Saliva Hormone Tests - need some help

[kerrilyn]

I just got my saliva hormone testing back from ZRT labs and I'm a little confused.

I did 4x Cortisol and it says:

Morning is high 10.9 (normal range is 3.7-9.5)
Noon is normal 1.8 (1.2-3.0)
Evening is normal 1.1 (0.6-1.9)
Night is low 0.3 (0.4-1.0)

They say "this indicates low adrenal reserve. This type of circadian pattern is likely caused by stressors that raise adrenal cortisol production in the morning, followed ay adrenal exhaustion by the end of the day due to a persistent stressor."

Yeah - I'm sick all the time. What confuses me is that I assumed it would be the exact opposite (low in morning and high at night). I can't get up before 9-10 am or I'm sicker all day (shakes, chills etc). Before 6 pm I don't seem to be able to do anything and then I start to wake up and get energy and I have a hard time falling asleep before 1, 2 or 3 am.

The day of the test I got up at 7:30 am so I could do the 8 am morning test (as a doctor said I should) and I stayed on the couch all day till 6 pm, feeling absolutely horrible. It was a struggle to stay awake the whole day.

The other odd finding is that I'm high in DHEA. This was sent in with the am saliva sample. My DHEA is 20 (the range for a 20 y.o., but I'm 40). ....this is the anti-aging hormone - so why do I feel like I'm 100 years old?!

With high DHEA, you are suppose to have irregular periods, acne and extra hair growth (if involved with Polycystic Ovary Disease) - I have none of those things. It's also involved with insulin resistance, now that I can see because I am overweight, cannot lose weight and have a family history of diabetes.

I had bloodwork in June, September and October and DHEA was near the high end of normal.

My testosterone level is now low normal. I was very low in blood work last June, so started supplementing with bio-identical cream. Within a 6 months it was double the high end of normal (and I was irritable). I reduced the dosage and recently stopped taking it, so I guess that's why it's started to fall again.

I've always had signs of estrogen dominance and have been supplementing with bio-identical prog cream too.

I also did a Vitamin D blood spot test and it was 23 (normal is 32-100 with optimal 50-80).

Can anyone give me some more info about the DHEA/Cortisol results? Thanks

 

[kat0465]

Hi Kerrilyn,
i had my saliva test, and showed NO cortisol in the am, and a slight bit of it in te PM. which is why i probably feel better in the evenings.i wake up every morning feeling justike you do
but by late afternoon i start to feel slightly better.
i would think your cortisol level would be low in the mornings also, but maybe it's so extremely high is why you feell so awful.
Just a thought. the adrenal fatigue we expierence is so awful, and hard to treat. i did Isocort & dhea for almost a year & didnt feel much better
So sorry your having a rough time. Hang in there
Kat

 

[gracenote]

Kerrilyn,

I'm puzzled by your results, also. I'm very slow in the morning and only start to get any energy in the late afternoon. I feel better in the evenings, usually. My morning cortisol was low and then matched up to normal later in the day.

The only suggestion I have for you is to retake the test at a later date. Sorry. That is not very helpful.

 

[kerrilyn]

I just don't understand why it showed this. I've had a doctor, compound pharmacist and ND say that I have adrenal fatigue/exhaustion (I don't think they even believe in CFS, but that's another story). I've never felt that adrenals are my only problem, although do think it's part of it, but this test doesn't necessarily show they are much of a problem at all. Isn't this almost what a healthy person's test would display?

5 years ago I did the same test with a different lab and it showed low morning, high noon and normal evening/night. They said it was likely because I got up at 8 am and went back to bed for a couple hours before noon, which I did, because it's so hard for me to get up early and stay up. So I didn't learn much from that test. This time I stayed awake.

You don't take the test in the morning when you normally wake (say 10 am) and then push back the other samples back 2 hours too? I mean, even if you normally sleep till 10 am and stay up till 1 am, you still do the test at the times that are requested (8 am, noon, 4-6 pm and 10-11 pm), right?

 

[gracenote]

kerrilyn,

Here are my labs. I always took them at the right time, but I don't know how to explain them. The lab uses different numbers than yours.

As you can see, I test low to normal on the Free Cortisol Rhythm, high normal on the blood test for AM Cortisol, and high on the 24-hour Hormone Profile urine test.

DIAGNOS-TECH
Free Cortisol Rhythm
saliva
6/25/08

7:00 - 8:00 2 DEPRESSED (Ref Values 13-24 nM)
11:00 - noon 6 NORMAL (Ref Values 5-10 nM)
4:00 - 5:00 3 NORMAL (Ref Values 3-8 nM)
11:00 - midnight 2 NORMAL (Ref Values 1-4 nM)

LAB CORP
blood
2/09/08

Cortisol AM 21.5 (Reference Interval 4.3-22.4)

RHEIN CONSULTING
Hormone Profile
24 hour urine collection
4/28/08

Cortisol 274 HIGH (Reference Range 25 - 115 ur/24hrs)

My intention isn't to confuse you (although I've probably done that), but just to agree with you that it's complicated.

 

[kerrilyn]

Thanks Gracenote. It is complicated. What is even stranger is that I have noticed for the last couple weeks I've gradually been getting tired earlier and waking up earlier. Last night I went to bed at 11:30 pm and woke up at 8 am - like a normal person!! Bizarre. I still feel like death warmed over but strange hormonal changes are going on. I was freezing most of yesterday and then a bit before bed I started sweating, I rarely sweat. I can count the number of times I've actually sweated. I wonder if my cortisol levels change throughout my menstrual cycle. I've got to keep better track this month of what symptoms are happening at what times.

Oh, the joy of hormones....

 

[fred]

Have you read the articles below? They discuss adrenal fatigue and also refer to dysfunctional adrenals' impact on the thyroid.

My cortisol levels are within the specified range but DHEA is suppressed. My TSH (Thyroid Stimulating Hormone) is at the top of its acceptable range (bordering on hypothyroidism) and has increased by 4.5 times over time. My theory is that there is not enough DHEA to counterbalance the cortisol which, in turn, is suppressing thyroid function.

www.stopthethyroidmadness.com is a useful site to help understand the adrenal-thyroid connection. It also suggests that you record your temperature four times a day over two weeks to monitor the thyroid. I did this for four weeks and was surprised at the results. The average temperature was very low but there were significant fluctuations on a daily basis. My temperature was lowest when I felt most hot and highest when I felt most cold.

http://www.ei-resource.org/illness-...tment-for-adrenal-fatigueadrenal-exhaustion/

http://www.ei-resource.org/articles/related-conditions-articles/adrenal-fatigue:-what-is-it?/

http://www.ei-resource.org/articles...drenal-fatigue-with-the-adrenal-stress-index/

 

[kerrilyn]

www.stopthethyroidmadness.com is a useful site to help understand the adrenal-thyroid connection. It also suggests that you record your temperature four times a day over two weeks to monitor the thyroid. I did this for four weeks and was surprised at the results. The average temperature was very low but there were significant fluctuations on a daily basis. My temperature was lowest when I felt most hot and highest when I felt most cold.

Thanks Fred I just read that last night, and thought I would start monitoring my temp today. I know my mother's side of the family has messed up thyroids. Hormonally speaking there has been problems for every female on that side of the family for generations. I also have a lot of hypothyroid symptoms, but my tests were said to be fine.

My hormones have been an issue since puberty and my grandmother and her sisters actually went 'insane' during menopause. I'm trying to get things sorted out to avoid something like that.

I'll read those articles and include some one my bloodwork results in this thread incase someone can see something that is being missed. Thanks

 

[kerrilyn]

Incase these results mean something from a thyroid standpoint.

All bloodwork was taken day 18-22 of cycle.

06/09 bloodwork: draw taken at 1:50 pm
sTSH: 1.86 (0.35-5.00)
Free T3: 4.2 (2.6-5.7)
Free T4: 12 (10-20)
Anti-thyroid Peroxidase and anti-thyroglobulin: both negative
DHEA: 8 (1.65-9:15)
Random Cortisol: 211 (65-540)
Free Testosterone: 1.4 (ND - 8.9) (considered very low for age)
Progesterone: 14.5
Estradiol: 495 (Estrogen dominant ratio prog:Est)

Started supplementing with progesterone and testosterone cream.

09/09 bloodwork: draw taken at 3:00 pm
Free Testosterone 16.8 (ND-7.0)
Now too high. Increased from 1.4 to 16.8 in 3 months


10/09 bloodwork: draw taken at 10:00 am
sTSH: 2.15 (0.35-5.00)....was 1.86
Free T3: 4.9 (2.6-5.7)....was 4.2
Free T4: 13 (10-20)....was 12
Anti-thyroid Peroxidase and anti-thyroglobulin: both negative
DHEA: 7.6 (1.65-9:15)....was 8
Random Cortisol: 463 (65-540)...was 211 (morning vs. aft blood draw)
Bioavailable Testosterone: 2.9 (0-1.2) (Still high on bioavailable vs. Free)
Progesterone: 22.2 .....was 14.5
Estradiol: 487 .....was 495

FWIW, I have low BP (102/60 at the doc's office), with high DHEA I read it can cause hypertension, I've never had a reading higher than 110/75 in my life.

 

[gracenote]

I started waking up earlier when I went through menopause. I hadn't been up regularly before 10 or 11 (and then didn't feel awake until 2) for years and years. All of a sudden I had a couple of more hours in the morning. It was very disconcerting for awhile what do people do in the mornings?. :Retro smile: My sleep changed at that time and became more fragmented and I started needing medication to help me stay asleep (not just get to sleep).

 

[L'engle]

I'm also confused about the hormone test results. Mine are actually pretty similar to yours, Kerrilyn, except I haven't had the cortisol test yet. I'm supposedly in the normal range for everything, I guess, but have mixed syptoms of thyroid and adrenal fatigue. I have a px for Armour, but I'm worried that taking it will further deplete my adrenals. I'd like to get a px for 7 Keto DHEA or adrenal glandulars, but I think this may be difficult given my DHEA test in the normal level. Still I've heard the test results are often in inaccurate and it is best to prescribe by symptoms rather than the numbers. Hopefully I can get a doctor to go with this, since I need a px fro 7 Keto DHEA where I live. Any luck for anybody else? I can usually get up in the morning and sleep at night but I am tired/sick all the time. BTW the tests I had were blood tests, not saliva.

Thanks.

 

[kerrilyn]

Hi L'engle

From what I have read, getting a 4 cortisol SALIVA test is more accurate to monitor adrenals than with blood. That's why I was disappointed the doctor I was seeing just kept testing my blood when I knew he actually did you saliva testing as well. So I ordered the test myself through ZRT labs.

I would be hesitant to take meds until you have a baseline of function to go by. But yes, I think it can be valuable to treat based on symptoms and not strictly what lab results, are in some cases.

There are a lot of other things to test for that can be useful in the overall picture too. For example I am very low in ferritin, I have been for a long time and it doesn't seem to improve with supplementing. I also just did a Vitamin D test, and that was also extremely low - I'm not surprised. I'm just starting to look at www.stopthethyroidmadness.com and there is some really good info on there about what to test and why.

Next I'm getting tested for B12, folate and MMA (Methylmalonic Acid). I'm going to do both serum and urine. I've ordered a urine test that is called MAP (metabolic Analysis Panel from Genova labs, through Direct Labs online so I didn't need a doctor's requisition). You can read more about that here http://www.forums.aboutmecfs.org/showthread.php?3819-B12-Tests-any-point-and-what-are-they B12 deficiency can be very overlooked, some people can supplement and do much better, with others it's more complicated.

I had another thread about adrenals that forum members were helpful on, you can read it here. http://www.forums.aboutmecfs.org/showthread.php?3052-CFS-or-Adrenal-Exhaustion

I may not find out anything with the tests, but I have to try. Good luck to you too.

 

[L'engle]

Thanks Kerrilyn

The blood work I just got back said I am actually too high in B12 and almost too high in Vit D, so I'm stopping those. My ferritin was 45, which is supposed to be good. I had about 30 blood tests taken this week, and another 10 next week. I looked into the saliva testing,but $170.00 to get some tests that a doctor might not take seriously anyway seems to me very roundabout compared to trying out a supplement at a very small dose and monitoring for side effects. If I were in the States I would just go out and get 7-Keto DHEA for $10, but up here it is impossible to come by without a px. My naturopath last year said a small dose of 5-10mg a day is usually safe for women. I'm really leery of taking any cortisol replacements or other hormones, though!

Thanks for the links, I hope you can feel better soon. I take a large amount of VCO (virgin coconut oil) which I think will have a beneficial effect in the long term, for both glandular problem and possible viruses. It is certainly effective for candida, which was making me dizzy on top of fatigued. If you do take VCO, please start with a small dose, since some people are allergic, and even without an allergy it can overwhelm your system with die-off of whatever it is we have. (hopefully someday we will know!)

Take care!:Retro smile:

 

[kerrilyn]

L'engle:
Hi from up here :Retro smile:
It's good that your doctor is willing to test for so many things. I've been supplementing some hormones and it's not been a 'quick fix' that's for sure. It is all so complicated.

I'm going to chart my temp for a while and see if I get any valuable info, it's free. Info here: http://www.drrind.com/therapies/metabolic-temperature-graph

 

[L'engle]

Thanks for the link. I should start charting temperature as well. I'll keep you posted on any progress I can hopefully make. Do you know if doctors can order the saliva tests through an ordinary lab?

Hopefully if you can get some vitamin D you will feel somewhat better!:Retro smile: