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Any doc can test for adrenal fatigue. Like I said before, most will just do a one-time ACTH and cortisol blood test, which should be done prior to 8am. The saliva test, while giving a better overall picture, isn't always accepted by conventional medical practitioners, in spite of clinical studies that support its legitimacy.

The saliva test itself: Get a kit either from your dr or order one from an online lab. Pick a day to do the test. Some labs prefer that you do the test on a certain day of your menstrual cycle. You spit into the little tubes they give you - once when you wake up, at noon, at 4pm, and again right before you go to bed. Believe me, coming up with all that saliva isn't as easy as you'd think, but there are tricks. Send the kit in and 1-2 weeks later you get your results.

Now as to optimal levels - These are a general rule of thumb that I've gathered from various forums (I'm on about 8 of them, altogether). Your mileage may vary, as our bodies are all different. Many of the forums I'm on are run by patients who have had to resort to self-treatment due to inadequate care by conventional medical practitioners. These optimal results are from years of patients experimenting, finding out what works best for them, and compiling the results from there.

TSH - Close to 1, closer to 0 if dealing with an autoimmune thyroid disease. Now, a word about TSH. While this is the gold standard for most endos and conventional docs, its a [I]pituitary [/I]hormone, not a thyroid hormone. TSH levels can be affected by medications, illnesses, time of day the test was taken, and even the time the test was done during your menstrual cycle. Its not the end-all and be-all that most docs are making it out to be. Prior to the 3rd-generation TSH tests coming out in the 70s, docs actually had to [I]listen [/I]to their patients and diagnose by [I]symptoms[/I].

FT4 - This is the unbound T4 in the body that's available to be converted into T3. Optimal levels are generally the upper 1/3 of the range.

FT3 - This is the active unbound thyroid hormone your body actually uses. Optimal levels are generally in the upper 1/3 of the range.

Serum Cortisol - This should be at the upper end of the range (20-25).

ACTH (Adrenocorticotropic hormone)- This is a pituitary hormone that stimulates cortisol production. This should be double the serum cortisol level (40-55).

Saliva Cortisol - Optimal levels will vary, based on which lab you use, and most include a chart along with the test results. Ideally, it should be in the upper half of the range, with high levels in the morning, declining at noon, raising again in the afternoon, and then at its lowest level at night.

There are other tests that can be done, such as DHEA (a hormone precursor produced by the adrenals, which then converts into testosterone, estrogen and estridiol), aldosterone (a hormone produced by the adrenals which regulates sodium and potassium levels), and renin (which is really kinda complicated to explain, but impacts the aldosterone levels).

Hope this helps. :)
Nyxie-thanks for all the information. What a hard road you have had. It does indeed get pretty tough out there.Besides working on the ferritin, thyroid , adrenals etc. have you tried any body mind techniques??I started tai chi about 5 months ago and I think it has changed my life. Of course it's only been 5 months but I find it so helpful. There is something about these ancient movements and getting out of my head and into trying to learn a movement I have never done and balancing at the same time--it has been a vacation from some worries and has really helped. Tai chi is ancient, there is a reason why people keep doing this-and I think it is that it is because it feels good. Maybe you could give it a try or perhaps some other form of body mind movement that appeals to you?
This last year has been medical hell for me, but I am hoping that things are now getting somewhat better. It has been very hard for me to get the kind of doctors on my team that I wanted to work with and it is a work in progress. But at least the pcp part is settled and that has made alot of difference.And, now I have more familiarity with the issues and know things I can improve- like the ferritin, vitamin d etc. I am so thankful to the wonderful and informative people I have shared with on these healthboards, I have really learned alot here and also been sort of stabilized by the sharing.After being on the boards for awhile- you know you are not alone going through this stuff!
I don't know if it was improvement in ferritin , vit d level or thyroid just having more time on correct dose and /or the tai chi- but I don't seem to be so in the dooomsday scenario camp . I have to say too that getting worked over , through various diagnositic procedures can really wear on a person. And, not to forget, I will have my colonoscopy chapter to write in about 3 weeks. Again Big Thanks to the wonderful people on this board who spoke about osmoprep and who told their story--very helpful information!!!!! This is a wonderful community here at the anemia board!
And last but not least I will have my ferritin checked again in the next few weeks. I got it up to 47 , I know this seems so high to those on this board who are starting from 8 or so. Well, I will see if after 2 months no iron supplements whether it has declined. I had to stop the iron for a bit because I was going through a bad gi disturbance and the doc felt the ferritin was ok and wanted me to just stop anything that might hurt the intestinal tract. The weird thing was that apparently it was a viral thing that damaged the lining of my gi tract and then made me lactose intolerant. They think the lactose intolerance will diminish in time. But for now , I am getting my calcium through supplements and have gone back to 18mg ferrous fumarate a day.
Sorry to go on so long- you would think I was hyper which I know I am not at this time

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