Adrenal assitance - low cortisol

[hrmuser]

Hello,
 
I’ve been experiencing numerous symptoms since August of 2014 and after much testing and research on this forum I have a current diagnosis of Adrenal Fatigue (Low Cortisol) after having a 4 point cortisol test performed.
 
Leading up to my crash I realize now that I had a lot of physical and mental stressors in my life.  Around that time I started a new job (mentally stressful), got engaged and was training/performed a Spartan race. I look back and realized that my training/eating/lifestyle habits weren’t ideal for my hectic lifestyle. I could run 10k in under 50 minutes and now I can’t even think about running.
 
Current symptoms:
Fatigue
Low blood pressure
Brain Fog/Concentration Issues
Low body temperature
Cold extremities and low sensitivity to the cold.
Feel worse after high exertion.
Don’t feel rested after 8-9 hrs of sleep
Some Anxiety/Perfectionism
 
I wanted to get some additional opinions based on the tests I have had so far:
 
Cortisol test:
Morning – 15.06 nmol/L
Noon – 1.59 nmol/L
Evening – 2.02 nmol/L
Night – 0.96 nmol/L
DHEA: 311.13 pg/ml
 
Bloodwork - August 2014:
 
Sodium: 141 mmol/L
Potassium: 4.2 mmol/L
Chloride: 104 mmol/L
Total CO2: 26 mmol/L
Anion GAP: 11
 
Glucose Random: 4.0 mmol/L
Urea: 4.1 mmol/L
Creatinine: 75 umol/L
Calcium: 2.38 mmol/L
Phosphorus: 1.30 mmol/L
Magnesium: .89 mmol/L
 
ALT: 15 U/L
AST: 22 U/L
GGT: 19 U/L
 
TSH: 1.18 mIU/L
T4 free: 17.5 pmol/L
 
Vitamin D: 84.4 nmol/L
 
Cortisol: 320 nmol/L at 15:00
 
CBC:
WBC: 7.64 x10 (9) / L
RBC: 4.75 x10 (12) / L
Hgb: 142 g/L
Hct: .440
MCV: 92.6 fL
MCH: 29.9 pg
MCHC: 323 g/L
PLT: 281 x10 (9) / L
MPV: 9.6 fL
 
Automated Diff:
Neut: 67.8
Lymph: 22.5
Mono: 7.6
Eos: 1.0
Baso: 0.7
Immature Grans: 0.4
Neut: 5.18 x10 (9) / L
Lymph: 1.72 x10 (9) / L
Mono: 0.58 x10 (9) / L
Eos: .08 x10 (9) / L
Baso: .05 x10 (9) / L
Immature Grans: .03 x10 (9) / L
 
Vitamin B12: 512 pmol/L
 
Ferritin: 92 ug/L
 
Iron: 20.64 umol/L
Total Iron binding capacity: 53.34 umol/L
 
Blood test – Dec 2014:
 
Sodium: 141 mmol/L
Potassium: 3.9 mmol/L
Chloride: 106 mmol/L
Total CO2: 26 mmol/L
Anion GAP: 9
 
Glucose AC: 4.9
Creatinine: 90 umol/L
Albumin: 39 g/L
Triglycerides .70 mmol/L
 
Cholesterol: 3.86 mmol/L
HDL-Cholesterol: 0.72 mmol/L
LDL-Cholesterol: 2.83 mmol/L
Non-HDL Cholesterol: 3.14 mmol/L
Non HDL Cholesterol: 3.14 mmol/L
Cholesterol/HDL Ratio: 5
 
Testosterone: 15.8 nmol/L
Bioavailable Testosterone: 2.30 nmol/L
Sex Hormone Binding 46 nmol/L
 
CBC:
WBC: 4.52 x10 (9) / L
RBC: 4.51 x10 (12) / L
Hgb: 133 g/L
Hct: .413
MCV: 91.6 fL
MCH: 29.5 pg
MCHC: 322 g/L
PLT: 270 x10 (9) / L
MPV: 9.5 fL
 
Automated Diff:
Neut: 51.8
Lymph: 33.0
Mono: 9.7
Eos: 4.0
Baso: 1.3
Immature Grans: 0.2
Neut: 2.34 x10 (9) / L
Lymph: 1.49 x10 (9) / L
Mono: 0.58 x10 (9) / L
Eos: 0.18 x10 (9) / L
Baso: 0.06 x10 (9) / L
Immature Grans: 0.01 x10 (9) / L
 
Body Temp test:
 
Jan 5
-Temp at 7:30 - 96.9F
- Temp at 10:30 - 97.7F
- Temp at 1:30 - 98.6F
- Temp at 4:30 - 98.1F
- Average: 98.1F
 
Jan 6
- Temp at 7:30 - 97.2F
- Temp at 10:30 - 97.7F
- Temp at 1:30 - 97.9F
- Temp at 4:30 - 97.7F
- Average: 97.8F
 
Jan 7
- Temp at 7:30 - 97.2F
- Temp at 10:30 - 97.7F
- Temp at 1:30 - 97.9F
- Temp at 4:30 - 97.7
- Average: 97.7
 
Jan 8
- Temp at 7:30 - 97.2F
- Temp at 10:30 - 97.2F
- Temp at 1:30 - 98.3F
- Temp at 4:30 - 98.3F
- Average: 97.9
 
Jan 9
- Temp at 7:30 - 97.2F
- Temp at 10:30 - 97.9F
- Temp at 1:30 - 97.7F
- Temp at 4:30 - 98.5F
- Average: 98.0F
 
Jan 12
- Temp at 10:30 - 97.2F
- Temp at 1:30 - 98.1F
- Temp at 4:30 - 98.7F
- Average: 98F
 
Jan 13
- Temp at 10:30 - 97.2F
- Temp at 1:30 - 98.1F
- Temp at 4:30 - 98.2F
- Average: 97.3F
 
Jan 14
- Temp at 10:30 - 97.6F
- Temp at 1:30 - 98.1F
- Temp at 4:30 - 98.3F
- Average: 98F
 
Jan 15
- Temp at 10:30 - 98.1F
- Temp at 1:30 - 98.1F
- Temp at 4:30 - 97.9F
- Average: 98F
 
Jan 16
- Temp at 10:30 - 97.9F
- Temp at 1:30 - 97.9F
- Temp at 4:30 - 98.0F
- Average: 97.9F
 
Candida test:
 
I also had a stool test for Candida just to rule that out as a potential cause. No yeast growth in my stool sample. 
 
Daily Regime:
 
Eating a more Paleo type diet lot of fruits/vegetables/whole foods
Cut out alcohol
Sleeping at least 8 hrs
Drinking water with Himalayan sea salt
 
 
High Quality Probiotic – 50 billion
2000mg Vitamin C capsules, going to be swapping to AOR Ascorbic acid powder.
500 mg of Mag Oxalate
Thorne Cortrex
2000 ui Vitamin D
2 ML of Licorice Root Extract
Omega 3
 
I find the Licorice Root extract works really well for giving me more energy and bringing up my body temperature but I have recently read that it can bring down my Testosterone which is already quite low for my age. I would like to find a replacement.
 
I have also ordered a portable infrared sauna to assist with my circulation/immune system/body temp.
 
I am interested in hearing any additional suggestions or recommendations. Thanks a lot! 

[rumpled]

AI is a salt wasting disease. I have AI - my sodium and potassium are always off when I am ill, and usually when I am feeling okay still at the upper or lower end of limits. I have to take a medication to hold sodium.

Yes, renin/aldosterone control the sodium/potassium system, but AI will lower sodium, and sodium will effect potassium.

But you can have a renin/aldosterone issue without having a cortisol issue as well.

[PraxxtorCruel]

I'm not a doctor but I thought one can still have adrenal insufficiency (secondary or tertiary) even if Sodium and Potassium are within normal limits as they are controlled by seperate systems?

[rumpled]

Your sodium and potassium are in normal limits which pretty much rules out a cortisol issue. Not sure why you are drinking salt water.

Fatigue is a... general symptom. It can be attributed to SO MANY things that to just think it is specific to adrenals... just cannot make the leap. It could be a vitamin, another hormone, an auto-immune disorder or... anything!

Licorice root may only add to your fatigue.