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Adrenal Stress Profile - Cortisol & DHEA - Comments and advice please.

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by justy, Oct 10, 2013.

  1. justy

    justy Senior Member

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    Hi all, just got my Genova Diagnostics Adrenal stress profile results back (saliva)

    Cortisol results:
    Sample 1 (post awakening, approx 7.50 am)
    18.2 (12 -22) In range.

    Sample 2 (+ 4-5 hours - approx 12.15pm)
    1.5 (5.0 -9.0) Low.

    Sample 3 (+ 4-5 hours -approx 5pm)
    4.4 (3.0 -7.0) In range

    Sample 4 (prior to sleep -approx 1145 pm)
    0.5 (1.0 - 3.0) Low.

    Total daily Cortisol: 24.6 (21 -41 nmol/L) In range.

    DHEA Levels:
    Sample 2 (AM) 0.07 Low
    Sample 3 (PM) 0.41 Low No ranges given for DHEA results

    DHEA : Cortisol ration - 0.41 (1.0 - 4.0) Low
    DHEA Mean - 0.10 ( 0.30 - 1.00) Low

    Notes: Resistance stage 3 - Maladaption: This generally reflects the 'pre exhaustion or pre adrenal fatigue states.
    Stress ana;lysis and adrenal supprt and restorative measures are exceedingly important. A recheck in one month is strongly recommended.

    I am sure this explains my problems with taking Armour thyroid (got much more ill after initially feeling much better)

    Please also note i have been using an inhaled steroid long term, but dose low (in the past has been very high)

    Any suggestions/expalanations gratefully received - is this why i feel so appaling? are these results terrible or not that bad? Interesting that they are normal on waking - and yet feel so crap when i wake up.

    All the best Justy
  2. Ema

    Ema Senior Member

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    Other than that second noon level, they are not the worst.

    You've got a little bit of a swinging rhythm going on right now. OK in the AM, too low at noon. OK at evening, too low at night. That's typical for stressed adrenals that are still fighting the good fight.

    So if I had those results, I would try to support my adrenals with adaptogens. Since your total cortisol isn't too high, I would consider trying licorice (if you don't have high BP) because it can help extend your own cortisol. You could take some in the AM and then again at noon to try to help perk up that level.

    You could also try something like Isocort at noon and right before bed to see if that worked well for you. It contains small amounts of cortisol - something like 1.5 mg per pellet. People have varying luck with Isocort though. Some really like it and others don't find it helpful.

    Since your DHEA is low, I would also consider supplementing that hormone as well which may also support the adrenal function.

    I would also consider taking some general adrenal support like Celtic sea salt, Vit C, B complex and phosphatidylserine if those work with your other meds and supps.

    I think a swinging rhythm can make you feel out of sorts. But you still do show a good peak in the AM and that is good news because once you lose that, it is really hard to get it back again.

    If the supps don't help, I would re-test in a few months to see if things have progressed downwards.

    Ema
    justy likes this.
  3. justy

    justy Senior Member

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    Thanks for the suggestions Ema - i have taken licorice root in the past and i have no idea if it helped or not. I was given it by my herbalist to try and bring my BP up - it is very low usually. How likely is it that these results are enough out to have caused my reactions with Armour do you think? I have been debating wehter or not to add in some cortisol.

    I have also today sent the results to both Dr Skinner and Dr Myhill and decided to have a phone appt with Dr M (21st Oct) as she seems to have more of a broad overview than Dr S of all things M.E related. I really would like to try some thyroid med again, but need some advice on where to go from here. Since stopping the Armour i have slipped backwards about 2 years in my recovery - two years of very gradual but steady improvement down the drain.

    All the best,
    Justy.
  4. Ema

    Ema Senior Member

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    I think it's certainly possible that the swinging rhythm caused intolerance to thyroid meds. Especially if your thyroid was peaking at the same time your cortisol was diving. I really think you need to try to smooth out that rhythm into more of a curve rather than a seesaw. It's worth a try anyways.

    Are your iron levels good too? Low iron can also cause intolerance to thyroid meds.

    I don't think you need a full replacement dose of HC. Some people can do well with a "top up" of 5-10 mg whereas others find it suppresses more than it replaces and leaves them feeling worse. It's really hard to add to our own hormone production unfortunately. The people that seem to be able to take small doses of HC are generally those with swinging rhythms like yours though which is why I suggested Isocort because it is OTC.

    You could also try small doses of 1% HC cream applied transdermally. For some people, this also can help.

    It's so frustrating to watch years of progress slip away in a short time. I'm struggling with this as well thanks to giardia...it's just heartbreaking so I know your pain! :hug:
    justy likes this.
  5. justy

    justy Senior Member

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    Ema thanks for all the great suggestions - i will read up on it a bit more and then can ask Dr M what she thinks and maybe try some things - it always helps to be very informed before appts.

    So sorry to hear about your troubles with the Giardia - the one step forwards two steps back nature of this illness is so frustrating. In a way i found it easier when i was more severe - i just had to get my head round it and practised a lot of acceptance - now i have my hopes up its harder to slide back!

    :hug: For you to - its amazing how those cyber hugs can help.

    Justy.
    Ema likes this.
  6. bertiedog

    bertiedog Senior Member

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    Hi Justy
    I would just add that you might well find that something like Siberian Ginseng would be helpful to level out your adrenal function taking a dose after breakfast and lunch. Probably a tincture is best because you are sure it is being absorbed.

    I don't know if you have looked into B12 because that can also support the thyroid and adrenals but you might need both forms of B12 for it to help.

    Good Luck
    Pam
    justy likes this.
  7. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    I just like to add to what others have mentioned that might help. could try pregnenolone. Transdermal creams work well and pills in lipid matrix. preg can help increase cortisol and dhea, but start low and go slow is the best way as it can be quite stimulating at first.

    cheers!!
    justy likes this.
  8. snowathlete

    snowathlete

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    My unprofessional opinion is that you have good morning cortisol to get you going (which is good, but of course that doesn't mean you don't have other things holding you back is why you are struggling in the morning, but at least it doesn't look like a cortisol problem in the morning). Mine was quite a bit lower when I had mine tested if I remember correctly.

    Your second sample is very low, you're crashing quite badly there. I imagine your adrenals can't keep it up because its not just the fact its lower (it should be a bit lower at this point) it is the fact that you have less than 10% what you started with. That is going to screw with you for sure.

    Following my test my doc sent me for a different test at the hospital but it wasnt really the right test in many ways. It proved that when stimulated my adrenals could produce cortisol. But it didnt prove whether it could do that repeatedly and it also didnt look at whether my adrenals were getting any message to produce cortisol in the first place or at the right times. Be aware of that if you go to your doc and subsequently a specialist because you also may be able to produce cortisol when stimulated but your second result makes it look like you cant maintain that. But I would still see your doctor about this if I were you and explore it as best as your able to.

    by sample 3 youre rebounding quite a bit, if not for your second reading this one wouldnt look bad at all.

    sample 4 is good - what you want to sleep. mine was too high at this point. I guess that's why I am up at gone 2am writing this...sigh

    So the major issue is what on earth is going on with your adrenals at noon? It doesn't fit the rest of your picture at all. Good that you know there is a problem that you can now investigate and hopefully improve. Good luck.
    justy likes this.
  9. justy

    justy Senior Member

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    My evening one being low made sense to me as i dont suffer from insomnia (unless i stay up after 12) by 9 pm i am crashed out pretty bad and find it hard to lug myself up the stairs at 10pm for bed - then i hit the pillow hard and sleep till the dreaded night time peeing wakes me up in the early hours. I would definately rather have low at night rather than high.

    snowathlete - i have had the ACTH stim test a couple of years ago and was just told 'normal' this test is really only for Addisons which i clearly dont have. I have never looked at the actual numbers though. One thing that was strange about the ACTH stim test was that i felt fantastically calm for the whole day after i had it - more serenely calm than i have ever felt in my life.

    I need to check up on B5 and Siberian Ginseng (thanks you all) i know there have been some herbs i couldnt take (too stimulating) and i have had to be very careful in the past with B vits after a severe reaction to a SSR1 5 years ago (may well be ok now though)

    More research then!

    Thanks all
    Justy.
    snowathlete likes this.
  10. Tammy

    Tammy Senior Member

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    I have always been confused about the DHEA issue............In the beginning when I was practically
    bedridden with CFS ....my cortisol levels were too high and my CFS specialist put me on DHEA to lower the cortisol levels. Now my DHEA is low as well as my cortisol levels so I'm concerned that whenever I take DHEA it will work against me?
  11. Ema

    Ema Senior Member

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    No, I have not seen it to work that way. Yes, it can help to normalize high cortisol levels but I've never seen it lower already low levels. I took it for over a year with low cortisol levels and it never made it worse.
    Tammy likes this.
  12. justy

    justy Senior Member

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    Ema - did the DHEA help you at all, did you take it because your levels were low, and any side effects i should consider?

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