Question re cortisol test

[otterjack]

Frustratingly, I wasn't able to talk to the GP today as she rang earlier than stated. And when I rang the surgery was told "they only try once" so now have to wait until the 14th October to talk to someone about my result. So brassed off. Anyway, got the receptionist to at least give me the reference range for the cortisol levels and it is 250-650. I have no idea of the units they're measured in though. I've been trying to find information online but all the ranges seem to be in far smaller ranges, so I guess the unit of measurement is different. I'm going to request a printout of my results too.

 

[barbc56]

Can you ask to be put on the cancellation list. I have found that helpful and there have been times I actually got an earlier appointment. But many times it can be very short notice.

Good luck!

 

[otterjack]

Can you ask to be put on the cancellation list. I have found that helpful and there have been times I actually got an earlier appointment. But many times it can be very short notice.

Good luck!

Thanks, I have another telephone appointment tomorrow afternoon, albeit with a GP I'm not keen on. Oh well, I'll see how it goes. I'm getting aggravated just thinking about it as she's the type to say "oh well, it's not too bad so we don't need to do anything". Feel another fight coming on

Thanks to all who have replied!

 

[King Elliott]

This topic is relevant to me as well because I'm due for a cortisol test but my qualms with it are completely different.

One thing that nobody has ever been able to adequately explain to me is why cortisol rhythm supposedly remains the same even if a person's circadian rhythm is completely screwed up. I would've expected that cortisol would rise in response to waking and not because the clock happens to hit 9am. I wake up at 2pm most days. I'm a bit skeptical of the idea that my cortisol level peaks in the middle of (what is to me, at least) the night. My internal clock believes that early afternoon is morning and, with my blinds shut, there are no external zeitgebers for my body to respond to.

The literature on the subject seems confused as well.

 

[CFS_for_19_years]

There are actually two cortisol peaks. The first one, which is the strongest peak, happens around 8 a.m. and the second one happens 30 minutes after rising (cortisol awakening response). This goes into more detail about assessing the cortisol awakening response:
http://blog.zrtlab.com/cortisol-awakening-response

Your question seems to be about the 9 am peak. Unless you're a nocturnal species, you're going to have a morning peak. It's hard-wired.
Relationship of Morning Cortisol to Circadian Phase and Rising Time in Young Adults with Delayed Sleep Times
https://www.hindawi.com/journals/ije/2012/749460

Corticosteroid production by the adrenal gland also exhibits a robust circadian pattern in mammals. In contrast to melatonin production, however, the timing of corticosteroid [cortisol] synthesis is closely related to the photic niche of the species, with peak levels occurring at the daily transition from quiescence to activity. Thus, peak levels of corticosteroids in diurnal mammals occur in the morning, whereas peak levels occur in the evening for nocturnal mammals. The daily pattern of corticosteroid production is influenced by several interacting systems, only one of which is the master clock in the SCN (suprachiasmatic nuclei) of the hypothalamus.[....]

Although regulation of the adrenal is complex, with the multiple control mechanisms that can be differentially important to corticosteroid production, the SCN plays an important role in anticipatory corticosteroid production

Glucocorticoids and the circadian clock
http://joe.endocrinology-journals.org/content/200/1/3

[.......]This release is under control of the circadian clock, an endogenous biological timekeeper that acts to prepare the organism for daily changes in its environment. Circadian control of glucocorticoid production and secretion involves a central pacemaker in the hypothalamus, the suprachiasmatic nucleus, as well as a circadian clock in the adrenal gland itself. Central circadian regulation is mediated via the hypothalamic–pituitary–adrenal axis and the autonomic nervous system, while the adrenal gland clock appears to control sensitivity of the gland to the adrenocorticopic hormone (ACTH).

The morning peak can be absent due to disease (Addison's disease) or suppressed by not getting enough sleep the night before.

 

[King Elliott]

^

Demonstration of a phase shift in morning cortisol peak in response to general circadian rhythm changes using light as a modulator:
https://www.ncbi.nlm.nih.gov/pubmed/8596632