Hi! this topic was covered here a few years ago: http://forums.phoenixrising.me/inde...g-with-me-feel-soooo-awful.23407/#post-358521 I have the same problem: serum total cortisol in the normal range, free cortisol levels very low. I frequently get nauseated and feel very weak, aching all over, especially a dull and deep ache in the midth area (low back - abdomen - thighs). I checked my hormone levels and despite being extemly low in testosterone (I am female, 38), estrogens and progesterone were fine, no estrogene dominance, the ratio of estrogenes to porgesterones in the second half of the cycle was "perfect". The months before testosterone was just fine, so it seems to fluctuate. Never the less I feel much more energetic in the first half of the cycle with rapid decline of energy in the second half (more fragmented sleep, more pain, extreme symptoms of low cortisol). It gets better with day 1 of menstruation. So I really ask myself: if estrogenes are probably not the culprit, why do I have such low free cortisol? I also measured the levels when I had a good night sleep (levels then were low but more normal) and when I did not sleep enough (very, very low levels of free cortisol). That's why I am struggling with hydrocortisone therapy, because my levels vary a lot and probably my hormones do so, too. I am also on synthroid (50 mcg) which increases my exhaustion but is necessary to prevent my nodules from further growing/surgery. Andy ideas/suggestions? I can hardly function due to low cortisol but doctors here don't have any ideas why it's so low. My mitochondrials seem not to be the main problem and most of the time I don't have the typical tiredness of an overactive immunesystems. So I guess the cortisol is my biggest issue most of the time. My morning free cortisol is normal, I forgot to mention, and then rapidly declines. My ACTH is also in the low normal range. I have also low epinephrine, elevated dopamine, normal serotonine / norepinephrine, I am MAO A& B ++ und COMT +/- and when doctors put me on antidepressants I felt I have to die! Again, any ideas appreciated. I did a lot of research but am at my wits end. Thank you, I know this is complex stuff!