1. Patients launch a $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!
Entrevista: la apelación del millón de dólares de Ian Lipkin para un estudio en el Microbioma
Simon McGrath se aseguró recientemente una entrevista con el mundialmente famoso doctor Ian Lipkin - un científico que sigue creyendo que EM / SFC tiene una causa física - para descubrir más sobre sus planes para un importante estudio del microbioma intestinal y para averiguar por...
Discuss the article on the Forums.

Please help me understand my saliva cortisol test results

Discussion in 'Hormones' started by tiredofbeingtired, Oct 17, 2013.

  1. tiredofbeingtired

    tiredofbeingtired

    Messages:
    10
    Likes:
    0
    Hi everyone,

    So I did a 4 point saliva cortisol test through ZRT labs recently and got my results today. I am a 27 year old female who is currently working nights, but my schedule is regular in the sense that I pretty much wake up and go to bed at the same times every day (I just sleep during the day and work at nights).

    Here are my test results:

    Morning (I usually wake up around 6 P.M.) Result: 7.8 Range 3.7-9.5
    Noon Result: 7.6 H Range 1.2-3.0
    Evening Result: 2.1 H Range 0.6-1.9
    Night Result 0.6 Range 0.4-1.0

    Also, I had my DHEA-S levels tested via blood work and the result was 8.7 (Range 2.68-9.23)

    My TSH is 3.97, FT4 is 18 (Range 12-22) and FT3 is 4.7 (Range 2.6-5.7)

    So, my "noon" and "evening" cortisol levels are high, would this be contributing to my fatigue? How are my cortisol levels upon awakening? Why are my DHEA-S levels high? Do I have early stages of adrenal fatigue?

    I also have symptoms of hypothyroidism, but do I need to address my adrenals first before I can start taking thyroid medication?

    I would really appreciate any insight any of you may have and I look forward to reading your responses.

    Thanks in advance!
  2. ukxmrv

    ukxmrv Senior Member

    Messages:
    3,123
    Likes:
    1,362
    London
    Can you repost with the actual times (and not the times relative to your shift) please?. Sorry just want to be clear, having a brainfog day today.

    I've had 2 different cortisol saliva tests and one was when I was still working and doing (what was for me an early shift). The two I had done showed the same results although my actual sleep pattern was different at the time.

    Is the daytime sleeping thing a natural thing for you? How are you when not working nights?

    I come from a family of night owls and we all do best sleeping during the morning and staying up late at night. We tend to have low cortisol in the mornings.
  3. tiredofbeingtired

    tiredofbeingtired

    Messages:
    10
    Likes:
    0
    Hi ukxmrv,

    Thanks for your response. The first sample was taken at 6pm, the second at around 9pm, the third sample around 2am and the last around 630am before I went to bed.

    Due to my schedule, I have been sleeping during the day for about 2 years now. My "morning" cortisol came back normal and my cortisol right before I go to sleep seems to be normal as well, but pretty much while I'm awake, the levels are too high. I get stressed out really easily and would like to try rhodiola rosea to lower my cortisol levels during my waking hours. From my understanding, it's a bit easier and more straight forward to lower your cortisol levels than it is to have to raise them...am I right?

    Also, with my thyroid levels being a bit whacky (hypothyroid), would it be wise to sort out the high cortisol levels first prior to taking thyroid meds or can this be done simultaneously with the rhodiola rosea? Is my hyopthyroidism caused by my high cortisol levels? Is there anything else you can recommend to lower cortisol levels?

    Thanks a bunch!
  4. ukxmrv

    ukxmrv Senior Member

    Messages:
    3,123
    Likes:
    1,362
    London
    Sorry, I don't have any experience of lowering cortisol as mine is really low. Hopefully others will chip in and give us some more information.

    Historically though PWCFS have used things like Seriphos to try and lower cortisol.

    http://www.naturalhealthyconcepts.com/seriphos-IP100-p-interplexus.html

    If you do a search you should find threads on patients use of that supplement here.

    Good luck!
  5. Ema

    Ema Senior Member

    Messages:
    2,797
    Likes:
    2,618
    Midwest USA
    I would say that your cortisol levels are representative of the increased stress of working opposite our natural circadian rhythm unfortunately. Your waking level is slightly low at 70% of the range but still shows a good peak for waking though it could be more robust. Usually you would want this in the top quarter of the range but the top third is acceptable. Then you are too high during the day and fine at bedtime.

    Your DHEAs levels are creeping up also which is reflective of adrenal stress. Usually DHEAs increases before it plummets in later stages of dysregulation.

    So, yes, I would say that your cortisol levels are contributing to your fatigue more than likely. I would strongly consider a return to working daytime hours if at all possible as your best strategy to improve the cortisol rhythm.

    If that is not possible, you may wish to look into cortisol lowering herbs such as holy basil or phosphatidyl serine. Rhodiola is also used for reducing stress hormones especially in Europe. I would stay far away from any ginsengs or other stimulating adrenal herbs.

    Your thyroid results confuse me because your TSH is too high which generally indicates hypothyroidism but your free thyroid hormone levels are also too high. Generally people feel best with a FT4 at about 40-50% of the range and you are at 60%. Your FT3 range goes up higher than is typical for these days - what units are they using? Are you taking thyroid hormone replacement at this time? That high FT4 could also be causing fatigue and other symptoms as well but I don't know enough to say why it is high with a high TSH at this point.

    Ema
  6. August59

    August59 Daughters High School Graduation

    Messages:
    1,471
    Likes:
    387
    Upstate SC, USA
    Are you taking any hormones of any sort? Taking testosterone or thyroid medicine can cause your TSH to be elevated and the actual prescribing information says to test Free T4 and Free T3 when checking thyroid.

    Just my opinion too is that saliva test are only accurate for cortisol and I would have serum pulled for DHEAs, Vit. D, Free T4 and Free T3 plus any other hormone levels.

    Your DHEAs is within range and your Free T4 and FreeT3 are in range and proportional within their respective ranges.

    I'd love to have your thyroid and DHEAs levels. The TSH wouldn't mean anything to me with those Free T4 and Free T3 levels.

    Other than your non cortisol it's not real bad in relationship to your sleep schedule. I want to sleep all day and stay up all night. My cortisol is around 1.0 at 8am and goes up to 4.0 for the rest of the three test and drops back to 1 sometime between 12am and 8 am. I'm getting ready to take another test and I'm going to coordinate it with my actual sleep schedule to see how it looks. Will then probably start some phosphatylserine. I was going to start Isocort in the morning to try to get cortisol up a little bit, but Isocort is made from wild yams now instead of adrenal gland. I'm not convinced that it has the cortisol in it that it used to have. If the wild yams have not been already converted then it doesn't have any cortisol. Our body can't make anything out of wild yams.
  7. Tammy

    Tammy Senior Member

    Messages:
    257
    Likes:
    173
    New Mexico
    August.........I thought thyroid medicine (for hypothyroid) would bring TSH down instead of up............low TSH indicative of hyperthyroid while high TSH indicative of hypothyroid.............I do agree that one should look more
    at the FT3 and Ft4 levels and symptoms rather than TSH. According to her post she did have her DHEA checked via serum as well as her thyroid levels..........I'm not sure you can have you thyroid checked via saliva? Just clarifying!
  8. Tammy

    Tammy Senior Member

    Messages:
    257
    Likes:
    173
    New Mexico
    Ema I agree with the confusion about the high TSH with the high end range FT3 and FT4????????????
  9. Tammy

    Tammy Senior Member

    Messages:
    257
    Likes:
    173
    New Mexico
    Tired..............what are your hypothyroid symptoms?............I am a bit puzzled with your thyroid results as Ema mentioned. I am not sure yet if you should even consider thyroid med..............I don't like the way most DR's try to fix it with synthroid anyway and your FT4 and FT3 are in the high end range. What did your DR. suggest?
  10. August59

    August59 Daughters High School Graduation

    Messages:
    1,471
    Likes:
    387
    Upstate SC, USA
    It is suppose to, but TSH is released from the hypothalamus. The hypothalamus only releases TSH when it gets TRH from the pituitary gland. All the negative feedback loops go back to the pituitary gland. There is just a lot going on before the TSH actually gets to the thyroid.

    It's better to know that your thyroid is putting out what it is suppose to be putting out than what it is receiving. All the other hormones are tested downstream of where it is produced, but the TSH is produced prior to getting to the thyroid.

    I should have worded that different and not included the "thyroid hormone" inversely affecting the TSH level. I have attached a link to the Synthroid - Full Prescribing information. It has about 2 full pages of other medicines that effect thyroid test. The TSH test is just not a good test all the time. If the free T4 and free T3 is good like TOBT's is you wouldn't want to give her anymore thyroid meds as she would go hyperthyroid then. With a high TSH and the other labs good they might start looking for thyroid nodules or pituitary tumors.

    I would probably get it re-checked in about 6 weeks just for piece of mind.

    Drug-Laboratory Test Interactions

    Changes in TBG concentration must be considered when interpreting T4 and T3 values, what
    necessitates measurement and evaluation of unbound (free) hormone and/or determination of the
    free T4 index (FT4I). Pregnancy, infectious hepatitis, estrogens, estrogen-containing oral
    contraceptives, and acute intermittent porphyria increase TBG concentrations. Decreases in TBG
    concentrations are observed in nephrosis, severe hypoproteinemia, severe liver disease,
    acromegaly, and after androgen or corticosteroid therapy (see also Table 2). Familial hyper- or
    hypo-thyroxine binding globulinemias have been described, with the incidence of TBG
    deficiency approximating 1 in 9000.

    http://www.rxabbvie.com/pdf/synthroid.pdf

    CONTRAINDICATIONS

    Levothyroxine is contraindicated in patients with untreated subclinical (suppressed serum TSH
    level with normal T3 and T4 levels) or overt thyrotoxicosis of any etiology and in patients with
    acute myocardial infarction. Levothyroxine is contraindicated in patients with uncorrected
    adrenal insufficiency since thyroid hormones may precipitate an acute adrenal crisis by
    increasing the metabolic clearance of glucocorticoids (see PRECAUTIONS). SYNTHROID is
    contraindicated in patients with hypersensitivity to any of the inactive ingredients in
    SYNTHROID tablets
























  11. Ema

    Ema Senior Member

    Messages:
    2,797
    Likes:
    2,618
    Midwest USA
    But they are too high for the elevated TSH. I would consider getting evaluated for Hashimoto's/Graves (autoimmune thyroid disease) because there are often swings from hyper to hypo with this condition. There is a blood test for thyroid antibodies (TPO Ab and TgAb - you need both) and some doctors might want to do an ultrasound to look for nodules.

    The high TSH is the body's way to call for more thyroid hormone but according to your frees, you already have more than enough. So it is paradoxical and I would want to dig deeper.

    ETA: The thyroid hormone levels, particularly the FT3, are not as high as I originally thought. I am used to seeing these in conventional units and these appear to be SI units. So these would convert to roughly FT4 1.4 ng/dl and FT3 3.0 pg/ml in conventional units which are higher than would be expected given the TSH but not as high as I originally thought. Sorry for the mixup - and please always post units! Myself included...

    My understanding is that Isocort is derived from soybean oil...but it does not contain any residual soy. But wild yam or soy, it doesn't matter, because it all comes out chemically and functionally identical to our own hormones.

    This is the way that steroid hormones have been made since a very interesting man named Percy Lavon Julian created this new and vastly cheaper way to synthesize steroid hormones in the 1940s.

    Percy Lavon Julian's achievements cannot be understated. He was born a black man in 1899 in Alabama - not exactly the easiest start. He was one of the very first African American men to be granted a doctorate. He made a salary of approximately $50,000 (almost $500,000 in 2013 dollars) in a time where other men of his cohort were having trouble getting a seat in a restaurant. His accomplishments would be phenomenal for any time but were unbelievable for that time.

    Before Julian, steroid hormones could only be produced from the extraction of huge amounts of animal spinal cords which made them extremely expensive and limited in use. Julian is directly responsible for progesterone coming to the mass market at a reasonable cost.

    Julian then figured out a way to convert progesterone to other steroid hormones, including cortisol in the early 1950s. Before that time, cortisol was not used very much due to the expense so this was a game changer for many diseases.

    This is the same process that is used today to make all the steroid hormones we get from compounding pharmacies. This is a very safe and efficient way to make steroid hormones at a reasonable cost.

    I have no idea if the new Isocort works as well as the old Isocort but the way the steroid is made is not at all a cause for concern. This is a legitimate and common way to synthesize steroid hormones that is used all over the world thanks to the groundbreaking work of Percy Lavon Julian.

    Ema
  12. August59

    August59 Daughters High School Graduation

    Messages:
    1,471
    Likes:
    387
    Upstate SC, USA
    Ema - I was of the understanding that the new Isocort was made with "Wild Yams" in their original form. If the Wild Yams have been processed to diosgenin then yes it should have active hormones in it. I wonder if it's still the same as it used to be at 2.5 mg per pill.

    That was very interesting about Percy Lavon Julian.

    I had to start hormone replacement therapy 10 years ago and about 5 years ago my thyroid started giving me high TSH and low Free T4 and low Free T3 just like it suppose to. I started with 50 mcg of Synthroid which worked somewhat, but didn't bring levels back to where they are suppose to be. Then I tried Armour for about a year and we finally was getting things to where they felt good and my insurance quit covering Armour. So, it was back to generic Synthroid at 75 mcg and now my Free T4 and Free T3 have been right at 50% of normal values, but my TSH fluctuates between 3 and 5 which is high I'm not about to change anything. They did however early on do an MRI on my pituitary and an ultrasound on my thyroid, but it all was normal. They did a Reverse T3 and it was normal and have been at this level for about 3 years now. The "prescribing information" for Androgel used to read that it could cause false TSH lab results and to go by Free T4 and Free T3 to get an accurate thyroid values. They changed it a couple of years ago to say that Androgel could cause false values on thyroid test and to use Free T4 and Free T3 to get accurate thyroid values. I've got to get my adrenal glands functioning right. My 24 hour cortisol is just all messed up.

See more popular forum discussions.

Share This Page