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Could someone help me make sense of adrenal test?

Messages
1
I was diagnosed with hypothyroidism back in Aug, TSH was 183, still working on fixing things.
I have an appt next week but I was wondering if anyone here can help me translate some of this, so I can have a good back and forth convo with my Dr next week. Thanks!
Free Cortisol Rhythm - Saliva

8 am 18 Normal 13-24 nM
1pm 5 Normal 5-10 nM
5 pm 8 Normal 3-8 nM
midnight 2 Normal 1-4 nM

Dehydroepiandrosterone Free [DHEA + DHEA-S]
Pooled Value 4 Normal Adults (M/F): 3-10 ng/ml

Insulin - Saliva
Fasting 31 Hyperinsulinic Normal: 3-12 uIU/mL

Non-Fasting 19 Normal Optimal: 5-20 uIU/mL

Total Salivary SIgA 8 Borderline Low Borderline Low: 5-9 mg/dL
Gliadin Ab, SIgA (Saliva) 4 negative
 

xks201

Senior Member
Messages
740
That fasting insulin level is a little scary. Cortisol looks good though. Make sure your testosterone and estrogen levels are in range to control blood sugar and make sure thyroid isnt being undertreated
 

Ema

Senior Member
Messages
4,729
Location
Midwest USA
I was diagnosed with hypothyroidism back in Aug, TSH was 183, still working on fixing things.
I have an appt next week but I was wondering if anyone here can help me translate some of this, so I can have a good back and forth convo with my Dr next week. Thanks!

Welcome to the forum!

That is one heck of a TSH. Any ideas on what is going on there? Have you had thyroid antibodies tested? How is your treatment going? Have you tested your free hormone levels lately?


Free Cortisol Rhythm - Saliva

8 am 18 Normal 13-24 nM
1pm 5 Normal 5-10 nM
5 pm 8 Normal 3-8 nM
midnight 2 Normal 1-4 nM

I would actually call this the beginnings of HPA axis dysfunction.

You are too low in the morning at 45% of the range. You should be in the top third at least.

You are too low at 1PM. This should also be closer to the 50-75% of the range.

You are too high at 5PM.

Midnight is OK, but also might be a little bit too high. It should be at the very bottom of the range by midnight.

So you have a swinging rhythm where your pituitary is sensing the lows and highs and overcorrecting.

You are losing your peak in the AM. Once you lose your peak, I can tell you from experience, it is VERY hard to get back. I would not waste any time in getting on a solid plan to improve your circadian rhythm and cortisol levels with your doctor. This is when you want to catch things....before they have flatlined out totally and you no longer make cortisol properly.

A light box might also be a useful tool for you to help get up your morning cortisol.

You have some options here to discuss with your doctor...with a swinging rhythm, you might be one that could benefit from a low dose of HC (5-10 mg in the AM). However, that might make your noon cortisol go too high and feel worse.

You might want to try some licorice in the morning which works metabolically to extend the life of your own cortisol. And other adaptogens during the day (like rhodiola, ashwagandha, schisandra, etc etc there are many choices and things to consider when picking the appropriate adaptogen for your situation) to modulate your cortisol levels.

Phosphatidylserine would also likely be a good choice as it is a modulator as well. It is involved in the cell membrane of every cell and is of vital importance.

Dehydroepiandrosterone Free [DHEA + DHEA-S]
Pooled Value 4 Normal Adults (M/F): 3-10 ng/ml

This is low too which is typical of HPA dysregulation. You would likely wish to discuss a low dose replacement with your doctor.

I have had the best luck with micronized versions of DHEA. Women typically need no more than 10-15 mg of DHEA a day.

Insulin - Saliva
Fasting 31 Hyperinsulinic Normal: 3-12 uIU/mL

Non-Fasting 19 Normal Optimal: 5-20 uIU/mL

I would agree that is way too high. I am not sure where they are getting those optimal numbers...I personally think an optimal fasting insulin would be somewhere around 3-5 uIU/mL.

ETA: Possibly the discrepancy is because I am more accustomed to seeing serum numbers, not saliva.

What's going on with your fasting glucose? Do you have weight problems? Blood pressure issues? PCOS?

Total Salivary SIgA 8 Borderline Low Borderline Low: 5-9 mg/dL
Gliadin Ab, SIgA (Saliva) 4 negative

Here is a nice write up that talks about possible causes of low sIGA:

http://www.metametrix.com/files/learning-center/articles/Secretory-IgA.pdf

Hope that helps!