Low cortisol Genova test - how to raise?

[gm286]

Hello.

My results for the 4pt saliva cortisol test. I think it goes without saying, my levels aren't where they are supposed to be. How do I proceed?

I have decided to see an endo (though I realize they aren't always of much help). Still, maybe other aspects of my hormones are off. I'd like to take this seriously because I think it's been affecting my life, in many ways, for a long time (ME/CFS, CCI, joint issues, mood issues, fluctuating energy).
I have been on a physiologic dose of prednisone (5mg) this year. Not sure if my rheumatologist will want me to wean off soon.

If anyone knows how to guide me in improving my cortisol levels, I would really appreciate the input.

Would also really appreciate if someone could point me to the right things to ask from my endo when I see her (what other hormone tests do I need? GH, more adrenal, thyroid, sex hormones?). Thanks. @Learner1

 

[Judee]

I wonder if the Pred is suppressing your adrenals. You could see if your doctor would be willing to switch you to hydrocortisone instead. It does not suppress the adrenals to the same degree. He would have to convert the amounts though because they're not equivalent, i.e. 5mg of Pred does not equal 5mg of Hydrocortisone. There are conversion tables on the internet.

Also the half-life of hydrocortisone is much shorter so you would need to split the dose throughout the day to get the same affect. The brand name is Cortef in case he isn't aware.

Also if you ever go off of steroids do a very long taper. Even the doctor recommended taper can be too fast for some people.

Edit: Also your Dhea levels look low and the ratio is low-ish. I'm not sure how one would affect the other but there are articles online about it like this one: https://marcellepick.com/how-to-balance-your-dhea-to-cortisol-ratio/