Marked insomnia related to low cortisol levels

Firstly, here is a bit of recent health history.  I am a 47 year old white female who has been suffering from progressive marked insomnia  continuously for over 1.5 years now. Over the past 2 years my health history has been positive for 4 buldging discs in my spine, 1 cervical and 3 lumbar. My back is slowly healing and the pain is greatly reduced.   I had encountered larnygitis for 3 consecutive winters in a row, and went the typical general medical route, and was told to not talk.  Well, after the third year of this and with the larnygitis starting in the fall while on a trip to Israel and lasting for two months and my voice getting more raspy, I felt there could be something structurally wrong and sought out an ENT specialist who did a larnyscopy which showed a granuloma.  During surgery to remove the granuloma, an large cyst was also found on my right vocal chord which was removed at that time.  Subsequent to surgery , the surgeon placed me on a round of steriods as he wanted absolutely no swelling of the vocal chords and with no talking for 10 days. In looking back, I believe that was the time that the insomnia begain getting even worse, that was in January of 2007, and I believe that was like the final insult to my adrenal glands.  I got to where I was only getting one hour of sleep a night and the window of opportunity for getting that hour came between the hours of 5a.m to 9 a.m.  
I had believed that I was low on progesterone and estrogen dominant and felt that could be the cause of my insomnia.  I was still menustrating (and still am) however it was erratic, therefore it was a few months before I could obtain a saliva sample.  When I did obtain a saliva report it confirmed I was very low on progesterone and estrogen dominant w/ low norm testosterone. Progesterone was 44 pg/ml and norm for reporting lab is 75-220 during the luteal phase.  I started on natural progesterone cream. After 2 months I showed no improvement in  the insomnia, so I felt the root of the issue was elsewhere in the hormonal cascade.  I got to the point I said I cannot take anymore of going on one hour of sleep  I cannot go on like this and must cut back on some of my activities. I must have some sleep.
I began doing lots of research online until I would get information overload and would have to wait a bit and let it all absorb.  A showed me a book by James L. Wilson ND,  DC, PhD entitled "Adrenal Fatiuge The 21st Century Stress Syndrome"  I studied this book and did some more research.   I, initially thought that my cortisol levels were too high at night and that was keeping me from sleeping.  But I also read, too low cortisol levels can cause insomnia, so I thought I should obtain dinural cortisol salivary samples and send them off for testing on 10/13/07.  I have not mentioned that my window of opportunity to get a bit of sleep shifted to 9a - 10a.m to 11 a.m. to 12NN.   The results of the salivary adrenal profile were:  morning cortisol  1.3  (range for ZRT Labs 3.7-9.5), noon 3.0 (range 1.2-3.0), evening cortisol 0.7 (range 0.6-1.9), and night cortisol  0.1 (range 0.4-1.0).&nbs p; So, that showed that low cortisol levels were at issue and causing the insomnia rather than too high at night.
After getting these results, I started myself on the adrenal recovery program for severe adrenal exhaustion in Dr. Wilson's book using products devised by him (via a company, Future Formulations).  One of the products is called adrenal rebuilder which is an adrenal cell extract, without hormones, from porcine and bovine sources.  
I had hoped to have shown more improvement with the insomnia after 2 months of this regimen. I am getting more than one hour of sleep but no more than 3 hours every day and that sleep comes during the day when my coritsol levels rise to into the normal range.  The premenstral nights are without more than one hour.  I am really in need greater relief of the insomnia with a resetting of my circadian rhythm.  I do not wish to take low dose cortef to raise my cortisol levels due to the concern of knocking out my adrenals ability to produce any coritsol on their own. I am aware of William Jefferies MD book regarding the safe uses of cortisol. What can help the insomnia?  At times melatonin and a generic unisom will help to get some sleep of the day, but not always and it is contigent upon when cortisol comes into normal range.

[ifupleze]

You don't mention anything about your thyroid.  Have you had your blood tested for any thyroid dysfunction?  Insomnia is one of the biggest complaints of hypothyroidism and hyperthyroidism.  What does you doctor say about your insomnia?  Have they Rx any kind of medication for this?  I am no doctor, but I would start by going to  one and having a full panel blood test done.   If your adrenals are not functioning then chances are your thyroid is not doing it's job, either.  I would make a copy of what you have just posted here and take it to an endocrinologist. I had an emergency doctor tell me that he had a surgeon friend that had insomnia so bad because his thyroid was off, it took a year for him to be able to get back to his normal sleeping pattern.  Anyway, just my suggestions.  Good luck and God bless.

[ifupleze]

One more thing . . . I take 5mgs of  DHEA at night for my adrenals, and it knocks me right out!  I don't know why.  No reason for it but it might help.

[Applecore]

I don't really have the insomnia but I am being checked for my adrenal glands yesterday.  The post by seaotter is the first that I knew that cortisol is what he was checking.  I am so exhausted usually by noon and then if I don't rest I get worse.  My emotions don't feel that they can handle anything much.  I feel good one minute and then boom I get anxious and exhausted.  After resting I do feel some better.  I am still taking the lorazapam as the doctor told me to.  I do have some good new, my thyroid test finally came back in the normal range  tsh 4.4  (.40-4.5)  I have had my days becoming more peaceful and I could tell it was better.  He increased my doseage of levothyroxin (levothyroxine) on Sunday only to 50 the rest of the week I take 37.5.  It brought my levels down from 5.6 to 4.4 in 3 weeks.  Now I don't know if it will stop coming down or not. I am waiting for the endo to call me.  In the meantime my holistic doctor is checking my antibodies to see what they are doing as he thinks I am having too much activity and also he is checking my adrenal glands.  I can't wait to see the results.  I think you are the one that said have them checked.   The hardest thing I am dealing with right now is the diagnosis of celiac and other related food allergies.  I don't know what to do with all that yet.  My insurance won't pay for a nutritionist and the allergy doctor won't take me because I have medicare and they won't let him charge me his normal fee of $400 even if I pay him, he won't take me.  I just got a book called The Maker's Diet and am reading it but it is a lot a diet change also.  I am the kind of a person that until I get an answer and a direction I fight being upset.  I didn't mind just the celiac doing without gluten and eggs but now they want me to do the whole list of things I am allergic to and that is why my doctor wanted me to see the allergist so he could give me shots so I could eat more things.  I really need an answer from the Lord as to what direction to take as this is getting more confusing for me as to what to do.   Thank you for letting me butt in on this  post but I felt it very much applied to me also as I am hoping that if it is my adrenals I can get something for them and feel better.   Do you have any problems with celiac or food allergies.   What symptoms do you get from the adrenals.  Thanks to both of you and I will be praying for you both.    love linda

[ifupleze]

Adrenal fatigue has the same symptoms as hypothyroid.  I have not found any other autoimmune problems, yet, thank God and am hoping they don't appear.  Still trying to get my TSH to normal.  I see the doctor Monday and then off the the lab again for another test.  Won't know til Thursday what my latest results are.  Just hanging in here.  Hope we all feel better soon.

[sea0tter2]

Thank you for your input and suggestions. I am not presently under the care of a physician for the low salivary coritsol levels.  I have not yet had my any thryoid testing. I am taking a herbal formula also created my James L. Wilson to support the thyroid gland.  I don't have health care insurance and finances have been tight. I can look into have blood spot testing done by the lab where I submitted the dinural coritsol, DHEA-S, and progesterone, estradiol and testoterone salivary samples.  
I have tried DHEA supplementation rather than pregnenolone and felt like I got a bit agigtated with it so, I use pregnenlone instead.

[sea0tter2]

The most problematic and disruptive symptom is the marked insomnia and total disruption of my circadian rhythm.

[sea0tter2]

Thank you very much for your comments and especially your prayers!!!

[sea0tter2]

Some of the symptoms of adrenal fatigue (per Dr. James L. Wilson's book "Adrenal Fatigue; The 21st Century Stress Disorder") may be lethargy (lack of energy), increased effort to do every day tasks, continuing fatigue not relieved by sleep, craving for salt or salty foods, difficulty getting up in the morning, decreased ability to handle stress, decreased libido, light-headedness upon standing up from a sitting or reclining position, increased time to recover from illness, injury or trauma, increased PMS, thoughts less focused/more fuzzy, memory less accurate, decreased productivity, decreased tolerance, feeling like don't really wake up until 10 a.m., afternoon low between 3p-4p and feeling better after evening meal.
In regards to food allergies:  cortisol is a strong anti-inflammatory agent and adequate circulating levels of cortisol is a key factor in regulating inflammatory reactions in our body.  Because of this the adrenal glands play an important role in mediating histamine release and inflammatory reactions that produce symptoms assoc. with food allergies.  Hope this helps