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according to the blood test done in the morning my cortisol is very high -627 nmol/l (150-650). the day i did this test at 8.30am i had cycled to the hospital about 2 miles.
my saliva tests show i also have a high morning level of cortisol, but that it drops very quickly during the day and by lunch is below range. it also shows dhea is below range at this time and later in the afternoon.
So i have conflicting reports on how the adrenals are working. what is likley to be the correct view?
i am taking 7.5mg of hc a day (2.5mg at breakfast and 5mg at lunch). at the moment i cant see any progress, but some times i do see the hc works for me because i become very calm.
i imagine i have high norepinephrine signalling as when young i had a very over active para sympathetic system (i would sweat very easily and blush instantly).
after becoming unwell aged 21 this system was not half as active.
@marsaday 1289 wrote:
according to the blood test done in the morning my cortisol is very high -627 nmol/l (150-650). the day i did this test at 8.30am i had cycled to the hospital about 2 miles.
my saliva tests show i also have a high morning level of cortisol, but that it drops very quickly during the day and by lunch is below range. it also shows dhea is below range at this time and later in the afternoon.
So i have conflicting reports on how the adrenals are working. what is likley to be the correct view?
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How are the results in conflict?
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A blood cortisol level can also be done at multiple times of the day. Generally, an AM and PM level can be done. This would help one obtain a performance curve similar to what is done with saliva cortisol tests. However, the stress may be higher since the person is given a needle insertion in a laboratory as opposed to doing a saliva test in the comfort of home.
Generally, in both saliva and blood cortisol tests, the result obtained will depend on the stress experienced.
Thus, for example, if a person heavily worked out the evening before the morning blood cortisol, I would expect the cortisol level to be over the reference range the next morning.
The reference ranges for cortisol (saliva or blood) assume that a person is at rest and has an unstressed mind.
The actual interpretation has to take into account a person’s level of stress and activity.
Thus exercise (such as weight lifting or bicycle riding) before a blood cortisol or saliva cortisol will tend to increase the level of cortisol production over what is expected if the person was at rest. And thus what is “normal” may be shifted elevated state.
the blood cortisol test shows i am top of the range.
overall i have low cortisol when you take into account the noon and 4pm readings.
my morning cortisol result which is the most recent showed 15.6 nmol/l at 8am. this is middle of the range and i was feeling very ill that day. i was under no stress at all.
noon = 2.7 (5-9)
4pm = 3.4 (3-7)
evening = 0.9 (1-3)dhea was 0.83 am and 0.84 pm (geneva D)
What do people think about these results?
Can you not give me some help on this thread. i would like an answer to the over stimulated para sympathetic nervous system and the levels of stress i think i experience. if this is high in my system what can i do to reduce it. the Hc does work, but i am frightened of taking it in larger doses (greater than 10mgs)
@marsaday 1294 wrote:
the blood cortisol test shows i am top of the range.
overall i have low cortisol when you take into account the noon and 4pm readings.
my morning cortisol result which is the most recent showed 15.6 nmol/l at 8am. this is middle of the range and i was feeling very ill that day. i was under no stress at all.
noon = 2.7 (5-9)
4pm = 3.4 (3-7)
evening = 0.9 (1-3)dhea was 0.83 am and 0.84 pm (geneva D)
What do people think about these results?
Can you not give me some help on this thread. i would like an answer to the over stimulated para sympathetic nervous system and the levels of stress i think i experience. if this is high in my system what can i do to reduce it. the Hc does work, but i am frightened of taking it in larger doses (greater than 10mgs)
Generally, when saliva cortisol and DHEA results show suboptimal levels of cortisol and DHEA, then a person has hypothalamic-pituitary-adrenal axis dysregulation with low adrenal cortex output in response to stress.
Norepinephrine – the primary signal of the sympathetic nervous system – is the primary signal for stress. It is also the signal for wakefulness and also stimulates energy production, among its other functions.
When adrenal cortex output does not match stress / norepinephrine signaling, then one feels “stress”.
Excessive norepinephrine signaling also causes one to feel negative emotions including fear/anxiety and irritability/anger – either one or the other or both simultaneously. When dopamine signaling is reduced in order to raise norepinephrine signaling, then depressed mood / sadness occurs.
An increase in norepinephrine may occur in response to an external stress (e.g. relationship conflicts, job problems, etc.). An increase in norepinephrine may also occur in response to internal physiologic problems. For example, if one has impaired energy production as a result of hypothyroidism, then the nervous system increases norepinephrine signaling to compensate. If one changes position and blood pressure falls, then the nervous system increases norepinephrine signaling to compensate (otherwise one would fall).
Increasing norepinephrine signaling may cause problems. Aside from directly causing insomnia and anxiety, it triggers secondary signaling problems. For example, it may cause other cells of the nervous system to produce pro-inflammatory signals as a defensive maneuver. These then may increase immune system activity. The immune system is our built-in mobile army that helps kill foreign invaders and cancer cells. The immune system may respond by further increasing pro-inflammatory signal production. This then may cause a shut-down adrenal cortex production. This allows the immune system to be even more active, but at the cost of impairing one’s ability to control stress signaling and generate energy. Cortisol, for example, is a signal that improves energy production and reduces stress. The increase in pro-inflammatory signaling may also trigger behavioral programs in the nervous system that reduce a person’s desire to perform activities, cause changes in appetite, etc.
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Treating the above complex of problems can be complicated or easy depending on a person’s circumstance.
For example:
1. Life stresses may need to be addressed.
2. One’s psychological framework may need to be addressed.
3. The nervous systems signaling systems may need to be improved – e.g. reduction in norepinephrine signaling
4. Physiologic problems that resulted in compensatory norepinephrine signaling may need to be assessed and treated. This includes nutritional deficiencies, hormonal problems, etc.
5. Adrenal supportive measures may need to be done.
6. If possible, addressing immune system problems may need to be done either directly or indirectly.
7. etc.—-
Note that generally, once a person develops a mental illness, then there is going to be a very complex set of health problems underlying the condition, causing the problem aside from the environmental and psychological problems a person may have. If these problems are mild, then a person may improve greatly from a simple treatment – e.g. using an antidepressant or using hydrocortisone supportive therapy, simple behavioral changes, etc. But if the problems are more severe, a more complex treatment would be necessary.
Thats for info DrM.
What about exercise. i have heard this stresses the adrenals and can be bad news. i am very active and do exercise every other day (cycling, swimming, football). i have stopped playing squash because i noticed it made me ill afterwards. i really hope i can start playing again, but i am waiting.
psychologically i think i am sound of mind, but when my body switches off i become worried and nervous. sounds like this is the Norepinephrine kicking in and not being damped down enough.
i am in a happy marriage and trying for children. it seems the thyroid problem has left me with lower fertility and so things are not going too well there.
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