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Normal Cortisol Levels
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Normal Cortisol Levels

Dr. Mark,

Good morning. Thank you for all this help and info.

I have posted my results before, but my concern is that my pc physician will not be willing to do further testing since I am in "normal" range.

I have reviewed and researched and what strikes me are these couple of things that I'd appreciate your comments on.

1.  My AM Cortisol is 10.1 (Range 4-22) which is the lower 1/3
    and taken after a stressful morning--please keep in mind
    I have unrefreshed sleep; extreme fatigue througout the
    day; wake up several times a week at 2 or 3 and don't
    get back to sleep til 5 or 6 (In bed btwn 9 and 10); I
    have no hair growing under arms, only couple small patches
    on legs, scalp loss, forearms greatly minimized.

2.  My other adrenals are also low--DHEA 47 (Range of 40-325)
    which is lowest 2% and my ACTH is 9 (Range 5-27) which is
    lowest 18%.

3.  My Progesterone is high at 27.3 (Range 3-26)--I
    see progesterone is a natural suppressor of cortisol--just
    don't understand if progesterone rises b/c cortisol is
    low or if cortisol is low b/c the progesterone is high.
    Other female hormones are all LOW in the range.

4.  I have unresolved neck and shoulder(blade) pain,
    cravings for sweets and alcohol, afternoon slumps.

I believe my problems are hormonal because they all began after my second child was born.  I must mention that 4 months postpartum I was in a rearend accident w/ whiplash--I read somewhere stressors can alter cortisol.

TSH 1.58; FT4 1.1 (R .8-1.8) Need FT3.

Any thoughts?
Related Discussions
97953_tn?1193367871
Thyroid likely is fine.  It does not look like an adrenal insufficiency based on what you present.  Consider DHEA supplementation after talking with your health care provider about it.  I would not worry about a slightly high Progesterone but a gynecologist may be able to address the more precisely.

ACTH stimulation testing could confirm that you do not have a clinically significant adrenal insufficiency.
11 Comments
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Avatar_n_tn
Hello,

Look for my response under the post you wrote: Thyroid and Adrenal Test Results(3/28). There are safe uses of low dose hydrocortisone/cortisol, up to 20 mg/day, regardless of what many physicians say. Many mainstream docs shy away from it, as well as the use of adrenal cortex extracts, even though they can be very helpful. I would still work with a doctor though, one who knows about the safe uses and isn't shy about using it if deemed necessary.

A quote from the book I recommended under my other response, "Doctors are down on what they are not up on." Otherwise, if they are not familiar with it, they frequently dismiss it, etc. I have found this to be completely true.

Dixie1

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Avatar_f_tn
Dixie,

Thanks for your help!  I have reached an extreme level of frustration with how I feel and being told I'm normal.

I can't even function in the real world -- please do NOT tell me there are people out there who feel like this that are performing surgery, keeping us safe, teaching our children, and so many other important jobs that require so much more.  I'm not an idiot, albeit I feel like one when I can't think clearly, I graduated at the top of my class through earning my bachelor's degree...I used to be able to have an intelligent conversation with someone...now I don't even have the energy to do it, let alone the brain power.

I have removed every stressor in my life that I can think of -- I work part-time just to get out of the house 4x a week for hours hours (very PT), don't need to do it for finances as my husband is a very successful (and supportive) attorney.  My kids are great -- smart, help around the house, don't get into trouble at school...I've virtually eliminated caffeine, eat protein at every meal, go to bed by 10, laugh every chance I get...

But is it normal to feel stressed that there's a basket of laundry to put away and a dishwasher to empty?  Really?  I have piles of mail to go through, but sometimes it's just so overwhelming...do NOT tell me I'm depressed.  I am NOT.  I am thankful for everyday and all I have been blessed with -- I just want to be able to enjoy everyday again.

Does depression cause hair loss under your arms, on your legs, your head?  Does it cause dry skin?  Cold hands/feet?  Low BBT? Low CO2 levels? Dizziness? Weight gain around the middle? Perhaps fatigue, okay, maybe yes here...but inability to focus?  Sensitivity to bright light? Unexplained, although thoroughly checked, pain in neck and shoulders?

If not thyroid or adrenal, then what does?

Sorry for venting...I am waiting to hear from the endo my pc doc referred me to...but I'm sure it will be the same old thing.  I'm not sure what will become of me if I continue on this path.

Thanks again for your support.
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Avatar_n_tn
You sound just like me!!

No, it is not normal to get stressed over small things! I get stressed over the most minor things. I can't function in the real world either and barely work. Cortisol has many functions, but one of it's 2 main functions is to combat stress. The other is to fight inflammation. Low cortisol can cause most of the symptoms you mentioned. I also have scalp hair loss, hair loss top half legs, chronic fatigue, 3 skin conditions, light sensitivity, etc. Was diagnosed incorrectly with A.D.D. Weight gain around middle is a definitive symptom of adrenal fatigue. I was also having neck/shoulder pain and I got severe hives(both because of mass histamine response and barely any cortisol to combat either!). I was put on one of the prednisone drugs at first before finding that it was a hormone problem. Let me tell you, all my symptoms, including the cognitive ones, vanished!! An obvious sign that low cortisol is a big problem. My last am cortisol was 11. Just because it is within this wide range of 'normal', does not mean it is normal for you or me. We are all genetically different, and too many doctors treat people as lab values and not as people.  

When doctor's like the one on this forum refer to adrenal insufficiency, they're talking about adrenal failure which is Addison's Disease. Adrenal fatigue is not the same, but I think if not properly treated could advance to this. Another thing, I went to the doctor's website. He is a specialist in thyroid and osteoporosis, NOT adrenal fatigue. He may know the standard traditional take on how to treat Addison's, but from what I've read from his responses, he does not truly recognize adrenal fatigue as a significant health condition. You and I are not normal!

I also have hypothyroidism, but think the adrenal gland fatigue led to it. The doc mentioned possibly taking 25-50 mg DHEA, don't do it! I saw he recommended that to someone else on here, very cookie cutter mentality. Maybe 5-10 mg, not more than that for women. Can cause heart palpitations, and more hair loss that you are already experiencing! Pregnenelone is the better choice, somehow knows what to convert to based on what is deficient. Converts to DHEA, testosterone, and I think estrogen. I highly recommend buying that book I mentioned, as well as going to the site womentowomen.com. Run by 2 women who have been in practice for over 20 years, and treat all different hormonal problems. Great info on both thyroid and adrenal on there. They practice both traditional and holistic medicine. The book, however, is the best thing since sliced bread.

I hope you don't get the same old thing! I did, and am getting prepared to see an excellent naturopathic doctor. Another thing, when doctors don't talk to you about diet and nutrition for a condition, there is something seriously wrong. Mine hasn't, and he still hasn't tested free T3. Nutrition is the single most important thing to help heal or reverse a condition, not medication. I had to find out for myself to eat low potassium foods and add generous amounts of salt to my diet to hopefully raise the aldosterone(mine is below 'normal')...no worries for adding salt because of low blood pressure. This is an example of a simple piece of info to give someone and not a peep from my doc. Insane. The doc well knows the function of aldosterone and what happens if it gets low. Docs trying to keep us sick?? Keeps them and the pharmaceutical industry in business!! That's why going to naturopath, he is also an acupuncturist physician, and is recognized in my state as a primary care doc. Has helped many people reverse their conditons, and completely get better, even people with cancer...and this came from the mouths of patients of his that I have randomly and coincidentally met.

Long note! Needed to vent, too!

Dixie

I am

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Avatar_f_tn
Dixie,

So glad to not be alone in this! THANKS!  I actually posted above to you b/c I din't see this, SORRY, you pretty much answered all the questions I asked.

I've seen about eating sea salt -- as much as tastes good?  Is that right?  Or should I aim for a certain amount?  I've reduced caffeine intake (my one vice) and hope to totally eliminate soon.

I am waiting for my referral endo to call and schedule an appt.  I'm just debating adding the sea salt (I've always liked things saltier, even on my occasional margarita!) and ordering some Isocort...just go back and forth about waiting til I make it to the doctor so I present how I feel (don't want to skew results)

BUT it is my strong belief that they will disregard everything anyway and so I'm only delaying feeling better.  I guess I'll decide when I see how long it's going to take me to get in...

Any thoughts?

Also, what Vitamin supplements do you take?  I've read about C, Bs and about fish oil.  Do you do any of this?  And in what dosage?

I'm really going to see if I can get them to put me on a trial of cortisol, monitored, so that I can work hand in hand with a doctor.  I have a bizillion doctors through my insuance, but no osteopaths or naturopaths -- don't know if they're classified somewhere else.

Funny about the shoulder and neck pain hyou have, too.  I never did anything to it when it started, had x-rays, MRI, physical therapy...no cause, no reason, and no relief.  I really hope some cortisol supps will help!

I wish you the best.  Please let me know how you're doing.

Best.

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Avatar_n_tn
I responded in a longer note to your other response, so please also look there. Get the book! Will talk about all the supplements and herbs that help adrenals, and in what dosages. However, on the phone the naturopath said that every person is unique and you may not need the exact same dosages the book mentions. He is only charging me $200 for all of the testing, diagnosing, discussion, and supplements(may only be one month's worth). That is actually excellent. My insurance has paid for some of his client's bills, am discussing it with them now. Will see him once in awhile after that for monitoring and testing. Hope I can reverse this.  

I did start on Isocort, my adrenals are severe and there is no way I can't not take something. I am not going to take it the day I see him for testing. Should not screw up the results. He also knows how severe I am from everything I've told him, including suicidal thoughts at times, and would put me on hydrocortisone anyway. Only taking 3 pill/day now.  Waiting to work with him to see if should increase or not.

Good luck with everything!
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Avatar_n_tn
I posted an earlier comment on a different thread that you wrote. It was from March. I am experiencing many of the same weird symptoms that you are and I am very depressed and angry about it. My last year and a half have been a true nightmare. I don't know what to do anymore or where to go. I am so tired of doctors, lab tests, and pills. I have very little support from my husband and our families. They think I should just accept this and move on. I cannot. I used to be a very high energy professional woman. I had long curly thick brown hair and worked out all the time. I had a very active social life and felt good about myself. In 10/05 I was dx with a rare autoimmune disease that effects my liver. I am doing okay with that on meds, but it often is associated with thyroid problems. Little is known about it all though and I have found very little help in the medical community. I have lost 50-60% of my hair and don't look like the same person anymore. I have no hair on my legs or it grows really slowly. No underarm hair. Thin eyebrows and thin eye lashes. I had the pain you described in my shoulders and neck and see a chiropractor to help with that. I have dry eyes and am cold all the time, especially my hands. I am tired and irritable all the time and get very angry very quickly. This is not me. I don't want to be this way any more. Have you found any help or answers? I don't think my Armour is helping and need to know where to go from here. I have an appt with my PCP in a few weeks and can ask for some additonal tests, but don't know where to start. Please let me know what you have learned. I am glad to know I am not alone. I have felt this way for too long. Thanks!
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Avatar_f_tn
Hi.  Sorry it has taken me so long to get back -- I have been away.

I am still waiting to speak to the endo -- left me a message that all my tests were pretty normal -- albeit I believe fairly inadequate tests...we'll see.

I have physical with my PCP this week -- not much left to go over with her, but she can take a look at me.

FYI -- I have not been diagnosed with a thyroid or adrenal issue.  They just look at me and see my "normal" test results and say oh, you're fine.  I cannot imagine how I will function in a couple of years.  

I wish you luck -- please let us know how you're doing.

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Avatar_n_tn
I am having similar problems to the previous posts - tremendous hair loss, anxietym, depression, shakiness, trembling. This all started with a month trial of Synthroid at 25 mcg. None of these symptoms existed before. Every doc says it's impossible to have these side effects, but I do, along with scalp pain, burning, and stiff neck, shoulder muscles. I am a wreck and cannot function anymore. My thyroid tests in the normal range now without any meds so no thyroid supplementation has been given. I can't cope and was wondering if I need to support my adrenals in some way. Is Isocort only for people with low adrenal function or can it be given to those with hyperadrenia also? I don't know who else to go to - I've been to dozens of regular and naturopathic docs with no results.
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Avatar_f_tn
Annie,

I, too, am not taking any thyroid med and remain "undiagnosed" b/c my labs are within the "normal" range despite countless symptoms.  I have been playing phone tag with an endo and I plan on asking her for some more tests -- never have been able to get a Free T3 even though I've requested it and my cortisol, DHEA, and ACTH are all on the low end of the normal range, so I'm looking to have some additional adrenal tests.

I am by no means an expert, but what I would recommend for you is -- first peruse the www.stopthethyroidmadness.com website.  They have sections for adrenal and hypopituitary in addition to the thyroid.  They are also very helpful in advising you.  And, secondly, ask for adrenal testing...there is a list of tests to request on their site.  

I hope you find the help you need.  I wish you luck.
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Avatar_n_tn
I too have felt for the last 2.5 yrs that i could not function. Every day is a struggle - and i was such a high energy person before!!

Recently I have tried a few things. A cleanse by Enzymatic Therapy (Whole Body Cleanse) and quitting Aspartame. I was a 32 oz Diet coke a day drinker. After trying to quit cold turkey (and getting a hellacious migraine) I weaned myself off of it and feel much better.

Does anyone else do Aspartame and noticed a serious difference from not doing Aspartame?

Maggie
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