Cortisol test interpretation

[HrtWife]

Hi all, I am new here.
I was hoping you can help me to interpret results from multiple cortisol tests.
They are of my husband's who experiences a lot of hypothyroid symptoms and has severe insomnia.
In particular, I have questions:
1. Does last test result (01/14/2015) looks good or bad?

2. Do results look to you as an improvement or decline (over time) and why?

3. Last test show only noon cortisol that is not in the range. What could this indicate? The doctor's comment states "This is usually due to chronic exposure to stressors which can be physical, psychological and/or metabolic. It's likely that most of his stressors are experienced around the noon time hours" WTH? and the rest of the day his "stressors" take a break? My hub's days are fairly the same - no extra activities at noon.

4. Also, dr. states that lowering cortisol is a sign of the adrenal distress getting worse. But if the cortisol was high, then got lower, is not it a sign of improving?

ZRT lab

Test Name 05/01/2013 ** 07/14/2014 ** 01/14/2015 Units Range
Cortisol (Saliva) 3.4 L ** 2.6 L ** 5.7 ng/mL 3.7-9.5 (morning)
Cortisol (Saliva) 2.3 ** 4.3 H ** 5.9 H ng/mL 1.2-3.0 (noon)
Cortisol (Saliva) 1.5 ** 2.4 H ** 1.8 ng/mL 0.6-1.9 (evening)
Cortisol (Saliva) 0.5 ** 2.8 H ** 0.7 ng/mL 0.4-1.0 (night)

and another result from different lab 12/17/14:
the ranges are not the same but show the same pattern.
CORTISOL, AM 0.54 L 1.8 - 3.8 ng/ml
CORTISOL, NOON 2.06 H 0.3 - 1.4 ng/ml
CORTISOL, EVENING 0.33 0.1 - 1.1 ng/ml
CORTISOL, NIGHT 0.18 0.1 - 0.8 ng/ml
5. also, if the evening and midnight cortisol is not high, why in the @#$% my husband cannot sleep? Hi is wide awake at 1 AM and cannot fall asleep until 2-3 AM. What gives?
I intentionally do not give any background yet, just want an opinion about cortisol only
Thanks in advance

 

[drob31]

1. The second test looks "better," but it's still not optimal.
2. The results look like HPA-axis dysfunction. Alternating highs and lows--would another test show the same results as the first indicating there is no consistency?
3. The doctor doesn't know what's causing it, and by saying it's stressors he's stating the obvious. The next question is what stressors are causing it? Candida? Hormone issues? Viral? Etc...
4. I don't agree with what the doctor said because 2 tests is not enough data in my opinion to go by. He should be getting allot more labwork done to look at the big picture. Your adrenal glands don't get tired and drop to low levels. If that were the case Cushing's syndrome wouldn't exist. What they do is take orders from pituitary and hypothalamus. So why are the sending the wrong signals?
5. If levels are too low your body may release adrenaline--that would keep you awake. Also, cortisol may be rising again after midnight.

I would go by the numbers. Low, High, Low Normal, Low Normal. This is HPA-axis dysfunction. The real question is how does he feel on the first test and the last one? Because numbers are one thing and symptoms are another.

 

[HrtWife]

Thanks drob31!
you gave me some ideas about what to research.
My husband has hormonal imbalance. The problem is - to find what is causing it. He initially was diagnosed with hypogonadism (low testosterone) 2 years ago. He started treatment and we hoped that it was "it". But testosterone therapy was not successful at all. If anything, it made things worse. He stared experiencing high cortisol, high adrenaline symptoms - heart palpitations, anxiety, insomnia. He was and still is in this "fight or flight" condition. The idea was that all this is caused by high cortisol, but now since it gets balanced (my hub is on adrenal support) and no symptoms are lifted, we are back to square one. He does have high adrenaline. Last test was 61 pg/mL (0-62), but before that it used to be 101(!). Any idea, what is causing it? What are the possible causes? And he has a whole lot of hypothyroid symptom, like dry skin, loss of hair, no sweat, no odor, change of taste of food, again, insomnia, depression, puffy face.Those developed about 6 months ago.
And his labs do not indicate thyroid disease at all. It was confirmed by different doctors.
We are sure that everything has one origin, but cannot pin-point it for two years.
You say, candida can screw things up? Can you elaborate? My hub's results from June of 2014:
Candida Antibodies IgG 54 High U/mL 0 - 29
Candida Antibodies IgM 51 High U/mL 0 - 9
Candida Antibodies IgA 16 High U/mL 0 - 9
Everything is super high. Can candida affect cortisol?

and his Rheumatoid Arthritis Factor is:
RA Latex Turbid. 238.6 High IU/mL 0.0 - 13.9
I know that high RA factor could indicate an autoimmune disease. Is it anyhow relevant? He was checked - he does not have rheumatoid arthritis...

 

[drob31]

I would ask @Jonathan Edwards advice on this, especially the RA factor, since that is his specialty.

The Candida antibodies do seem high. The question is, are they taking advantage of opportunity or are they the root cause? Most of the time I've seen on PR that they are a co-morbid factor of another condition.

Hypothyroidism can be a consequence of hpa-axis dysfunction. High cortisol can cause cellular resistance to other hormones like thyroid hormone, just as low cortisol can prevent it from being accessed by the cell. This is my primary issue, so far.

 

[Jonathan Edwards]

I would ask @Jonathan Edwards advice on this, especially the RA factor, since that is his specialty.

The Candida antibodies do seem high. The question is, are they taking advantage of opportunity or are they the root cause? Most of the time I've seen on PR that they are a co-morbid factor of another condition.

Hypothyroidism can be a consequence of hpa-axis dysfunction. High cortisol can cause cellular resistance to other hormones like thyroid hormone, just as low cortisol can prevent it from being accessed by the cell. This is my primary issue, so far.

When there is rheumatoid factor present ALL other antibody titres can look high as an artefact so I would not know how to interpret the candida antibodies. Rheumatoid factor does hint at the presence of an autoimmune process but on its own it is not specific enough to be a great help. An antinuclear factor screen would be appropriate.