Saliva Test Results - Borderline Adrenal Fatigue?

[Nyxie63]

I did a 24-hour cortisol saliva test back in May. Been kinda neglecting this issue due to other things being more urgent to deal with (like thyroid stuff, low ferritin, and vit D deficiency). Anyway, here are my results:

6am - 2.95 (1.0-8.0)
12pm - .18 (.5-2.5)
4pm - .68 (.2-1.3)
11pm - .17 (.1-.6)

The test results came back with a dx of Borderline Hypocortisolism. As you can see, my cortisol takes a nosedive around noon, which is, not surprisingly, when I feel an overwhelming urge to take a nap (give or take an hour each way). I'm seeing a holistic MD and not currently taking any meds for the AF. Now this is where it gets funky and would appreciate any input from you folks.

My dr said that, due to my vit D deficiency, he wants me to spend 15 minutes each day out in the sun with no sunscreen (in addition to taking 2000IU of vit D daily). According to him, this would increase the amount of melatonin(?) I produce, thereby helping me to sleep better (I sleep very lightly and have reverse insomnia - wake up at obscene hours of the morning) and, thereby raising my cortisol level. Now while this makes sense in a roundabout kind of way, I've been doing a lot of reading and haven't found this info anywhere else.

Do any of you have any input on this theory?

[rumpled]

Are you very thin?
I ask as well, I had very very variable cortisol readings and a loss of diurnal rhythm (low in morning, high at night) and I had cyclical pituitary Cushing's.
I literally failed many sleep tests as I would not go into REM as cortisol would rise - however, I would not hit highs on most blood or 24 hour urine tests as my average was so low...
It was only when a doctor let me test over 10 hours, 10pm to 8am that it showed that all my highs were overnight.
I was not overweight for many years, but then suddenly gained and gained and gained until I doubled my body weight. Due to my cycles, it took 12 years to convince a doctor that I was ill on paper! I ended up being so sick that I am now permanently disabled.
I am also vitamin D deficient, low ferratin, and have thyroid problems.

[Nyxie63]

Hi rumpled! Thanks for your reply. Sorry to hear you've had such a hard time.

No, actually I could stand to lose about 40 pounds. Been gradually gaining weight over the last 5 years, although it seems to have stabilized for now. Had some severe fatigue (took a force of will just to get up from a sitting position) and unintentional weight loss when I was on 3/4 grains of Armour. Lost 13 pounds in a month! While the weight loss wasn't unwelcome, it was surprising.

Since posting this thread, I've talked with other folks who have dealt with both Armour and AF. Apparently the Armour put strain on the adrenals and they couldn't handle the higher metabolism it caused. Think I'm going to talk to the dr about starting on a low dose of Isocort to see what that does. I'm hoping to be able to get back on the Armour again, since my FreeTs are still low.

Btw, woke up at 4am this morning. Ugh! Feel like I haven't slept at all. Thank goodness for coffee, even if it isn't good for me. Need the boost.

Thanks again!

[rumpled]

I would heavily advise against the isocort as it will simply shut down your adrenals and make a bad problem worse and make it so you cannot test.
But that is just me. It just seems that you have an odd rhythm.
Armour is heavy on the T3 side...more heavy than most but that can be good. And while I am a believer of the link between the hormones and have lived the thyroid/cortisol mess up in person... adding T3 helps support the body not mess things up as it is the form the body uses without the conversion. T4 has to be converted in order for the body to use it.
It may do you better to switch to a cytomel and T4 combo so you can control the amount of T3 or add a T4 to your armour.
Fatigue like that happens with cortisol issues - both high and low... if you don't get it figured out before you start taking meds.. well... you cannot test and you risk permanent damage to your adrenals.

[Nyxie63]

I understand the concern about starting on Isocort before getting tested. I'm going to be talking to the dr about getting ACTH, serum cortisol, and DHEA tested prior to starting any type of adrenal support. I'm sure he's going to have input one way or another and he's the one dr I'll listen to.

According to the chart that came along with the saliva test results, it looks like I hardly have any circadian rhythm at all. Its almost a flat line. I suspect, rather than having borderline AF, I'm more likely in stage 3. The wellness center I go to has recently changed their testing company to the one that most folks use and I think I'll do my 24-hour saliva tests again. This time including DHEA.

Even when I was on the Armour, my FTs were still below midrange, although TSH was "perfect" between 1-2. When I'm finally well enough to start on it again, I'll see how it goes and maybe add either T3 or T4, depending on what the test results are. Problem with all this stuff is, even when you have all the tests in your hot little hand, proper dosing is still a trial-and-error process.

In addition to the saliva testing, I've also done the flashlight test (pupils look like they're singing - oOoOoOoOo) and my positional blood pressure dips 20 points. I've added celtic sea salt to my diet and its helping to avoid those dizzy spells/blackouts when getting up. Am still having some trouble with the shakes from time to time and am working on eliminating all refined sugar and flour from my diet. That's going pretty good so far, but there's still room for improvement. Caffeine is currently my crutch and will probably continue as such until I can get some kind of adrenal support.

How did you do an overnight cortisol test? I'm assuming it was a saliva or urine test?

Thanks again for all your input and I look forward to hearing from you.