different cortisol levels

[hmarria]

recently my naturopathic doc tested 24hr saliva test for cortisol, insulin,DHEA etc.
my morning cortisol level are 6nM (normal range is 13-24) LOW
Noon levels are 10nM (normal range 5-10) NORMAL
4:00-5:00PM levels are 9nM (normal range is 3-8)HIGH
Midnight levels are 10nM( Normal range is 1-4) VERY HIGH

DHEA 15ng/ml (normal range 3-10) which is HIGH ofcourse.
Insulin levels @ fasting 4 (normal 3-12uIU/ml) NORMAL
Non fasting insulin <3 (normal range 5-20uIU/ml) LOW

17-OH-Progesterone 30 pg/ml (optimal range 22-100pg/ml) NORMAL
Total salivary IGA <5 mg/dl (normal 25-60) LOW

Gliadin antibodies NEGATIVE

my question is why I have low cortisol in morning (although I feel horrible mostly in the morning, feel tired and sleepy). and high cortisol at night times (I do have problems with sleep).
what is the relation b/w adrenal fatigue and high DHEA
my doc said I am just a step away from "adrenal fatigue", what happens if it leaves untreated?
I am taking seriphos(phosphorylated serine), licorice, TFN plex,Ora-Adrenal, Omega 3caps and on synthyroid 125mcg(I am hypothyroid)

My prolactin levels are 18.9 which is a lil high for the lab range.
irregular periods (cycle lenght changes every month) with horrible PMS (breats tenderness for 2weeks and mood changes, gain weight, swelling etc)
In a year  I have lots of migraine episodes.
Highly irritable mood...mostly all the time!
Gained so much weight and its hard to lose it all. do aerobic exercise 5Xweek for 30minutes (includes brisk walk and jog)

Not sure what to do? my family doc and endocrinologist dont think that ther's anything wrong with adrenals. he checked 24hr urinary cortisol whaich was normal(he was thinking could be cushing).should I tell my family doc about the tests results my naturopathic doc has given me?

I dont know whats wrong with me?is it true if you have one autoimmune disease{ I had graves disease, had RAI and now Hypothyroid} you can have other auto disease too?somebody tole me I could have "addisons".....I am not sure what is exactly is....but if anyone has some experience please do share it.Thanx

[sick and tired 47]

Welcome to the club... I am in a very similar situation. I am hypothyroid ( on synthyroid) , saw endos who all ran many tests and said all are normal. I am fatigued, heart palps/racing, insomnia, muscle aches, spasms.
I too had saliva test with naturopath. I had HIGH morning, normal lunch, dinner levels, and HIGH nighttime ( thus the trouble sleeping).
I too started working with naturopath recently and am hoping for the best.
Good luck to you.

[satori1]

I have just started taking TFN-Plex and  Dessiccated thyroid glandular for low thryroid. I am also taking probiotics, trace minerals, B vit., RR formula for my GI tract (on recommendation from naturopath). I also used to take calcium, fish oil, multi and iron for low iron.
I have heard that both calcium and iron interfere with thyroid absorption  and can negate the effects. They should be taken 3 hours apart. I am wondering if anyone has experience of this and if they know of other contraindications of combining thyroid and other medications.
Also, I just wanted to mention, my general practitioner didn't pick up any thyroid or adrenal problems in his tests, which he thought were adequate, and said that more in-depth testing is not possible through NHS. I'm glad I didn't trust his diagnosis. It is worth paying the money to see a naturopath and get a real diagnosis.

[rumpled]

High cortisol as well as low cortisol causes fatigue. Many of the symptoms overlap. I know this firsthand as I used to have Cushing's disease, and in order to resolve it, I had my adrenals removed, so now live AI.

The energy you feel are the spurts of high cortisol - they also cause the mental feeling of being overwhelmed and stressed out. It is entirely within the realm of Cushing's to be a whirling dervish one minute, and a potato the next. My sleep studies were interesting. I never went into REM.

I have no experience with CLA, but I did try a lot of stuff with my Cushing's - yeah but er, you have to treat the source. Treating it symptomatically is not going to work - the docs will try it too.

[hmarria]

thanks once again.....you are full of information!

I actually would like to tell you that although my cortisol levels from after noon till midnight are high, but I feel drowsy at these times too...once I am on bed at night I feel I am sleepy and I fall asleep soon, but I wake up many times...and sometimes I even know that I am not sleeping.
The other thing is its been 5days now since I stopped taking homeopathic meds  and I am feeling relieved so much, I dont know why? I was so overwhelmed and stressed out last week....I cant tell you.  

If its adrenal problem, I dont understand why a few weeks I go so energetic and do all kind of house hold chores and the very next day or week I become a couch potato....feeling lazy and lethargic.

My trainer has told me that I should give CLA a try....(she also works in the local health store) if any one has any insight about it please tell me.

[rumpled]

In Addison's, the body cannot handle stress. As your body is demonstrating in the exercise (you should journal it for the doc), your BP drops instead of rising. In times of stress, the body needs the increased heart rate to get blood every where and if you do not, you risk passing out or more.

However, you are saying you are not thin - still makes me think Cushing's. I had the low heart rate and high weight with my Cushing's as well. Exercise does not help - only tears up the muscles which cannot repair themselves due to the cortisol. You are not sleeping - the body is not repairing the muscles and bones like normal.

[hmarria]

thanks acker for replying me!

yep, this exaustion does come in my workouts....like I do a good jog for 25min on 3.6M/hr and just finishing exercise, I feel terrible.....I just want to relax and sit on one couch..dont have much energy left, even when I go sleep my legs (dont have pain)but are sore and feel weak...a weird sensation that I dont have words to explain, bothers my sleep rhythm.
so my naturopathic doc said, I dont have to exert so much to get my weight goal...since It 'll drain my already weakend adrenals.....I dont know, every doc or naturopath has different things to say.....I dont know what to listen and what not to....finally I have come to a point where I just listen to my body!! and I am happy although I am not working out like crazy, but I exercise upto my comfort level(not forget to mention that I did exercise like crazy.....but no effects on weight).

The other thing happens to me is my blood pressure is way too low...through out the day,especially after working out, my BP comes down to 85-90/40-50mmHg. I dont knwo what to do about it either. I have changed my exercise habits and am not any longer a crazy person....I brisk walk for30min only...sometimes everyday, sometimes 5xwk.

I am not sure, I am not taking any treatment for adrenals, bcuz ny doc and endo dont think much about adrenals, I am searching a new endo......lets see how it goes.

can you explain me why its dangerous you have mentioned in your post?

[acker]

you didn't make much mention about if you get exhaustion or not... the massive bone-deep intolerable exhaustion that can precede addisons.  ..my concern is the exercise you do - great if you can do it - definitely - please  just don't overdo things thinking that you'll break through some sort of tiredness barrier very dangerous, not to mention, it won't work! just be careful and closely listen to your body and muscles...

[rumpled]

Er, if you have  high cortisol at night, you are not getting Addison's or AI. Sorry.

I had Cushing's disease - I was just like you - high at night, and my 24 hours were largely normal. I was considered Cyclical pituitary Cushing's disease when I finally got diagnosed.

You have gained - that is the opposite of AI. While the guy was on the right path with the cortisol testing, your GP was right with Cushing's only like 90% of the docs out there, has no clue how to test or why a normal test pops up when a person is really sick. I gave you a bunch of reasons.

The thyroid is separate - while Cushings does impact the thyroid, you had an autoimmune disease. I did too.

Get to an endo that knows Cushing's.

[hmarria]

thanks rumpled.
so you meant, if I have a reverse diurnal rhythm, it could be cushings? I am thinking to call my family doc and make an appointment for the referral to some other endo, since in my city (small town) there's only one endo!

yes you are right, I have multiple issues with endocrine system, but its unclear rightnow how to deal with each and eveything all at once. I am also not sure whether I need to continue my natural treatment or not? the naturopath said, take the supplements for a couple of months and get back to me. its only been 1 week I am on the supplements. although my doc doesnt know I am seeing a naturopath, but in my next appointment I 'll tell him.

I still dont understand why I started with hyperthyroid and now ended up with adrenal issues(cushing or adrenal fatigue....if I am not wrong adrenal fatigue eventually leands to addisons disease).

I have low grade headache all the time, and last weekend I had migraine too.....not sure if anythings wrong with the brain???I feel my eyes are heavier and swollen.

for 2days I have swelling in my fingers too.but I am trying to get another appointment and see what happens. I 'll ask my doc to evaluate for cushing disease and do every test for it. can you or anyone please tell me what are the tests I should ask him to give me?
thanks once again.

[rumpled]

If you read up, you really are showing more signs of Cushing's than adrenal fatigue. You have what is called a loss of diurnal rhythm. You are low when you should be high, and high when you should be low. You are reversed.

The normal urine can be explained many ways - the average was normal (since you are very low during the day), you have high cortisol binding globulin, you are on a medication that binds free cortisol, lab error (ie. letting the specimen get too warm) - all sorts of stuff - so one test - bah - not enough to tell you anything!!!

You need to take all the tests that you have had done, and find another endo - one that has intelligence because the last one is an idiot. It may take a while, but be persisitent, and find a GP too if you can to test you in the meantime properly for Cushing's if you can - it can bolster your case.

Some docs may or may not accept the other results - you have to feel it out to see if they will or not - egos play a role so some are nice, others will just scoot you to the door.

You have multiple endocrine issues here - they should pay more attention. I know it is hard. I had thyroid, pituitary and female issues and it was like pulling teeth to get them to look at anything...