Adrenal insufficiency? Lab results... Please help!

[Mozartcowgirl]

Hi everyone I was going through my latest labs ..  My saliva test does not seem right.. Can any one please take a look.. My endo said its good.. But I'm a bit confused..

8:00 am cortisol saliva ----0.54. Ref range 0.04-0.56 8-10 am
4:00 pm cortisol saliva ----0.27. Ref range (<or =0.15) 4-6 pm
10:00 pm cortisol saliva --0.11. Ref range (<or =0.09) 10-11 pm

ACTH 25  ref range 6-50
Microsomal TPO-Ab  298 ref range <35
Thyroglobulin antibodies 26 ref range <41
Vit B 12 is good at 478 ref range 243-894
Sed rate normal
I already have hashimotos .. Hypothyroid and other auto immune diseases.
Any insight on the saliva test would be greatly appreciated
My blood pressure ranges from
120/77- 94/54

It seems like I'm teeter tottering on adrenal insufficiency
Just very frustrated . But aren't we all.

[Mozartcowgirl]

Ty for all the replies... I'm getting on a more regular sleep schedule.. Feeling better already!!

[rumpled]

Sleep issues can be caused by messed up cortisol, or other things. Either way, to do the test when you were on a messed up schedule like that would not make the test valid for me... I agree with red star on the shift work. You really need more testing on a regular pattern.

[Mozartcowgirl]

Thanks you guys I appreciate it!! I'm going to try tonight to sleep .. Try to get back into a natural rhythm .

[Red_Star]

I see what rumpled is getting at with levels dropping throughout the day. The cortisol levels are still higher than they should be which could be due to your sleep patterns. I had a look online and found shift work is associated with elevated long term cortisol levels.

[Mozartcowgirl]

Thank you for your insight !!
My one question is this... At the time of the saliva testing, my sleeping hours were very messed up. Such as when 8 am rolled around I had just fallen asleep an hour before, then at the second saliva test, I was just getting up, and the third, I was wide awake. I did tell my endo this . She didnt seem worried.
I am currently trying to fix my sleep schedule.. I was on such a different sleep schedule... Falling asleep around 6 am and getting up at around 3 pm...
The second shift blues I guess.
Would this alter the test? Should I first fix my sleep schedule?
I feel like a jerk now. My dr said no big deal but now I'm wondering

[rumpled]

I thought your diurnal rhythm was perfect - it was highest in the morning and declined as it should. But one set of tests is no way to know - it is just one day. Several sets is better to judge. If though you have normal sodium and potassium it is unlikely you have AI.

B12, yeah... my doc likes it on the higher side too. How is your D?

[Red_Star]

In Japan and Europe vitamin B12 deficiency is under 500 or 550 pg/mL. They are not using outdated lab ranges like the rest of the world.

The early morning cortisol level should be the highest of the day so you meet the demands of the day.  A healthy person's output of cortisol drops throughout the day until it falls to its lowest level by 11 pm or midnight so you can have a good night's rest. Clearly something isn't right with your cortisol results. Btw, you haven't posted your midday cortisol saliva and total sum cortisol saliva results.