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Please help me understand my saliva cortisol test results

Hi everyone,

So I did a 4 point saliva cortisol test through ZRT labs recently and got my results today. I am a 27 year old female who is currently working nights, but my schedule is regular in the sense that I pretty much wake up and go to bed at the same times every day (I just sleep during the day and work at nights).

Here are my test results:

Morning (I usually wake up around 6 P.M.) Result: 7.8   Range 3.7-9.5
Noon Result: 7.6 H   Range 1.2-3.0
Evening Result: 2.1 H   Range 0.6-1.9
Night Result 0.6   Range 0.4-1.0

Also, I had my DHEA-S levels tested via blood work and the result was 8.7 (Range 2.68-9.23)

My TSH is 3.97, FT4 is 18 (Range 12-22) and FT3 is 4.7 (Range 2.6-5.7)

So, my "noon" and "evening" cortisol levels are high, would this be contributing to my fatigue? How are my cortisol levels upon awakening? Why are my DHEA-S levels high? Do I have early stages of adrenal fatigue?

I also have symptoms of hypothyroidism, but do I need to address my adrenals first before I can start taking thyroid medication?

I would really appreciate any insight any of you may have and I look forward to reading your responses.

Thanks in advance!
3 Responses
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Avatar universal
Sadly, there is no way to lower your cortisol yourself if it is abnormal. However, one set of tests is not enough to diagnose or treat anyone - nor to find the source of the issue (pituitary, adrenal or other). You would need to go to an endo to get the testing you needed to determine if you had it and the source and then determine how to treat the source whether by surgery and they have a few meds out but mostly older men can take them as far as I can determine due to the estrogen produced.

By TSH too high - that is low - TSH works opposite! I find it weird and forget to word myself correctly. So you are too high in the range and elevated cortisol does suppress TSH. It is hard to say (and I am also not a doctor, don't know anything else about you) if your cortisol is always like this you can adjust it, but if you cycle in cortisol, then the TSH will bounce too.
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Avatar universal
Hello rumpled,

Thanks for your response.

I'm looking into ways to lower my high cortisol throughout the day to take the "edge" off of life. I get stressed at the drop of a pin and can really feel the effects of all of this long term stress I have been experiencing.

If my TSH is high, but my FT3 and FT4 seem to be where they should be, would I benefit from thyroid meds? Should I lower my cortisol levels first in fear of over-stimulation from the thyroid meds?

Thanks for your input.
Helpful - 0
Avatar universal
Oddly, high cortisol and low cortisol have overlaps in symptoms. I used to have high cortisol due to a pituitary tumor and to control it, I had pituitary surgery and my adrenal glands removed. Lived both. Fatigue is both.

If you suspect high cortisol you need a good endo. Your TSH is too high IMHO but the rest look pretty good to me - my doc keeps my FT3 and FT4 on the upper parts or the ranges.

Your adrenals are not tired - they are working.
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