# Cortisol Results Help



## AlliKay (Jul 10, 2014)

I had my coritsol tested, and it came back at <1.0.

The sample was collected at 8:53 a.m.

The sample was resulted at 1:41 p.m.

I'm confused whether or not I need to check the reference range based on time of collection or results.

The cortisol reference range is:

Before 10 a.m. 4.46-22.7 ug?dL

After 5:00 p.m. 1.7 - 14.1 ug/dL

I would have thought it was the time of collection, but the doctor who reviewed my results said that I was only "slightly" out of range and that I shouldn't worry. So if it is based on after 5 p.m., I guess that's slightly, but it makes sense to me that it would be before 10 a.m. considering that's when the sample was collected.

Does anyone know the correct answer? And, if it is before 10 a.m., isn't that MORE THAN SLIGHTLY out of range?

I'm seeing a new doctor this week (another one who doesn't accept insurance), but she is a functional medicine doctor, and I'm hoping to get some more answers... When I had an initial phone conversation with her, she said that I may have a hypothyroid and adrenal fatigue combo and that she'd want to do a 4x a day saliva test to check for adrenal fatigue on top of the hypothyroidism.

Help, please!


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## fttfbass (Jan 8, 2014)

Starting your day with cortisol levels that low is something to worry about. Cortisol levels should be at the very top of the range first thing in the morning. The doctor who reviewed your results is one of the many idiots out there with a PhD.

The functional medicine doctor that you do plan on seeing sounds promising. A 4x a day saliva test would be more accurate and show the complete picture of how your adrenals are functioning at key points of the day.

It sucks that you have to pay out of pocket, but if you can afford it, it'll probably be worth it in the long run.


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## fttfbass (Jan 8, 2014)

I probably should have asked in my previous post.....

You are on a normal sleeping schedule, right? Because if you're awake at night and sleep during the day that would change things a bit.


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## AlliKay (Jul 10, 2014)

Yes. I am on a regular sleep schedule. Sadly, the doctor who reviewed my results was a good ol' internist, who also said my thyroid was fine. Still trying to figure out those results before I see the functional doctor this week. If you have any thoughts that would be great. Results below.

TSH .95 (no range given)

T4 Free 1.2 (Range .8-1.8 ng/dL)

T3 Free 2.6 (Range 2.3-4.2 pg/mL)

T3 Total 63 L (Range 76-181 ng/dL)

Iodine is still low (Range 52-109 mcg/L)


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## fttfbass (Jan 8, 2014)

Your Free T3, your active thyroid hormone, is quite low in the range. Usually, people feel better when their Free T3 is around 3/4 of the upper part of the range, which would be 3.7. You're at 2.6.

I also saw from your other post that you had your reverse T3 listed as well. That was a bit high in range. With a high reverse T3 and a low Free T3 it looks like your body isn't converting your own thyroid hormones very well. This can be caused by many things, one of which is issues with the adrenals.

It'd probably be a good idea to request labs for thyroid antibodies and a thyroid ultrasound from the functional medicine doctor.


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## AlliKay (Jul 10, 2014)

fttfbass said:


> Your Free T3, your active thyroid hormone, is quite low in the range. Usually, people feel better when their Free T3 is around 3/4 of the upper part of the range, which would be 3.7. You're at 2.6.
> 
> I also saw from your other post that you had your reverse T3 listed as well. That was a bit high in range. With a high reverse T3 and a low Free T3 it looks like your body isn't converting your own thyroid hormones very well. This can be caused by many things, one of which is issues with the adrenals.
> 
> It'd probably be a good idea to request labs for thyroid antibodies and a thyroid ultrasound from the functional medicine doctor.


Thanks! I've had a thyroid ultrasound done in the past, but not recently. I'll definitely ask about thyroid antibodies.

Is Amour Thyroid used to treat this type of issue?

I'm trying to figure out the right questions to ask. The last doctor I went to wanted to put me on an all natural supplement that she sells. She didn't think my thyroid levels were that bad.


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## fttfbass (Jan 8, 2014)

Armour can definitely be used to treat it, but with your high reverse T3 and low Free T3, you'll either need to tackle your adrenal issues first or while you titrate your thyroid meds up.

The problem is that if your adrenals aren't worked on, your reverse T3 is going to keep increasing while your Free T3 doesn't really budge much. You'll end up with high reverse T3, high Free T4, and low Free T3 which will actually make you feel worse on the thyroid meds.

Hopefully, the functional doctor can figure this all out and set up a gameplan to get you feeling back to normal. It's not easy and takes time. Ask me how I know. Lol


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## fttfbass (Jan 8, 2014)

Working on your adrenal issues could possibly get your thyroid in proper working order on it's own. But, with a lowish Free T3, it's difficult to get the adrenals working optimally. It sucks how that works.


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## AlliKay (Jul 10, 2014)

fttfbass said:


> Working on your adrenal issues could possibly get your thyroid in proper working order on it's own. But, with a lowish Free T3, it's difficult to get the adrenals working optimally. It sucks how that works.


This sounds like so much fun! Can you give me an idea of some of the options to treat the adrenal issue?

I hate to say it, but I'm skeptical of all doctors... This one sounds promising, but I also feel like I need to go in with as much information as possible and questions.


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## AlliKay (Jul 10, 2014)

I should probably say that I'm already on Iodine 675mg a day


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## fttfbass (Jan 8, 2014)

AlliKay said:


> This sounds like so much fun! Can you give me an idea of some of the options to treat the adrenal issue?
> 
> I hate to say it, but I'm skeptical of all doctors... This one sounds promising, but I also feel like I need to go in with as much information as possible and questions.


It really depends on how bad your adrenals are. You definitely need the 4x a day saliva test to see what's going on there.


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## AlliKay (Jul 10, 2014)

fttfbass said:


> It really depends on how bad your adrenals are. You definitely need the 4x a day saliva test to see what's going on there.


Just mailed off my 4x a day saliva test. It's going to take about 2 weeks before I hear back. On Armour 60 to start since my T3 was out of wack.

I did some research and it seems as though oral hydrocortisone is one options for low adrenals. Some are saying that causes weight gain though, so I'm a bit worried.


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## fttfbass (Jan 8, 2014)

If your saliva test shows all lows, hydrocortisone may be your only option at that point. If it shows a mix of highs and lows there are other options, but it's definitely a struggle to see what works and what doesn't. I'm going through that right now.

You'll be ok on armour 60. Once getting above 90 with adrenal issues, you will run into more problems. Either the T4 will convert into reverse T3 instead of Free T3 or the Free T3 will pool in your blood without actually getting into the cells where they're needed.


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## AlliKay (Jul 10, 2014)

fttfbass said:


> If your saliva test shows all lows, hydrocortisone may be your only option at that point. If it shows a mix of highs and lows there are other options, but it's definitely a struggle to see what works and what doesn't. I'm going through that right now.
> 
> You'll be ok on armour 60. Once getting above 90 with adrenal issues, you will run into more problems. Either the T4 will convert into reverse T3 instead of Free T3 or the Free T3 will pool in your blood without actually getting into the cells where they're needed.


Do you have issues with weight gain as well? If so, have you found any combo that helps?


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## fttfbass (Jan 8, 2014)

Out of the many symptoms I have, weight gain isn't one of them.

I'm currently experimenting with Ashwagandha. It's an adaptogenic herb. Basically, if your cortisol is elevated, it's supposed to bring it down and vice versa. So far, it's helped with some symptoms, but brought on other symptoms. The newer symptoms are more tolerable than my previous symptoms, so I'm going to give it some time before I decide if I want to continue taking it or not.

I also drink an "adrenal cocktail" throughout the day, which is supposed to help. I'm not really sure if it is or not. Their are several recipes that can be found online through a google search.


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## jenny v (May 6, 2012)

I have low, normal, high, high and I have some minor issues trying to lose a bit of belly chub (adrenal problems can cause it), but I've lost 35 pounds since my thyroid surgery and I keep losing. I'm trying Seriphos to lower my highs and see if it naturally brings up my morning low. Low and high cortisol symptoms can mimic each other so it's great you've done the saliva test.


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