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testing cortisol while on HC
Is there any possible way to test your own body's adrenal function while taking HC?  If not, why do doctors test your cortisol levels while you are taking HC?

How do you tell when you are on an optimal dose for YOU?
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657231 tn?1453836403
My doc tests my dose on HC using a 24 hour urinary free cortisol test - but even he says there is NO good test to know exactly how to test the levels due to how the medication metabolizes.

Best way is how you feel - not to wired, not to tired - no symptoms of Cushing's, none of Addison's. Until the long acting cortef is approved in the US, it is hard to dose correctly as well.
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The last time my cortisol was tested, my doc used a fasting morning drawn done at 8 am.  He had me not take my cortisol the day of the test. My levels were really low.

He had done two different serum cortisol levels that were showing high--both fasting and at 8 am--before I was put back on meds.  then he did a 24 hour urine test, which came back slightly low.

When he actually physically examined me, he tested my blood pressure sitting down and then again standing up----I had orthostatic hypotension.  He also tested some ankle reflex, which he said was low and was another symptom of low cortisol.    I know he has been studying balancing the endocrine system for quite some time and gave up a career as a thoracic surgeon at a prestigious hospital to do this for people.

He said it really didn't matter what the cause of my low everything was because they treated it the same regardless.

i don't think I have ever had so much blood work done in my life.

I'm just wondering if there is any chance I would ever be able to get off HC--but probably not likely since i was diagnosed with central hypothyroidism.
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How accurate is a 24hr urine cortisol if you are on HC already?  I just had one done and it showed very slightly elevated, but I've also heard that this does not mean you are on too much.  The lab range on the test was 4-50mcg, and mine was 60.4mcg.  Does this mean that I should lower my dose?  I'll be honest in saying that I can't tell if I'm on too much or not enough.  My blood pressure is consistently low (100/60), and I am always fatigued.  But, I also have no thyroid and have only just gotten my thyroid levels where they need to be in the last few months.  I have also gained quite a bit of weight around my middle, and I've lost considerable muscle mass.  I wasn't able to exercise at all a few years ago without passing out, and now I seem to tolerate it fairly well will moderation.  Is it perhaps time to wean down some?
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657231 tn?1453836403
It is not the best test, and as well... the doc ordered a less specific urine test.

There are two types HLPC and the other - all I know is that the higher the reference range, the less specific the test so the developed another way to do the urine test - HLPC so that it could be a better test.

BTW fatigue is a symptom of TOO MUCH as well as too little cortisol! It will also kill muscle mass. By your symptoms your doc should see you are on too much. To raise your BP he should give you florinef.
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