1. Patients launch $1.27 million crowdfunding campaign for ME/CFS gut microbiome study.
    Check out the website, Facebook and Twitter. Join in donate and spread the word!
9th Invest in ME International ME Conference, 2014 - Part 2: Pathogens and the Gut
Mark Berry continues his series of articles on the 9th Invest in ME International ME Conference in London, with the emphasis shifting from autoimmunity to pathogens and the gut ...
Discuss the article on the Forums.

Adrenal Fatigue?

Discussion in 'Hormones' started by Wackersjackers, Nov 25, 2013.

  1. Wackersjackers

    Wackersjackers

    Messages:
    15
    Likes:
    4
    UK
    Im new here and have just been tested for adrenal fatigue and it showed my levels were terribly low...in exhaustion stage.
    my cortisol levels were 15.9 /nmol - should be between 21 - 41for my age

    My DHEA was 1.04 and should be between 2 - 6...

    This is through a private clinic which has tested me, not available through our normal medical system...NHS (in uk) so as suspected, I have hormone imbalance

    Does anyone have advice on this? Is this very low or normal for people with CFS? Could it be I have this instead of CFS? I am about to take supplements to support this...

    This could be the main reason for my fatigue
     
  2. Ema

    Ema Senior Member

    Messages:
    3,413
    Likes:
    3,777
    Midwest USA
    Hi and welcome!

    Low cortisol is a really common finding in ME/CFS. Sometimes it is a result of infections causing hypothalamus/pituitary/adrenal axis dysregulation and other times it is a result of autoimmune disease, so it is important to dig a little bit more to find out what exactly is going on to know how best to treat it.

    Was this a blood cortisol test? Was it in nmol/L? What time of day was it done?

    It's certainly likely that your low cortisol is contributing to your fatigue. Unfortunately, you won't know if it is the cause of your ME/CFS until it is treated and you see whether or not things improve.

    It's also very common for hypothyroidism to occur along with low cortisol so I would also consider having this assessed. It's the free hormone levels that are most important to test - FT4 and FT3. This can also be a major contributor to fatigue and other problems.
     
    helen1 likes this.
  3. barbc56

    barbc56 Senior Member

    Messages:
    1,530
    Likes:
    939
    What kind of test did you have? If it was the saliva cortisol test, the readings are only valid at night and you need a blood test. Good luck and welcome. :)
     
  4. Ema

    Ema Senior Member

    Messages:
    3,413
    Likes:
    3,777
    Midwest USA
    Actually, that's not true. Saliva cortisol test readings are valid all day long too. They are not vampires that only come out at night.

    From a study done in 1983:

    http://www.ncbi.nlm.nih.gov/pubmed/6316831

    Ann Clin Biochem. 1983 Nov;20 (Pt 6):329-35.
    Salivary cortisol: a better measure of adrenal cortical function than serum cortisol.
    Vining RF, McGinley RA, Maksvytis JJ, Ho KY.
    Abstract
    Salivary cortisol concentration was found to be directly proportional to the serum unbound cortisol concentration both in normal men and women and in women with elevated cortisol-binding globulin (CBG). The correlation was excellent in dynamic tests of adrenal function (dexamethasone suppression, ACTH stimulation), in normals and patients with adrenal insufficiency, in tests of circadian variation and randomly collected samples. Women in the third trimester of normal pregnancy exhibited elevated salivary cortisol throughout the day. The relationship between salivary and serum total cortisol concentration was markedly non-linear with a more rapid increase in salivary concentration once the serum CBG was saturated. The rate of equilibrium of cortisol between blood and saliva was very fast, being much less than 5 minutes. These data, combined with a simple, stress-free, non-invasive collection procedure, lead us to suggest that salivary cortisol is a more appropriate measure for the clinical assessment of adrenocortical function than is serum cortisol.


    There's about 2500+ more that say the same thing. Both serum and saliva cortisol measurements can offer useful information.
     
    Last edited: Nov 25, 2013
  5. barbc56

    barbc56 Senior Member

    Messages:
    1,530
    Likes:
    939
    http://www.aetna.com/cpb/medical/data/600_699/0608.html

    http://www.sciencebasedmedicine.org/bogus-diagnostic-tests/
     
  6. Ema

    Ema Senior Member

    Messages:
    3,413
    Likes:
    3,777
    Midwest USA
    Seriously, you're posting a reference from an insurance company? Of course they only want to pay for saliva cortisol tests at night. It's about a million times cheaper than an overnight in a hospital which would be the only way to capture a midnight serum cortisol. That doesn't mean that the cortisol tests have a clock inside them. LOL!

    All of the literature disagrees with your second link. Not to mention the problems previously cited with that source. It's hardly unbiased.

    Seriously, this is not the thread to debate this though. Please start a new thread if you want to re-debate this completely settled issue rather than clutter this one up with misinformation. This new member doesn't deserve for her thread to be taken over that way.
     
    Last edited: Nov 25, 2013
  7. Wackersjackers

    Wackersjackers

    Messages:
    15
    Likes:
    4
    UK
    hi there ...i had saliva four times test throughout day...through private clinic in UK...do you think i need to push to see an endicronolgist (sp) and see if I can get a blood test - or is this something my GP can do?

    I haven't been diagnosed with CFS or ME, just fibromyalgia...but GP suspects CFS also...im now wondering if this adrenal fatigue is cause of everything?

    I actually have overactive thyroid...which is strange
     
  8. Wackersjackers

    Wackersjackers

    Messages:
    15
    Likes:
    4
    UK
    was n mol/L and was 4 times a day - morning to 11pm
     
  9. Wackersjackers

    Wackersjackers

    Messages:
    15
    Likes:
    4
    UK
    also im female..lol
     
  10. Ema

    Ema Senior Member

    Messages:
    3,413
    Likes:
    3,777
    Midwest USA
    Can you post all four results and the range along with the times that you took the test?

    If they are all under range (or very close), I would pursue further testing with a serum cortisol test and an ACTH stimulation test to rule out Addison's disease.

    "Adrenal fatigue" is a term that doesn't have any basis in the medical literature and people are prejudiced against it. It's better to discuss adrenal insufficiency, partial adrenal insufficiency and HPA axis dysregulation. They mean similar things to adrenal fatigue but without all the associations of quackery.

    If you have overactive thyroid, I wonder if you've been evaluated for Hashimoto's thyroiditis which is an autoimmune thyroid condition. It can cause swings from hyper to hypothyroid. You might be in a hyper phase now.
     
  11. Ema

    Ema Senior Member

    Messages:
    3,413
    Likes:
    3,777
    Midwest USA
    Sorry! Fixed...
     
  12. Wackersjackers

    Wackersjackers

    Messages:
    15
    Likes:
    4
    UK
    lets see if this works

    upload_2013-11-25_20-46-25.png
     
  13. Ema

    Ema Senior Member

    Messages:
    3,413
    Likes:
    3,777
    Midwest USA
    I would go be evaluated for adrenal insufficiency for sure. You're low in all periods and have lost your circadian rhythm. As someone with a very similar profile, I can tell you that this feels like absolute walking death.

    If this is all that is going on, you will feel like a new person once you get on appropriate replacement of the hormone cortisol. This is not typically something that can be solved with vitamins or herbs.

    Unfortunately, AI is really hard to get diagnosed (everywhere but particularly in the UK). Doctors just aren't familiar enough with it and you will have to be super informed to advocate for yourself.

    Here is a good place to start:

    http://www.addisonssupport.com/Documentation/adrenal-insufficiency-2003.pdf

    I believe Dr Arlt is an endocrinologist in Birmingham. One woman on my Addison's group ended up having to get a referral to her before she got diagnosed.
     
  14. Wackersjackers

    Wackersjackers

    Messages:
    15
    Likes:
    4
    UK
    how do you pursue an ACTH simulation test? im in UK, we don't have these sorts of tests...also the testing report I have print screened, goes onto say im not in the scale for Addisons disease, though I googled it (i know i know) and I do have a lot of the symptoms! Including low blood pressure
     
  15. maryb

    maryb iherb code TAK122

    Messages:
    2,882
    Likes:
    2,013
    UK
    @Wackersjackers
    Many people with ME have adrenal and thyroid problems including me, not so before I got ME however.
    Hopefully your GP will refer you to an Endo, but if not you just need to stick with the private clinic , in a way you'll probably get a more holistic treatment and more monitoring from them, which is far better than the NHS.

    Of course you may end up with drugs which many people take long term with no ill effects.
     
  16. Wackersjackers

    Wackersjackers

    Messages:
    15
    Likes:
    4
    UK
    because of a year of being tested for different things, my GP refuses to refer me to anyone else (all tests were coming back negative). this is before I got this new information...the clinic isn't a medical clinic and they won't be able to refer me, but are practitioners so are looking at helping support this with hormonal supplements

    maryb how did you help your adrenal fatigue? and advice would be appreciated...i will have to leave it a while and do my own investigations before I can get her to refer me to endo...she is already my 3rd doctor and has been the best one so far (in helping me) but now she has exhausted all possiblities (except endo) because I hadn't thought of that at time...stupid huh! my symptoms started with muscle pains, which is why fibro was diagnosed...now she attributes everything to that
     
  17. Ema

    Ema Senior Member

    Messages:
    3,413
    Likes:
    3,777
    Midwest USA
    You can definitely get an ACTH stim test in the UK. I'm not sure if that is through an endo though or a regular GP.

    I still think it is worthwhile to pursue given your saliva test results. Only dynamic testing (which is where you are infused with synthetic ACTH to see how well your adrenals can respond) can diagnose adrenal insufficiency definitively. I wouldn't rule it out based on your saliva test no matter what it says.
     
  18. barbc56

    barbc56 Senior Member

    Messages:
    1,530
    Likes:
    939
    My recommendation is that you see a doctor within the NHS and hopefully an endocrinologist.

    None of us are doctor's here so can only put in our two cents worth but reading up on these subjects is important when making an informed decisions.

    If you want to PM me, I can give you some information.

    This is a subject that is near and dear to me as I was once hyperthyroid.

    Take care.
     
  19. maryb

    maryb iherb code TAK122

    Messages:
    2,882
    Likes:
    2,013
    UK
    @Wackersjackers
    I haven't really sorted mine out at all. One year my cortisol was like your graph - Dr Peatfield called it flatlining - this year it high at all 4 times so???????? Still working on it all. No magic fix unfortunately for me.

    I would check out the doc that Ema suggested and ask your GP for a referral to them on this test results - if no joy maybe Dr Peatfeld? Sorry haven't a link - you can find him if you google.

    Ema has far more experiencein in this subject - even though she's in the US she does UK links!!:)
     
  20. Ema

    Ema Senior Member

    Messages:
    3,413
    Likes:
    3,777
    Midwest USA
    As someone who has dealt with adrenal insufficiency now for almost a decade, I've participated in and moderated Addison's forums and helped countless people through the struggle to get diagnosed properly with AI.

    All you can do at this point is continue to push for a referral. I have never seen anyone in countless numbers of profiles find sufficient support in herbs and supplements when they are flat lined below range.

    The good news is that it is eminently fixable once you find someone that knows what they are doing in this regard. Unlike fibromyalgia and ME/CFS, hypocortisolism actually has a treatment that works. It's just a real problem getting diagnosed for almost everyone.

    And maybe you don't have AI at all...but you will never know that without proper testing and proper interpretation of those tests.
     
    SickOfSickness likes this.

See more popular forum discussions.

Share This Page