That's a typical adrenal fatigue pattern. Your cortisol could be low in the morning when it's supposed to be high, and a bit higher at night when it's supposed to be low.
Hello. Not wanting to be irritating here but wanted to make a small suggestion here to help you out in the future and then expand if I may:
Firstly, cortisol should not be high in the morning. High morning cortisol is a sign of low blood sugar (stress on the body) or some other abnormal process that needs to be ruled out. Cortisol levels (in the absence of a stressor) should be within range in the morning. Perhaps you meant, cortisol levels are high
est in the morning Vs at night? As this would be the case.
Secondly, I would advise anyone with ME CFS trying to get help for their adrenal function that is 'off' to try to avoid using the term
'Adrenal Fatigue' as doctors will treat you negatively. In medicine, cortisol is either low normal or high. Doctors usually raise eye-brows if they hear patients say things like
'Adrenal Fatigue' as naturally, they want evidence of the claim which is understandable. As is stands, there is no direct evidence of
'Adrenal Fatigue' per se (without extensive testing of things like Thyroid and nutrients that help support adrenal function), but, these are rarely performed and indirect. Due to this, the medical profession will largely be hostile to patients who use this term, so be careful who you share the concept of '
Adrenal Fatigue' with.
Lastly. In ME CFS the universal problem (there are always exceptions) isn't with our adrenal glands, it's in our
brains. The brain in ME CFS unfortunately allows us to be become overwhelmed by stress and does not 'fire' cortisol in time to protect us from it. This makes us
think we have pathalogically low cortisol at times of stress, when we largely don't, we have a triggering and management problem from HPA axis dysfunction, probably due some kind of inflammation. In hospital based testing (Short Synacthen test) we tend to have low normal cortisol but still sufficient. It does rise (after an injection of synthetic ACTH), but produces a classical 'blunted' response in ME CFS patients. In itself, doctors will ignore this finding as largely insignificant and give you a clean bill of adrenal health as technically they are right if limiting the investigation to the adrenal glands alone.
Where they are mistaken, is they don't then don't advance onto other ways to measure cortisol brain utilization such as stressing your pituitary gland (Glucagon stimulation test) and then measure cortisol production this way, instead of activating your adrenal glands via an ACTH test only as mentioned above. If one had this additional test, you could get them to measure Growth Hormone (GH). In adult GH deficiency, cortisol production is impaired, as is utilization of glucose. What I'm suggesting is PWME CFS can erroneously put their 'low cortisol' and 'low blood sugar' issues down to ME CFS when in some patients, it's actually down to adult GH deficiency, and even worse patients have no idea because they get blocked from the test because their IGF-1 comes back normal. Then they are incorrectly told they don't have GH deficiency. This is incorrect though and we can have GH deficiency with normal IGF-1. In addition to IGF-1 there is also a marker called IGF-BP2 and IGF-BP3 to look at which is rarely investigated due to cost. A single GH blood test by the amateur ME CFS patient forced to play doctor is useless to asses GH deficiency unless trying to rule out high GH. What is more useful is a 24hr urine GH test, available from
ELN lab in Holland (Europe) or via their
American Lab. With this test, you must get some sleep to maximise GH as GH is produced in certain stages of sleep in bursts (don't drink at night or a few hours before bed), as if you don't sleep the test won't be as accurate if you're up all night peeing, it will be falsely low. Getting a result back of low 24hr urine GH may explain odd cortisol symptoms that aren't true deficiencies that endocrinologists demand. What it doesn't do is prove you have GH deficiency, and you may instead have a sleep disorder. Still, with low 24Hr Urine GH you may then be able to progress onto a Pituitary Stimulation (Glucagon Stimulation test, or similar) and at least see how much GH your produce. If it's really low, then you might feel a lot better on GF injections, if deemed suitable.
In addition if you wanted to investigate cortisol issues fully when you've thought of everything else 'conventional', I would do the following tests most people don't think of:
Adrenal CT scan
Adrenal Cortex Antibodies
I'm sure they will be normal, but if they aren't, then having something like atrophy of the adrenal glands (found in some ME CFS) might be interesting as well as having sub clinical low cortisol via the presence of adrenal cortex antibodies.
Hope that wasn't too much like preaching to the choir, and apologies if it was.
