thanks for the link. I wake with lower back pain usually most every day. I do the worst in the morning, all of which are signs of adrenal issues. We’re making progress; I pray.
I just got my 24 hour Adrenal Test results and I thought I would post them immediately, so I could get some feedback. Hopefully someone has a good idea where our numbers should be.
8:00am 0.44 (range 0.04-0.56)
12:00pm 0.07 (range< 0.04 or = 0.36) They didn’t really provide a range for noontime, but you have to imagine it should be inbetween the two.
5:00pm 0.03 (range<.04 or = 0.15)
12:00pm .05 (range<.04 or =.09)
The results are very confusing because I figured the morning # would be the worst, as this is when I feel the worst and your cortisol should be in the absolute top of the range. Mine isn’t at the absolute top, but it doesn’t look horrible in the early am.
The noontime is very low. It should only be a little bit lower than the morning number, this is what I read from most adrenal websites. Mine is in the tanks at noontime.
My 5:00pm number is horrible. It should be higher than this for a 5:00pm reading.
11:00am. The cortisol number is supposed to go down at night, but still seems a little low there too.
I’m going to post my numbers on some adrenal sites where I can get feedback from some people that are more versed than we are at looking at adenal numbers. This is only 1 morning reading, so who knows if I took a reading for a week they might be lower certain mornings. It definitely looks like adrenals are a problem for me anyway.
low cortisol can prevent thyroid hormones from making it to the cells….and you will still feel bad.
Hey
I wouldent give these saliva cortisol reading much value alone. I think what you should do next if you suspect adrenal insufficiency is to do the acth stimulation test. Its the only way to really know if you have an adrenal problem.
If i were you and suspected an adrenal issue i would do an acth stim test but also at the same time check for 21hydroxylase and 11b hydroxylase deficiency since its the same test just with more measurments.
1 case have allrdy been suspected of this enzyme defficiancy and to my knowledge its the only person who have done this test so far out of the forum members. Its my understanding that dr.jacobs find the results inconclusive but still pointing towards a 11b hydroxylase deficiancy.
Im having these tests done myself as soon as i can so im obviously interested in more ppl doing the same. We cant continue to just test the end products T, E2, DHT Cortisol etc for a 5th time, it will show us nothing new imo. We need to do more indepth testing to find new results and to put theories to the ground if nothing else.
With this test you would have the ability to exclude andrenal failure from the list of the possible causes for your persistant sideeffects and possibly find a cause for them. To me this is a valuble test! A 5th reading of Testosterone e2 dht etc at this point is of little value imo.
Read below in regards to acth stim test and cortisol pathway.
viewtopic.php?f=1&t=4239
He’s already done the acth stimulation test. read the thread.
Even if he did you are missing the point of my post.
All i could find about possible acth test is this:
[qoute]
“I also did a stimualtion test for Thyroid & Adrenals as well. I can’t recall the name of it but the procedure was the same. They drew baseline blood level of T3, T4 etc and then infused cortisone into my blood. They then test blood levels at timed intervals. This test is supposed to be very realible, similar to the Arginine stimulation test. The test results were negative for Thyroid and Adrenal problems” /[qoute]
Besides i cant find results of this acth test if indeed thats what it was you did boston? Do you have the results? Do you know if it was regular dose or low dose injection?
The point of testing the enzymes along with acth stim test is to find out if we produce more than needed of some hormones untill we reach the satisfactory level of cortisol. This would not show up unless specifacally looked for!
Can i suggest that we all in the future post all of our test result in the first post as they come aswell as dissgussing them in the thread. Just makes for a much faster overview when trying to establish similarities etc between sufferers.
It’s a good point about posting the tests and then discussing them, that’s ususally done in the blood tests section. However don’t muddy the water unnecessarily. We’ve been discussing thyroid adrenal treatment for months with the 24 hour cort saliva testing as one of the key pieces. Lots of thyroid/adrenal sufferers have used it and it seems to be the most useful in determining the 24 hour circadian rythem of cort. It’s not about how the body reacts to stimulation, it’s about how the body runs naturally on a 24 hour cycle, which is why one stimulation test is not applicable in this manner, because if someone is going to replace cort to feel better they will do it spread throughout the day, just like T3 treatment.
I still think you are missing the point imo. If you do an acth test with 21 and 11 hydroxylase measurements and find a defieciancy, that is PROOF your adrenals are not working properly and its a legitimate medical condtion as opposed to a 24h salivary cortisol where at best you can perhaps say that your levels are on that perticular day low or high.
Take me for instance i have had low serum cortisol then low sailvary 24h cortisol and then at the top serum cortisol at the next test. What does that tell me? Pretty much inconclusive…
If findings during this acth test lead dr jacobs to thinking that his patient might have 11b hydroxylase deficiency this could also be the same findings one would do as if we were still subjected to 5ar not doing what its suppose to do and this initself could be proof that F****** propecia did this to us. Namely elevated corticosterone.
Dr. jacobs findings were that he thought this patient might have 11b hydroxylase deficiency but the results were inconclusive. This lead me to belive that cortisol came up but still deoxycortisol and deoxycorticosterone was elevated or wichever one that was tested (as would happen if we have 11 b hydroxylase defiency) en.wikipedia.org/wiki/File:Steroidogenesis.svg
Now dexoycorticosterone also have below pathway via 5ar
Deoxycorticosterone --> 5a-DHDOC --> 5a-THDOC
So maybe its just the 5ar still not doing its job leaving us wth elevated deoxycorticosterone.
I would like to know if i have elevated deoxycorticosterone or deoxycortisol and i would like my doctor to explain possibly causes for this other than propecia or 11b hydroxylaze deficiency if such exists.
Theres just so much more info to be gathered from this kind of test than a 24h salivary cortisol test hence im all for it…
bigmike, thanks I had read this somewhere before as well and that’s one of the reasons I stopped taking Armour. If my adrenals are screwed up, it cause more harm than good.
Martin, I believe you’re right it was an acth stimulation test that I took. I need to go back through all of my old blood work and dig it up.
troubledfinuser2, None of us really know anything for sure and that includes Dr Jacobs. It’s great that these doctors are trying to help us propecia sufferers.
Let’s not forget they are business men. They are not devoting all of their time and effort and energy to curing us. I think too many of us tend to put these guys on a pedestal. I still haven’t seen 1 single guy on this forum that has had a dramatic improvement in their care.
I quite frankly don’t hold some of their thories to hold more weight than some of the ones that I have seen posted on this website by some of the users here. I just read boston332 say that Shippen scripted T3 for him without running a thyroid test. He thought he got the idea from reading JN’s thread on this forum.
So today my doctor scripted Cortef for me. I will begin taking it at low doses starting at 2.5mg to try to allow my adrenals to heal and recover.
My research indicates to ramp up to 5mg 4x per day before eating meals and lastly at bedtime.
I have stated before adrenals are linked to sex hormones so maybe there is some chance I get an uptick there too. For me, that would be icing on the cake. I don’t expect that and see Cortef as more a way to heal the adrenal glands and fix the adrenal/thyroid problem.
I had read that low testosterone can tax the adrenals and cause low cortisol. I can’t find the article now.
I’ll post an update in a few day if I notice any changes as well.
Ultimate oneself is reponsible to make sure one get the best care possible i agree with that.
And like you said doctors should definetly not be put on pedistals i learned this a long time ago. I for one dont think that Chrisler or any other doctor will cure us and i never did but doctors have very good way of measuring functions that we can not do ourself. I find dr jacobs possible find extremely interesting tho! But its not the doctors its the results of the tests they provide that is interesting to us as finally we will know more about our condition than any doctor will. We just have to fit the pieces together.
I dont understand how you dont know if you had acth stimulation test done and not even knowing the results yet you are on your way of taking cortef, i dont get it. If it were me i would know them by heart if i was thinking of taking adrenal supplements.
I think you should dig these test results up straight away.
Really hope you have great results with cortef.
Troubledfinuser2,
So I pulled the Test I did back in March:
It’s easy to see why there was a confusion with wether I could recall if I had the ACTH test done because it wasn’t under the same name.
The test report is named: Cortrysin Stimulation. When I googled this Cortrysin Stimulation test is another name for the ACTH stimulation test.
Results:
Cort Basel 12.6
Cort30 Min 21.3
Cort60 Min 23.5
Mornings: 8.7-22.4
Evening < 10
When I googled the test results. If your adrenal glands respond to the ACTH then you can rule out Adrenal Glands being the primary cause of the problem. So I would have secondary Adrenal fatigue, which would mean the pituitary is the cause of the problem. Which I’m sure surprises no one.
But now what? So I still clearly have a low cortisol problem. What other options would we have? I guess going into cortisol treatment I would have to realize it’s nothing more than a band aid and it would only make me feel better and not fix my problem.
I have been through the complete gamut. I have already been to have an MRI done and there was no tumor found.
Hey.
Do you know if the dose injected was 250, does it say on the test?
Thats the exact test i did aswell. And i believe you are correct in the assumption that there is no trouble for your adrenals to put out cortisol should the body need it or pituary realize your body need it. Your response / increase in cortisol after injection is alot stronger than i had during my test.
Basicly it comes down to if you belive that 24h cortisol salivary is a good measurement of cortisol or not.
One thing to take into consideration when trying cortef is that its not unlikely you will feel alot better on it even tho low cortisol isent the root of your problem. Most ppl would feel better on cortef initially i would suspect.
Im deffinetly not trying to put ideas in your head, hell you might feel perfect on cortef. Its just that ive had the exact same dilemma. low normal serum cortisol, low salivary cortisol. Inconclusive acth test (your isent even that, it seems perfectly healthy with a doubling of baseline). Then i go test serum cortisol again when i feel utterly rubbish and just after the lastest crash i had and to my suprise cortisol is top of the range high…
You could try do more testing as an option before taking cortef or be less of a chicken then me and actually try it 
troubledfin,
I don’t see anything on the test indicating how much they injected. Actually I appreciate the concerns you bring up. I would have done the same thing to myself anyway. I have always been a super healthy person prior to the propeica nightmare, so I hate to take any meds. The last time the doctor scripted HCG I ponderred wether or not to take it for at least a few days before actually doing so. Maybe what propecia did to us will always make us nervous of all meds.
My doctor said that if you go on it for only a couple of months and find it’s not helping very much or want to stop you can ween off gradually. He said when you have been on it longer period of time it’s very difficult to stop taking it.
I’m doing a little more research, but I’m favoring taking it. At some point I’m going to need to do something. I’m not getting any better and I’ve been off of the crap for about a year and 9 months. The more I feel I learn about what this pill did to us, the more I feel it’s a pituitary problem. I’m hoping I’m wrong.
I kind of agree with him, that its surprising you didnt know you’ve had an ACTH stim test done and were planning to go on Cortisol supps.
Did the test for ACTH values? If you think you have a pituatry problem then you should have a low ACTH, right? I didnt see the ranges for your cortisol (but i am guessing its the standard 10-25). So although your blood cortisol was low normal in the morning in the Serum test, it was higg in the Saliva test. So its still inconclusive. I would suggest you to take another AM cortisol serum test and see where you are. If its mid low, go for Vit C, pantothetic acid, aswagandha and test again in 1.5 months. If its at the bottom then go for HC or Iscort etc.
I think even before the test you had made up your mind that u have an adrenal problem. I was also a bit surprised that you started taking Armor when all your thyroid numbers were in range. Taking any of these hormones will suppress your own production, so be very very careful with any hormone supplementation. You may be causing more harm then good.
We know the ranges are based on samples not applicable to young healthy males. “in range” no longer has value in our world. All of the thyroid sites suggest values in the top of the range or above similar to how some PFS sufferers feel better when getting their test to the top of the range. Boston also had a low free t3/rt3 ratio which is a basis for t3 treatment, albeit not armour.
Your last two points are valid however, except that rt3 treatment seeks to reduce rt3 and t4 in the system, and cortisol can be supplemented if your body isn’t keeping up with the necessary production, like JN when his cortisol was tapped out due to thyroid hormone supplementation.
We need to keep this in perspective and thoroughly try a treatment if we are considering it as a method of feeling better. Were not questioning IF the body’s production ability is tapped out, because that doesn’t seem to be the case in any pfs sufferer. The question is WHY the body isn’t producing (which we don’t know) and can we feel better by supplementing additional hormones that we are low in? Again, I don’t know the answer to this question, but attacking the methodology that is being used successfully by patients with excessive rt3 in their bodies is not going to help us. We want to find something that works!
I realize I’m lagging on my end for testing and treatment in this route, however I have had some hang ups and now have had a successful return to proper form via marijuana, which I’m pursuing further before additional medical testing and treatment.
Do you belive that theres not a bunch of young perfectly healthy males walking around that do not have top of the scale testosterone / thyriod / cortisol readings?
I was alot hornier when i had Total T of 12 than i am currently at total T of 24. On top of this my shbg has gone down from 39 to 25 yet im less horny and feel less energetic. My cortisol is now top of range my thyriod has always been top of range and sometimes out of range high yet i feel worse now than when my T / Cortisol / were lower and thyriod the same. My e2 is always around 20. I should feel fantastic going by the top of the range.
I belive that the top of range isent all that we would like it to be and its advocated by questionable doctors imo. Perhaps if you supplement T or Thyriod you have to get to top of the range because there are different uptake of supplemented hormones than homegrown so to speak. This i have no experience with and its just my oppinon tho and ive been wrong before.
Texas,
The seems to be a lot of confusion between the ACTH test & the 24 hour test. I’m certainly not claiming to be the all knowledgable one, but simply taking an ACTH test and determing your adrenals have the ability to produce cortisol does not change not rule out treating with cortisol.
I’m not sure why so many seem to believe this. If your Pituitary is not signaling to your body to produce more cortisol you still need it. I realize Cortisol treatment is not likely the perfect solution, but I believe lack of cortisol is tied to many of our problems.
Your statement about the results of the ACTH test are incorrect. If your adrenals respond to the ACTH that they inject in you, then your adrenals are cabable of functioning and you are not adrenal insufficient. You would likely have a secondary problem being the Pituitary, although it’s not a guarantee.
Go back and read the prior posts, I stated I’m not taking Armour right now. I began taking Armour at the advice of a doctor. This is before I understood that a potential problem with adrenals should be dealt with first; and before I understood that cortisol is needed to get the thyriod hormone to the body’s cells.
Another point worth mentioning is that I posted my results on a Adrenal Fatigue mb and the moderator said the range provided by Quest Diagnostics does not match what he has seen for all of the other labs. He said the range should likely be higher, meaning my morning number actually looks better than it really is.
I’m done testing for a while. The tests I have conclusive. My body has a problem producing cortisol and none of us know why for sure. I can keep testing and debating and potificating. We still won’t know for sure.
From you last post Boston i would say it looks like you are pretty much on top of the tests and functions of adrenals. So you just have to decide treatment plan or if further testing is needed.
However texas was somewhat right in saying if you have a pituary problem you would have low acth. Unfortunetly ACTH readings are pretty useless since they flactuate so much depending on the situation. So from what i understand ACTH in serum is basicly only valuble in the settings of adrenal failure where its chronicly high with low cortisol.
Gl