Rosie
As Im in the same boat as you, I would suggest considering starting methylation simultaneously with lowering cortisol as I believe at teh end of the day, its getting methylation working properly that is the key driver (for many) as its the only way to get glutathione up again (and its the lack/depletion of glutathione that causes a lot of the ME symptoms). So in essence, I agree with caledonia "According to Rich Vank, treating the methylation cycle may correct the thyroid and adrenal problems." and endomeister 'I would start with methylation / transulfuration pathways corrections as these affect everything else downstream." but with the following caveat:
Having said that, something that has been diagnosed such as high night time cortisol needs to be addressed as its part of a vicious cycle and the high cortisol on its own exacerbates many ME symptoms.
I say key driver, as with ME the problem is usually a combination of several areas - not surprising when you think about it as the body struggles on for a long time in sub-optimal conditions until 'the straw that breaks the camels back' happens and then the whole thing collapses - not literally of course! just that a few systems/processes that have been running on empty finally crash. Its like the cogs that make a watch work - there are many and methylation may be the biggest/main cog but with ME there are usually a few processes that have crashed. Methylation goes a long way to getting the system operating again and for a lucky few, thats all thats required. For the rest of us, its a start and we need to solve the rest.
For me, it has been a struggle in getting some test results that indicate something is out of whack. Most come back relatively good. That in itself is not surprising as many of the bio chemical processes are either not adequately tested or testing has to be done via private functional pathology testing (that's the case here in Australia although it appears to me that it is the case in the US too) so as soon as a test (such as the cortisol saliva test) come back with any abnormal finding, ofcourse I will address that swiftly. (For me, there are no parasites etc etc although a number of my good gut bacteria are deficient and I am working on rebuilding these populations. Rich Vank also supports the view that gut issues often prevail with ME patients.
Please do your own research as I am just beginning in the area of cortisol management but the herbs that I listed in my first post appear to the common ones that are nearly always agreed upon (even by Dr Oz - lol! as I stated earlier).
I quickly looked into Relora which was mentioned above as I have not heard of this before. Relora is a patent blend of Phellodendron amurense and Magnolia officinalis. These are used in Traditional Chinese Medicine. Magnolia officinalis is known as magnolia bark and was mentioned in many of the articles I researched yesterday and was on my list but I dropped it in my first post above. I dont know much about Phellodendron amurense but googling it only brings it up in relation to its presence in Relora and on its own has more antibacterial properties. I would say the key ingredient for cortisol reduction in Relora is the magnolia bark and that can be ordered on its own. Relora is made by a number of brands and can be purchased on iherb. I now have to decide whether to add it my iherb order or stick with my original list.
All these decisions are debilitating for a PWC!
Good luck!