clear signs of insufficiency but normal cortisol?!

Hi, I recently got my morning cortisol level tested because I have suspected for a while that my adrenals are fatigued.  I have been in a really stressful grad school program for 2 years now and have been experiencing bad fatigue, muscle stiffness, brain fog, and abnormal sensations (sometimes it feels like a burning pain in spots on my arms), and really cold all the time. Also, the test where you take blood pressure lying down and then standing up was abnormal because my standing blood pressure decreased, and I have noticed that when I turn on a light in the bathroom my pupils kind of constrict and dilate a few times before stabilizing which I have heard is also a sign of insufficiency.

Anyway, my naturopath wanted to go ahead and start treating me for adrenal fatigue without bothering to do the test.  But I figured I would like to know for sure so I ordered the am cortisol saliva test.  I know that 4 samples throughout the day is better, but just the am was cheaper for me.  My level was 8.8 ng/ml (ref range 3.7 - 9.5)  i was expecting it to be low, but its not, so now i am not sure where to go from here.  any suggestions?  

[rumpled]

I personally do not follow the adrenal fatigue school. Fatigue can be caused by literally thousands of disorders so it is not specific enough to pinpoint one thing. Same with the others.

Adrenals as well as the rest of your organs are built for a lifetime unless diseased. To take replacements will just suppress them and BTW - once you do that you actually risk making the situation worse - making yourself dependent for a lifetime or giving  yourself Cushing's. People can vary. It can be a different disease altogether and messing up another organ is just sad.

One test at one time is not diagnostic. The stim test is more diagnostic. Low sodium is indicative of AI. AI is a salt wasting disease. The low BP is indicative - but you can have that problem with or without - it is autonomic. Do you crave salt or need it? Have a tan?

[horselip]

I just wanted to ask if your thyroid has been completely tested. Your symptoms could very well be thyroid. You want to make sure that your doctor tests your FreeT3 and FreeT4, not just TSH. Also it is important to look at the ranges. Many of us tend to perform a little better when our levels are in the top third of the ranges that the labs use.
Horselip

[penny3323]

rumpled - that makes sense, I did not want to start taking adrenal supplements until I knew for sure I need it!  I am definitely worried about making it worse.  I would say I crave sweets more than salt, and my blood labs said my sodium is normal (actually at the higher end of the reference range).  And I absolutely do not have a tan unfortunately.  I have natural pale skin and I have lived in the Pacific Northwest for a few years, so no tan for me!  

horselip - my thyroid has been tested because I have a family history of hypothyroidism.  My TSH is pretty consistently at 2.9, which is at the higher end of the reference range if you follow the school of thought that says it should be less than 3.  Also, my free T3 and T4 are within range, I can't remember if it was in the high end or low end though, and the last time I ordered labs from directlabs this is what they did:

TSH - 2.87
T4 - 6.7  (4.5-12)
T3 uptake - 32%  (24-39)
Free thyroxine index - 2.1  (1.2 - 4.9)  

No idea if that is free T4 and T3?  What do you think?  

[rumpled]

Free T3 and Free T4 were not done - it would say so... In my own case I feel tons better when TSH is on the low end of the scale and the thyroid tests are on the higher ends... My doc does not even run the uptake or index test so I don't know anything about them so I cannot comment on them maybe Horsey knows...

Only primary people have tans (or people odd like me with both primary and secondary). If your sodium is like that... I would find it kinda odd that you have an adrenal issue. Read up on medical sites, not fatigue sites.

[horselip]

yup your Free T3 and Free T4 were not tested.

Free T4 is the storage version of thyroid hormone.

Free T3 is what every cell in your body uses for metabolic processes.

For T4 to be converted into T3 there are a bunch of complicated biochemical steps that use copper, selenium and other nutrients.

So about 1/4 of folks are poor converters to the active T3 version that your cells use.

TSH is a hormone made by the pit gland that tells the thyroid to work harder. High TSH usually means that your active thyroid levels are low. But a low TSH can mean that your pituitary gland does not work right OR that you are normal or high on the active thyroid hormones.

Please get to a doctor and get proper testing. Low thyroid could be behind many issues. If it isn't, then it is one more thing that has been ruled out.
Good luck
Horselip

[Buckupnow]

Your symptoms do sound like thyroid.  The thyroid is the gas pedal and the adrenal glands are the engine.  Most people with thyroid issues also have some adrenal issues.