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Non-physician required lab test

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by August59, Oct 23, 2009.

  1. August59

    August59 Daughters High School Graduation

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    Does anyone knows of the best, or best value, or cheapest places to have labarotory test done that does not require a physicians order for it to be performed? I understand that some test have to be ordered by a physician, usually if a blood draw is required. Would also expect that this is the only way to accurate results for some test.
    One reason I ask is that I would like to have my cortisol/cortisone checked because I was prescribed low doses of Cortef 2 years ago and I have never had my cortisol checked. Also, have been on testosterone therapy for 4 -5 years and my direct and free testosterone is checked regularly, but I would expect that prolactin and estrogens would need to be check at some point.
    I have asked my Primary physician and endocrinologist to check these and they blow it off as a waste of money.
    I know saliva seems to be accurate for cortisol testing, but not 100% sure and don't know best place to have it done. Thanks
  2. jackie

    jackie Senior Member

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    Hi 59! Gotta make this quick (need to lie down!). I can't answer re: lab testing without dr. request but, I've just had a blood test done for Cortisol.

    This is the first time in MANY years that my doc has suggested/insisted on one being done. (previously "told" that my HMO wouldn't cover this - "not necessary"!)

    This is because of his interest in my "case" since hearing the XMRV news. Guess I'm "real" now...and I haven't even been tested for the new virus yet!!

    I will contact you with my results and any particulars about the test when the results come back. Perhaps you'll find some "ammunition" to use with YOUR dismissing docs!

    Buy the way, my Primary Care is ALSO an Endochronoligist. SOMETHING is making him change his tune!

    Good Luck.......jackie
  3. August59

    August59 Daughters High School Graduation

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    That's good to here and I hope that change of thought spreads rapidly through the medical community!
    That is the thing that gets me about doctors and HMO's. The doctor will tell you that the HMO will not cover it, but when the doctor decides it's necessary there seems to be no problem with the HMO anymore. KICKBACKS!!!
  4. Wayne

    Wayne Senior Member

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    Lab Testing for Cortisol Levels

    Hi August,

    I was in a similar position as yours about 10 years ago. I had heard normal testing with a blood draw was problematic. Cortisol levels often vary from hour to hour and day to day, so a single blood draw may not reveal much. Also, test results are open to interpretation. There are no standardized analyses of test results, so different doctors will interpret them differently.

    So I found a doctor who was able to get me a test kit to test my saliva cortisol levels at 3-4 different times in one day by sucking on bits of cotton. Well, every time I did it, I got a very bad headache. Quite likely the cotton was not organic, and I was reacting to it in a big way. Not a good way to measure baseline cortisol levels!

    I had been reading on adrenal insufficiency and supplementation with low-dose hydrocortisone. The book that impressed me the most was one entitled, "Safe Uses of Cortisol by William Jeffries. Dr. Jeffries devoted his entire career to researching and developing a low-dose hydrocortisone protocol for people with adrenal insufficiency.

    He has little confidence in any of the current tests to measure cortisol levels, including the Cortrosyn Stimulation Test or the Adrenal Stress Index test. He says our cortisol levels fluctuate too much to get an accurate snapshot of the true status of adrenal function. He instead relies primarily on a patients response to a trial supplementation.

    I presented this information to my doctor at the time, and she agreed to give me a prescription to Cortef without doing any actual testing. Looking back, I feel grateful for her cooperation, and feel it was the best course of action for me. Doing low-dose hydrocortisone made a huge difference for me and still does.

    I've posted a quite a bit on my successful low-dose hydrocortisone supplementation experience over on the ProHealth Board. I'll paste my first post on that thread below; you can click on this link which will take you to the entire thread. It's fairly long and has a lot of good contributions from a number of people.

    All the Best, Wayne
    ......................................................

    Im starting this thread because Ive noticed there has been no reference to the book Safe Uses of Cortisol by William Jeffries. I considered this book (and still do) the most authoritative literature on low-dose hydrocortisone Ive been able to find. Dr. Jeffries devoted his entire career to researching and developing a low-dose hydrocortisone protocol for people with CFS, FM, arthritis, post-viral syndrome, mononucleosis, HPA axis dysfunction, hypoglycemia, and many other conditions including infertility. He found even marginal adrenal insufficiency can have big effects. Some highlights Ill mention for now:

    1. The average body makes approx. 40 mg cortisol/day. If you have adrenal insufficiency, the adrenal glands are constantly trying to increase cortisol levels, and being unable to do so, virtually never fully rest. By supplementing with enough cortisol (Cortef) to bring levels back up to normal, the whole body starts to function better and the adrenal glands get a chance to start resting and hopefully start rejuvenating.

    2. The average dose necessary to bring cortisol levels to normal are 20-30 mg per day. As long as you keep the amount below 40 mg/day, your adrenal glands will not shut down, which is a problem with higher dose supplementation. He goes into detail the history of cortisone, and how the initial promise of it became obscured when early high dose supplementation created many of the problems that doctors are currently concerned with. Unfortunately, most doctors know nothing about the safety of lower doses.

    3. Cortef / hydrocortisone has the same molecular structure as our bodys natural cortisol. Prednisone and most of the other synthetic souped-up products that are often prescribed are on average about 4 times more potent than cortisol. Each pharamaceutical company had to come up with their own unique molecular formula so they could get a patent and get in on this market. Supplementing with these can be very problematic on a long-term basis.

    4. He has little confidence in any of the current tests to measure cortisol levels, including the Cortrosyn Stimulation Test or the Adrenal Stress Index test. He says our cortisol levels fluctuate too much to get an accurate snapshot of the true status of adrenal function. He instead relies primarily on a patients response to a trial supplementation. He starts out at 20 mg/day for about 1-2 weeks. If no improvement is noticed, he increases it to 30 mg/day. If there is still no improvement in symptoms, he usually determines that adrenal insufficiency is not the problem, and takes another 2-4 weeks to gradually withdraw the supplementation. In other words, if you dont need it, your body wont respond to it.

    Ive been taking 20-25 mg/day of Cortef for about 8 years now and I believe it is the difference between my being about 20-25% functional as opposed to being about half that or less. All the side effects have been good. To name a few: better digestion, better stress response, increased ability to relax, better sleep, and more.

    Ive experimented with two other brands of hydrocortisone. I believe one was a compounding pharmacy product and another a brand name I cant remember. Neither of them were good for me at all (gave me a very disconcerting feeling). Only the Cortef works for me.

    My initial dose of 5 mg felt like I had drunk too much coffee and went outside and walked like I hadnt walked in ages. Realize now that my body was so unused to having this degree of energy coursing through my system, and needed time adjusting to it. But gradually increasing the amount over a two week period brought me to appropriate and comfortable levels. I now feel very confident that this is both safe and highly beneficial for me.

    Im a big believer in researching things before trying them out. For those of you who have been contemplating any of this, perhaps this will be an incentive to take that next step in your research.

    Wayne
  5. lostinthedesert

    lostinthedesert Killer, Clown, Priestess

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    Most people I know are doing saliva cortisol.

    If you are willing to pay cash you can get almost any blood test you want through dozens of companies who will issue a lab order for Labcorp, Quest or sometimes a local hospital. You pay online, print out your lab order and then go in as if a doctor had sent you to the lab. You can then get your results online. If you google around you can find many such places but one is https://econolabs.com/ I have not used them but know of people on the net who have. Prices vary widely and and no single place is the lowest for all tests. It pays to shop.

    S
  6. Tony

    Tony Still working on it all..

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    This whole hormonal thing is a jungle isn't it! I did a 24hr saliva test (saliva in a separate vial 4 times over 24hrs) that measured cortisol, dhea, pregnenolone, melatonin, aldosterone and the dhea/cortisol ratio.

    It was the dhea/cortisol ratio that was low for me. The cortisol was high during the day and lower than normal at night. This symptom had really wiped me for some time. 100mg of dhea is very, very helpful for me.
  7. cfs since 1998

    cfs since 1998 *****

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    I had no idea such companies existed. Thanks so much for posting this.
  8. August59

    August59 Daughters High School Graduation

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    Found a couple of more places that do various types of labwork. Labtestonline.com, DirectLabs.com and zrtlabs.com
  9. Andrew

    Andrew Senior Member

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    Los Angeles, USA

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