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Cortisol not being consistent in blood and saliva

Beyond

Juice Me Up, Scotty!!!
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1,122
Location
Murcia, Spain
One thing I have noticed that is pretty nuts is that my saliva, DHEA, pregnenolone and progesterone and urinary cortisol are wicked low. My blood DHEAS is low as well BUT my blood cortisol is usually high, or very high, off the limit range. Is this because of my fear of needles? It is not such a big fear, I just get nervous when they draw my blood, like most of people. This really raises questions, because at the end blood cortisol should be the best measure, because cortisol travels trough blood and not saliva. I mean if the cortisol in blood raises because of fear then that means my adrenals are NOT that fried up.

My blood DHEA, ACTH and cortisol were tested by allopaths in blood several times and they were low, high and high respectively. The urinary and saliva were done by an alternative functional doc. Once I tested with a private lab my blood cortisol and it was low, but not wicked low, it was in range. I also tested saliva cortisol with this lab and it was very very low.

Why when the tests are performed by allopaths my basal cortisol is so high? Is blood a better measure as opposed to what we are told in the Internet or it is not? o_O
 

August59

Daughters High School Graduation
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1,617
Location
Upstate SC, USA
I believe serum measures total cortisol and saliva only measures free cortisol, but don't take this to the bank as I'm very unsure about it. Many people do believe the needle in serum test can cause a quick elevation of cortisol, but haven't seen this written in a study.

ETA: My cortisol test is very low at 8am, but climbs to above range by 12pm and is flatlined from then all the way to 12am, so it is dropping drastically between 12am to 8am when it supposed to be opposite. I had 2 - 24 hour cortisol - urine and both times it was "0" as in no detectable cortisol. I don't know what this means, but I know my rhythm is messed up since I usually don't go to sleep until 5 or 6am and wake up about 11am. I think I'm going to do another 4x saliva and see what it looks like and if it is still the same I am going to try some Isocort first thing in the morning and use phosphatylserine in the afternoon and night to bring it down.
 

Ema

Senior Member
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4,729
Location
Midwest USA
August59 is probably right.

Also, cortisol is deactivated into cortisone. This wouldn't be of the same use to the body but it might still be picked up on a serum cortisol test.
 

Beyond

Juice Me Up, Scotty!!!
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1,122
Location
Murcia, Spain
Interesting guys, thanks for answering. I definitely KNOW I have "adrenal fatigue", because as August, I too don´t have a circadian rhythm. I just lay in bed until I drop asleep and often takes hours. I don´t feel drowsiness or sleepiness at night since the onset of my symptoms three years ago (or four?). My 24 h saliva showed very low levels in all parts of the day.

I know that my adrenal hormones especially cortisol are very very low, but is strange that the serum test of the allopaths comes back so high and saliva and urine are SO low. Both urine and saliva test FREE cortisol so that might be why. I know that because the other day looking at the spreadsheet of tests in the GP I read that there is a test of urine and it said "free cortisol". ACTUALLY, my serum testosterone (total) is always very high, but my FREE testosterone is always low or very low.

http://www.macses.ucsf.edu/research/allostatic/pdf/faqs-salivcort.pdf

In the Internet it says "salivary cortisol measures unbound cortisol"... At the end, it never ceases to amaze me how clueless and pathetic are the allopaths. They test a person with severe adrenal fatigue and their test is so inappropiate that actually comes back saying that person has HIGH cortisol!! How many people are suffering needlessly because of this cyclopean incompetence?
 
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adreno

PR activist
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4,841
Free cortisol levels in salvia and serum do correlate, but they are lower in saliva. How much lower, I'm not sure at this point.

Due to their lipid solubility, steroid hormones can be detected in saliva. Salivary cortisol levels demonstrate excellent correlation with free serum cortisol levels (r = 0.97; Peters et al., 1982; Vining et al., 1983a). This high correlation is not affected by changes in concentrations of serum-binding proteins. However, the actual salivary cortisol levels are lower than the serum-free cortisol levels, possibly due to enzymatic degradation in the salivary epithelial cells during transcellular diffusion (Quissell, 1993).
http://cro.sagepub.com/content/13/2/197.full
 

Beyond

Juice Me Up, Scotty!!!
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1,122
Location
Murcia, Spain
That´s an interesting input Adreno. But the point is... what they are testing when they draw my blood is NOT free cortisol so...
 

adreno

PR activist
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4,841

Beyond

Juice Me Up, Scotty!!!
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1,122
Location
Murcia, Spain
No they never put that value (CBG) in my tests. What I can get out of all of this is that their blood measurements of "basal cortisol" are very misleading and of no diagnostic utility. Is pretty obvious that my free cortisol is very low, however what comes out always in the standard tests done by endos or GP´s is high "basal cortisol". Thus, we find that this statement from the link I provided,
Cortisol is a lipophilic steroid with low molecular weight (MW ~362 Dalton). Following ACTH
binding to membrane receptors on cells of the adrenal cortex, cortisol is synthesized and
released into the blood stream. Up to 95% of the secreted cortisol will be bound to large
proteins (CBG, albumin) and carried throughout the body in the blood.
Since the vast
majority of cortisol actions rely on binding to its cytosolic mineralocorticoid and glucocorticoid
receptors, only the small fraction of unbound, i.e., free cortisol is thought to be biologically
active. Due to its low molecular weight and lipophilic nature, unbound cortisol enters cells by
passive diffusion which makes it feasible to measure the free cortisol fraction in all bodily
fluids.
and what can be read in the study you linked (aprox 80% of serum cortisol is bound) correlates well with reality and my personal observations.

So now what is strange is, since my albumin is not high in tests, what could cause such an increase in CBG? o_O
 
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Beyond

Juice Me Up, Scotty!!!
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Murcia, Spain
Gread find adreno. The study shows people with certain mutation have higher CBG and lower cortisol and this mutation is more common in CFS people. This is actually such a good find that I will add it to a list/thread I am putting together about HPA and neurotransmitter genes and how to potentially treat them.

Full text here. http://www.researchgate.net/publica...R224_polymorphism/file/d912f5101ac2a66e8b.pdf

However, the most disabling and rare of these SERPINA6 (the name of the CBG gene) appearing in CFS studies are actually those that REDUCE CBG .I have to find that rs in the study.
 
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Ema

Senior Member
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4,729
Location
Midwest USA
Gread find adreno. The study shows people with certain mutation have higher CBG and lower cortisol and this mutation is more common in CFS people. This is actually such a good find that I will add it to a list/thread I am putting together about HPA and neurotransmitter genes and how to potentially treat them.

Full text here. http://www.researchgate.net/publica...R224_polymorphism/file/d912f5101ac2a66e8b.pdf

However, the most disabling and rare of these SERPINA6 (the name of the CBG gene) appearing in CFS studies are actually those that REDUCE CBG .I have to find that rs in the study.
So is this something we can look up on 23andme?
 

Beyond

Juice Me Up, Scotty!!!
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1,122
Location
Murcia, Spain
I am still trying to gather the rs´s, but yes we can look it up in 23andme. The gene is SERPINA6, but I haven´t been able to get the specific rs´s...
 

Ema

Senior Member
Messages
4,729
Location
Midwest USA
I am still trying to gather the rs´s, but yes we can look it up in 23andme. The gene is SERPINA6, but I haven´t been able to get the specific rs´s...
I have had all the fun I can have with 23andme tonight trying to get the text file...but please post the rs's here if you find them. I'd be very interested!
 

invisiblejungle

Senior Member
Messages
228
Location
Chicago suburbs
I've tested my saliva cortisol 4 times over the past 6 years, and it's always been low. However, my 24-hour urinary cortisol was normal, and my serum cortisol was near the top of the normal range.

If your serum cortisol is normal or even high, I would think of it as a "good" thing. Those of us who have spent a lot of time studying adrenal issues have probably made ourselves paranoid, thinking, "Omigod, my adrenals are dead!" If serum cortisol is not low, then it means that the adrenals are able to produce.

I definitely think that CBG is the culprit for some of us. I can't find the reference right now, but a thyroid website mentioned that hypothyroidism can increase CBG levels. http://tiredthyroid.com/ (By the way, this is the best thyroid info site I've found so far.)
 

Beyond

Juice Me Up, Scotty!!!
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1,122
Location
Murcia, Spain
Hey invisiblejungle, actually the mystery lays in the fact that my free cortisol is very low in urine and saliva along with all the other adrenal hormones, glucorticoids and metabolites. My adrenals are shot, that is for sure. So I was wondering why in blood is always so high... Yah I know I have sub-clinical hypothyroidism, you always develop that from years of adrenal fatigue, plus it was confirmed in my urine thyroid tests.
 

Hip

Senior Member
Messages
17,824
Two Types of Cortisol Test Provided by Genova Diagnostics — Which is the More Appropriate?

I am thinking about testing my cortisol levels, and noticed that Genova Diagnostics provide two types of cortisol tests, detailed below. Which might be more appropriate for ME/CFS testing?

Genova Diagnostics "Adrenal Stress Profile" Test. £75
This cortisol test utilizes 4 saliva samples taken throughout a 24 hour period.

Test description: This saliva test can detect imbalances in the daily circadian secretions of the stress hormones cortisol and DHEA. Imbalances in these hormones can indicate an inappropriate response that can negatively impact energy levels, emotions, and many other health complaints. These include anxiety, chronic inflammatory conditions, allergies, chronic fatigue syndrome, insomnia, depression, migraines, headaches, recurrent infections, menstrual difficulties and infertility.


Genova Diagnostics "Cortisol Awakening Response" Test. £71
This cortisol test utilizes 5 saliva samples taken in the first hour after waking.

Test description: The Cortisol Awakening Response (CAR) test is a salivary assay available to assess adrenal dysfunction. The CAR test involves measuring five separate salivary samples over an hour after waking, and has been extensively researched and validated as a means of analysing hypothalamic-pituitary-adrenocortical (HPA) axis activity.

I presume the first test above is the normal one taken by ME/CFS patients. It seems that most studies have shown ME/CFS patients have lower cortisol levels throughout the 24 hour cycle: this study found a cortisol was significantly lower in ME/CFS patients across the whole day, as did this study and this study.

The second test above appears to be a measure of HPA axis function. This study: Salivary cortisol response to awakening in chronic fatigue syndrome found that ME/CFS patients had a lower cortisol response to awakening, which implies impaired HPA axis function.

In an article by Cort Johnson, he says: "One area we do pretty much understand about ME/CFS is cortisol – the subject of dozens of studies. It’s pretty clear now that it’s the cortisol awakening response, not total cortisol levels, that’s primarily off in Chronic Fatigue Syndrome."

This statement by Cort is confusing, because both the cortisol awakening response, and cortisol levels throughout the 24 hour cycle seem off in ME/CFS.
 
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alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia

There are in fact multiple CBG snps that produce problems that resemble CFS. I was a subject in one of those studies, and test negative for the known CBG problematic snps (I am unsure of the date, but before 2000).

Its not just that CBG carries cortisol, and probably facilitates cell absorption, its that its also possibly a hormone that modifies the response. My info on this part is like 14 years out of date, I do not know the current position, but its worth keeping in mind.