Fireplace,
I'm no expert, but I think you can have a high AM cortisol and still have adrenal fatigue. I have so many symptoms of it, and since I went for many, many, many years with undiagnosed (and therefore untreated) Hashi's, my doc suspected the Adrenal problem when I recently had 3 surgeries in 3 months, and just did not bounce back. He ordered the saliva test in conjunction with blood test for AM Cortisol. While my AM's were often low normal to abnormally low, (both blood and saliva), my 11AM was normal, my 4PM Cortisol was ABOVE NORMAL, and then, the 11PM would shoot down to below normal.
It certainly explained why I am always so fatigued in the morning, and evening, but I perk up around 4-7PM and feel like a real person instead of a beat up rag doll. So, I suppose it IS possible to have an abnormally high cortisol level in the AM, but still have it be below normal during other times of the day.
I take 10mg of Cortef in the AM, and just recently began adding another 10mg in the evening. It does help.
I have also had problems with adrenal fatigue symptoms being aggravated when I adjust my thyroid hormone dose, either up or down, so that might be what is going on with you, too. I would encourage you, if at all possible, to have the saliva test done, and check your levels 4 times a day - you may find that your high AM cortisol comes at the expense of the rest of the day.
Good luck,
Ora