these were out of kilter you would be symptomatic. The pituitary supplies many hormones for other organs function and many of us have out of balance function seen by a TSH that never rises even when thyroid hormones have been reduced. The thought is many years of being left hypo or mismanaged hypo re-establishes a new base line that never reverses. However, this should not lead to other pituitary issues.

Regarding low calcium levels it depends what the reasons are for them being low. I constantly read we shouldn’t need to supplement calcium as it’s fairly easy to get from dietary sources. If it’s parathyroid problem, you could ask for PTH to be tested. We need PTH to stimulate Vit D activation into Calcitriol or 1,25 dihydroxy Vit D3. Is your Vit D optimal? Vit D is used to help calcium be absorbed in the gut but also causes the kidney to absorb more and the parathyroid gland to make less PTH in a feed back loop. Have you had a kidney function test? (Frequently low in un/mis-managed hypothyroidism). If not, ask your GP.

[Curious123 in reply to radd]

Vit D 118 (50-174) - I take 3,000IU daily + Vit K

PTH 5 (1.1-6.9)

Im wondering about adrenal fatigue too. They did bloods yesterday with cortisol but it was nearly 12pm so hard to interpret with the ranges but I’d say it’s on the lower side perhaps?

Cortisol 230 (6-10 am: 133-537 nmol/L 4-8 pm: 68-327 nmol/L)

eGFR >90