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Are 24-hour Saliva Cortisol/DHEA tests helpful?

outdamnspot

Senior Member
Messages
924
I went to see an integrative medicine GP today for some issues I've been having -- reactive hypoglycemia (though glucose isn't sub-normal, for whatever reason -- just rising, then dropping after meals), severe inability to handle stress, constant adrenaline rushes, dizziness and vertigo etc. An endo dismissed the symptoms because some tests came back normal (I was too unwell to complete half of them, though).

She was expensive and a bit fruity. She seemed to think Zinc and B6 would fix all my problems. However, I tried to explain that a major issue is that I've become completely *intolerant* of all supplements, which just seem to exacerbate my appetite and reactive symptoms.

Anyway, the appointment was really expensive and I wanted to get something out of it. She gave me forms for a bunch of tests (Pylouria levels etc., Zinc etc.) and said I could decide which tests I want to do, since they're all out-of-pocket.

I pushed for a 24-hour saliva cortisol/DHEA test because I know there's a connection between cortisol and blood sugar/appetite control. She was happy to give me it, but it is a bit expensive.

Would it be useful having that information on hand? My concern is that a doctor wouldn't take the results into account anyway, since I know most don't generally use the 24-hour test.
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
You can get ZRT dhea and cortisol test online for about $130. I just did it, no rx necessary. You take 4 samples through out the day. And zrt was very helpful explaining how to do the test.

I can't think of where I got it right now. Give me a few Minutes. It's on the tip of my brain. Oh canary club.

Was worth it? I don't know. I'm glad i did it. One less thing to wonder about.
 

Firefly_

Senior Member
Messages
235
Location
Oklahoma, USA
You can get ZRT dhea and cortisol test online for about $130. I just did it, no rx necessary. You take 4 samples through out the day. And zrt was very helpful explaining how to do the test.

I can't think of where I got it right now. Give me a few Minutes. It's on the tip of my brain. Oh canary club.

Was worth it? I don't know. I'm glad i did it. One less thing to wonder about.

Funny minkeygirl I thought you were cursing politely when you said "Oh canary club"
 

Firefly_

Senior Member
Messages
235
Location
Oklahoma, USA
My saliva test was very fruitful as it found I have no cortisol production and I think a fair amount of us have low levels or unusual patterns of production and at least this one problem can be helped.
 

outdamnspot

Senior Member
Messages
924
You can get ZRT dhea and cortisol test online for about $130. I just did it, no rx necessary. You take 4 samples through out the day. And zrt was very helpful explaining how to do the test.

I can't think of where I got it right now. Give me a few Minutes. It's on the tip of my brain. Oh canary club.

Was worth it? I don't know. I'm glad i did it. One less thing to wonder about.

well, I have the form and it will cost me about $160 aus, which is like $130us anyway.

I guess I will do it. I need to find a better integrative GP though
 

outdamnspot

Senior Member
Messages
924
Didn't know where you were. Try amazon. They carry them too from several places.

@Firefly_ Lol I don't swear politely.

Oh yeah, what I meant though was that paying to get it done locally for $160aus probably won't be much cheaper than ordering online anyway. I was more just debating whether to get the test done at all, since funds are scarce, but I'm struggling to find an answer to my symptoms.
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
I know what you meant. But you might be able to find it cheaper on amazon or other places. Lots sell the kits and there are different brands. Even if its only $10 that's $10 to waste on something else.
 
Messages
4
When considering the value of a test like this, what is important to me is to think about what the test will tell you, and what the treatment will be. Sometimes, it is better just to try the treatment and see if it helps. If the 24hr cortisol test comes back showing you have a problem, the most likely recommendations will be change of diet and adrenal supplements. Even if your cortisol *is* low, these treatments may or may not help. So, it might be better for you to just try changing your diet and see if you experience any improvement. You can always do the test later.

Here is the program my Dr. recommended:
https://www.adrenalfatigue.org/

It also has an "adrenal fatigue questionnaire" which is designed to help diagnose this without a blood test. IMO it is skewed towards telling you there is a problem, but it may be useful in helping to indicate if this is a road for you to go down to pursue further.
 

outdamnspot

Senior Member
Messages
924
When considering the value of a test like this, what is important to me is to think about what the test will tell you, and what the treatment will be. Sometimes, it is better just to try the treatment and see if it helps. If the 24hr cortisol test comes back showing you have a problem, the most likely recommendations will be change of diet and adrenal supplements. Even if your cortisol *is* low, these treatments may or may not help. So, it might be better for you to just try changing your diet and see if you experience any improvement. You can always do the test later.

Here is the program my Dr. recommended:
https://www.adrenalfatigue.org/

It also has an "adrenal fatigue questionnaire" which is designed to help diagnose this without a blood test. IMO it is skewed towards telling you there is a problem, but it may be useful in helping to indicate if this is a road for you to go down to pursue further.

I guess that, for me, I thought it would be helpful to have some kind of metric to correlate with my symptoms -- or something objective that I could show specialists. Though as I said above, I wasn't sure if any would take the saliva test into account anyway.

I have switched to a ketogenic diet recently and am seeing some improvement.
 

bertiedog

Senior Member
Messages
1,736
Location
South East England, UK
I think that its always worth taking this test if it is suspected that one's adrenals are working great. For me it showed up a huge imbalance in cortisol and DHEA, basically I didn't have enough cortisol when needed to handle stress or my need for thyroid medication due to Hashimotos but instead I had an over the range amount of DHEA at every point of the day and night.

Some doctors rubbish this test but in fact some Endos measure treatment success or otherwise with saliva tests and they do correlate what is in the cells and usable for the body.

Having organised these tests for several people through Genova I have only seen one that looked normal. Once my private Endo saw my results he said I needed hydrocortisone and it did give me my life back but unfortunately hasn't stopped me from still suffering with ME/CFS/lyme.

I think you can order Genova tests online without a doctor.

Pam
 

drob31

Senior Member
Messages
1,487
My opinion is: it depends.

One test is not helpful because of all of the variables involved.

You need multiple tests, probably 3, under controlled conditions over the course of a month. You need to be consistently taking or not taking supplements that affect these results as well as not eating prior to the test, as your cortisol triples when you eat.

If eat something too soon before a test, or take supplements like pregnenelone, and only take one test, the results are worthless, IMO.
 

whodathunkit

Senior Member
Messages
1,160
I found my cortisol saliva test to be helpful in confirming my suspicions of adrenal dysfunction. It was also rather appalling because I didn't expect it to be as bad as it was. :lol:

It won't help you get better but it will help you determine what's really wrong, which can help you get on the right track to getting better. If you get repeats it could also help you determine if your interventions are working.
 

justy

Donate Advocate Demonstrate
Messages
5,524
Location
U.K
I found the Genova test easy to do and was not suprorised at the result - low cortisol at every point except first thing in the morning and very low DHEA.

What to do about it when you can take supplements or steroids is another matter. DHEA supplementation did not work out well and I have bacterial infections so cant take steroids - and react badly to them at low doses anyway.

So in the end for me, it was just interesting information and not something I have been able to fix - like pretty much every ppther problem I have unearthed - trying to fix it only leads to awful reactions or worse symptoms popping up in a different direction.
 

outdamnspot

Senior Member
Messages
924
I think that its always worth taking this test if it is suspected that one's adrenals are working great. For me it showed up a huge imbalance in cortisol and DHEA, basically I didn't have enough cortisol when needed to handle stress or my need for thyroid medication due to Hashimotos but instead I had an over the range amount of DHEA at every point of the day and night.

Some doctors rubbish this test but in fact some Endos measure treatment success or otherwise with saliva tests and they do correlate what is in the cells and usable for the body.

Having organised these tests for several people through Genova I have only seen one that looked normal. Once my private Endo saw my results he said I needed hydrocortisone and it did give me my life back but unfortunately hasn't stopped me from still suffering with ME/CFS/lyme.

I think you can order Genova tests online without a doctor.

Pam

What if I started an adrenal extract to see if it helps my symptoms and then stopped it when I can afford to get the saliva test done? Would that be okay?
 

bertiedog

Senior Member
Messages
1,736
Location
South East England, UK
@outdamnspot You could always try that and monitor your symptoms. Its helpful to take your temperature at a couple of points throughout the day and keep a record.

One thing to be aware of is that sometimes people think they have got low cortisol but when they get the test done they find that they have some high cortisol readings. It is rare though but something to be aware of.

Were you thinking of an adrenal cortex only supplement or the herbal route like Siberian Ginseng? I think the Siberian Ginseng can be good because it also seems to support the thyroid. Its best taken after breakfast and lunch only because in some people it can be overstimulating and always start at a low dose and gradually work up.

If you do the test you need to be off any supplements or herbals for at least 2 weeks to get a true result.

Pam
 

outdamnspot

Senior Member
Messages
924
@outdamnspot You could always try that and monitor your symptoms. Its helpful to take your temperature at a couple of points throughout the day and keep a record.

One thing to be aware of is that sometimes people think they have got low cortisol but when they get the test done they find that they have some high cortisol readings. It is rare though but something to be aware of.

Were you thinking of an adrenal cortex only supplement or the herbal route like Siberian Ginseng? I think the Siberian Ginseng can be good because it also seems to support the thyroid. Its best taken after breakfast and lunch only because in some people it can be overstimulating and always start at a low dose and gradually work up.

If you do the test you need to be off any supplements or herbals for at least 2 weeks to get a true result.

Pam

Fair enough, Pam. I feel like I'm somewhat attuned to knowing when my cortisol is high or low (based on subjective symptom fluctuations throughout the day, and also my response to supplements), but you never know ..

I was thinking of trying an Adrenal Cortex supplement -- specifically ADRENergize by Enzymatic Therapy. Siberian Ginseng dropped my blood sugar (which is already a huge issue).

Damn, 2 weeks would be difficult. I really am not coping at all right now -- but I guess I'm worried that if I start a supplement and see an improvement, it might mask the problem.
 

poohsilk

Never gives up
Messages
36
Location
San Diego 2019
Started very low amounts of hydrocortisone 5 weeks ago and it has gotten me out of bed more. I have high hopes for it helping with just getting my feeling better. Then Doc will address infections he is still testing for. I have just ordered the Book Stop the Thyroid Madness II to see if I can learn more about monitoring my adrenals and thyroid. We will be adding T-3 to my Armour soon. I just started taking my temperature orally 3x/d.I have been taking adrenal cortex extract for years. Adrenergize by ET is the whole glandular and causes too much adrenaline. You can also read about it at STTM website a bit. I use Adrenal Stress End.
 
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