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I am hypothyroid and I read a lot of people have adrenal issues with their thyroid problems. My doctor won't treat my adrenal glands based on the results below but I would appreciate a second opinion from you all. The lab is a 24 hour saliva test.

7:00 am Cortisol 0.10 mcg/dL (0.04-0.56 is normal)
12:00 pm Cortisol 0.14 mcg/dL (0.04-0.56 is normal)
5:00 pm Cortisol 0.15 mcg/dL (<0.15 is normal)
10:00 pm Cortisol 0.07 mcg/dL (<0.09 is normal)

I can't fall asleep until 1:00 or 2:00 am usually and I don't normally wake up until 10:30 or 11:00 am. Bright lights irritate me too. I know the values are within the normal range but are they considered very low in the morning? Has anyone been treated with similar values and felt better? Any feedback? Thank you very much for helping.

David
[QUOTE=david45249;3727843]I am hypothyroid and I read a lot of people have adrenal issues with their thyroid problems. My doctor won't treat my adrenal glands based on the results below but I would appreciate a second opinion from you all. The lab is a 24 hour saliva test.

7:00 am Cortisol 0.10 mcg/dL (0.04-0.56 is normal)
12:00 pm Cortisol 0.14 mcg/dL (0.04-0.56 is normal)
5:00 pm Cortisol 0.15 mcg/dL (<0.15 is normal)
10:00 pm Cortisol 0.07 mcg/dL (<0.09 is normal)

I can't fall asleep until 1:00 or 2:00 am usually and I don't normally wake up until 10:30 or 11:00 am. Bright lights irritate me too. I know the values are within the normal range but are they considered very low in the morning? Has anyone been treated with similar values and felt better? Any feedback? Thank you very much for helping.

David[/QUOTE]
[QUOTE=david45249;3727843]
7:00 am Cortisol 0.10 mcg/dL (0.04-0.56 is normal)
12:00 pm Cortisol 0.14 mcg/dL (0.04-0.56 is normal)
5:00 pm Cortisol 0.15 mcg/dL (<0.15 is normal)
10:00 pm Cortisol 0.07 mcg/dL (<0.09 is normal)
[/QUOTE]

You can't diagnose adrenal insufficiency with simple blood tests, you need some kind of stimulation test to determine your maximum cortisol output. I suggest you ask for a visit with an endocrinologist. If he refuses then I would ask for the refusal in writing and then find another doctor; turns out not all doctors were created equal.

It is suspicous that your morning cortisol is lower than noon and 5pm. One day's readings don't mean much, but based on that result further investigation is needed.

The ranges you give differ from many I have seen:

7-9am 0.27-2.06 mcg/dL
11-1pm 0.03 - 0.77
3-5pm 0.03 - 0.56
10-12am 0.03 - 0.50

I don't see how the normal range would be the same for 7am and noon. It is well known that cortisol should rise dramatically within 2 hours of waking. Given these other ranges and the fact you have symptoms, you are deficient, at least on that morning. I would use a different lab for the next tests.

Other symptoms: morning backache that goes away as the day progresses, unrefreshing sleep, salt craving, low exercise capacity and blood pressure that drops when you stand up. Do you have any of these?

Normally low cortisol makes it very easy to get to sleep, and to sleep a long time. When you wake up you are unrefreshed and feel a few more hours would do the trick, but it doesn't. Consequently your inability to sleep at night runs contrary to low cortisol; of course you may easily have other problem that are related to low cortisol.

I would get blood tests for thyroid, prolactin, LH, FSH, DHEAS. DHEAS is normally very low if you have low cortisol. The other tests help determine the cause of the low cortisol.
Your test results certainly sound like low cortisol to me.
I have Hashimoto's Disease (Hypothyroid) Also Type 2 Diabetes, RA (i have an RA factor of 110, no antibodies although i may have them by now), and anemia (low B12).
For years (at least 4) i've had symptoms of Adrenal Fatugue/insufficiency (easily startled, unable to handle stress, dr had to prescribe valium for it, sluggish pupils, etc) I had a blood test for low cortisol (last year) and it was 7.0 (not taken in the morning but fasting) I recently had a 24 hr saliva cortisol, here are the results:


Reference Ranges (Quest Labs):

8-10am: 0.04-0.56
4-6pm: 10-11pm: <0r=0.09


6am: 0.06
11am: 0.17
5pm: 0.07
11pm: 0.07

I'm taking hydrocortisone 20 mg but i'm starting slowly until i reach 20 mg by 11/3.
[B]I am hypothyroid and I read a lot of people have adrenal issues with their thyroid problems. My doctor won't treat my adrenal glands based on the results below but I would appreciate a second opinion from you all. The lab is a 24 hour saliva test.
[/B]
Optimal range for most is in the 40-60% region of normal.

When are you taking your pregnenolone and DHEA? How much are you taking at time X? It can make a difference.

[B]7:00 am Cortisol 0.10 mcg/dL (0.04-0.56 is normal) [/B] You are at 11% or the normal range here.
[B]12:00 pm Cortisol 0.14 mcg/dL (0.04-0.56 is normal)[/B] You are boosted to 19 % of normal here.
[B]5:00 pm Cortisol 0.15 mcg/dL (<0.15 is normal)[/B] You are at 100% of normal range. This is what is interfering with your sleep pattern you are spiking at an odd time during the day.
[B]
10:00 pm Cortisol 0.07 mcg/dL (<0.09 is normal)[/B] You are at 77% of normal here. Still high optimal in range. Pregnenolone has a longer delay to get into your system. When taking it you have to account for the fact that you have to absorb it and then you adrenals have to take it and convert it into aldosterone and cortisol.

In theory your highest level should be first thing in the morning around 8 am. This is not the case with you. You climb to your highest point after waking. Depending on when you take your meds and the inherent delay time in conversion. It may be better for you to take your pregnenolone at bed time and then your body will be able to convert it to cortisol while you sleep. This is just theory. It would help to know when you take X and how much.

Orion makes a good point about the ACTH stimulation test with hormone evaluation. It is the only true way to determine if you have bult adrenal hypofunction or a genetic flaw in your conversion process. There are MANY steriods and hormones produced by the adrenals. The chemical reactions are in a state of flux and equilibrium. It is hard to know for sure what is going on when and how supplementation will affect things. In your case you are low on cortisol in the mornings. I think you would benefit for 10 mcgs of cortisol first thing in the morning. I do not know if your MD will look into it further for you though. BEFORE you can be effectively tested for adrenal issues you would have to be off DHEA and pregnenolone for AT LEAST 4-6 weeks. It takes that long to leave the adrenals to their own devices so an accurate functionality can be tested. I wish I could be of more help.

MG





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