Cortisol Blood Draw

[jwh7699]

I had a Cortisol Blood draw done at 8am on empty stomach. My Dr. says it looks normal. I was wondering what others think? Thanks!!

Test Name: CORTISOL
Result: 4.1
Units: ug/dL
Reference Range: (3.1-22.4)
Interpretation: Serum Cortisol (AM) Ref Range: 5.0-25.0 ug/dL
Serum Cortisol (PM) Ref Range: 2.5-12.5 ug/dL

[test-one]

I had a Cortisol Blood draw done at 8am on empty stomach. My Dr. says it looks normal. I was wondering what others think? Thanks!!

Test Name: SOL
Result: 4.1
Units: ug/dL
Reference Range: (3.1-22.4)
Interpretation: Serum Cortisol (AM) Ref Range: 5.0-25.0 ug/dL
Serum Cortisol (PM) Ref Range: 2.5-12.5 ug/dL

Jwh, that is low. I know because I just had a gambit of adrenal test ran and when you consider that was at 8am (when your levels should be their highest) Its even more apparent that you should consider further testing.

Specifically your ACTH.

[jwh7699]

Thanks for the info!

What tests did you have run for adrenal testing?

[test-one]

Thanks for the info!

What tests did you have run for adrenal testing?

I had the following...

24 hr urine analysis
24 hr saliva test
Blood cortisol test am, noon and pm
Acth test
Acth stimulation test (wrecked me for a week)
Progesterone
17oh progesterone
Urine analysis

Lastly, the good old fashion aldosterone test of shining a light in the pupils and see if they cannot hold tight (do they bounce back and forth)

I thinks that was the extent of my testing.

How are you feeling?

[jwh7699]

My energy level this week has been a little better since I stopped taking Melatonin before bed, not sure why, but that is only thing I've stopped taking.

The biggest symptoms I have are fatigue, can't lose weight to save my life, and even though I'm a warm person and perspire easily, if I get in a situation where I am a bit anxious I sweat profusely.

I also had a saliva cortisol test run on my own. I stopped supplement type hormones for 4 days prior. My Doctor said that saliva tests aren't reliable and left it at that.

Hormone Test 05/05/2013 Units Range
DHEAS (saliva) 16.2 ng/ml 2-23 (Age Dependent)
Cortisol Morning (saliva) 3.6 ng/ml 3.7-9.5
Cortisol Noon (saliva) 4.5 ng/ml 1.2-3.0
Cortisol Evening (saliva) 3.5 ng/ml 0.6-1.9
Cortisol Night (saliva) 1.5 ng/ml 0.4-1.0
Current Hormone Therapies
05-05-2013 - 1x/week IM/SC Injection Testosterone - Cypionate (Pharmaceutical) (daily Last used); 25 mg BID oral DHEA (OTC) (4 days
Last used); 10 mg oral Melatonin (OTC) (4 days Last used); 100 mg oral Pregnenolone (OTC) (4 days Last used);

[AnabolicDoc]

When screening AM cortisol levels are low, it's supposed to be followed up by a cortisol stimulation test. That's when the doctor gauges your cortisol response to ACTH.

[Joseph956]

"can't lose weight to save my life" sounds familiar.. I also had pretty low cortisol levels

Cortisol 7.4 6.7 - 22.6 ug/dL (taken at 2:31pm)

I was wondering if this might be an issue that I can approach a Dr with to get a script for HGH..

[jwh7699]

When screening AM cortisol levels are low, it's supposed to be followed up by a cortisol stimulation test. That's when the doctor gauges your cortisol response to ACTH.

Is this the same as the 24 cortisol urine analysis?

I had one of those done a couple years ago prior to getting diagnosed with low T.

Thanks!!

[test-one]

Is this the same as the 24 cortisol urine analysis?

I had one of those done a couple years ago prior to getting diagnosed with low T.

Thanks!!

Not not the same test at all.

The 24hr cortisol test measures your total cortisol level metabolites found in your urine. It's a picture of your total output.

The Acth stimulation test measures your cortisol levels in RESPONSE to the cortosyn (Acth mimicking hormone) in effect determining whether your primary or secondary.

Primary means adrenals are at fault for low levels (meaning the Acth didn't cause your adrenals to secrete cortisol because they simply can't)

Secondary means that your pituitary is at fault because cortisol levels with rise after the cortosyn has been administered. Your capable of making cortisol but the signaling hormone (Acth) isn't being sent from the pituitary.

There are wide gray areas as well which is where adrenal fatigue falls.

[jwh7699]

So out of the tests you had done. Would you say that the ACTH Stim test is the most comprehensive test to determine if you have a Cortisol problem or not?

The reason I ask is that sometimes it is like pulling to teeth to get my Primary Doctor to order tests. If I ask for one test she is more likely to order it.

Thanks!!

[test-one]

So out of the tests you had done. Would uou say that the ACTH Stim test is the most comprehensive test to determine if you have a Cortisol problem or not?

The reason I ask is that sometimes it is like pulling to teeth to get my Primary Doctor to order tests. If I ask for one test she is more likely to order it.

Thanks!!

Jw, I would be careful recommending one test as "comprehensive". The reason I say this is because ONE test is just a snap shot of a particular angle to an illness or syndrome.

But to answer your question...yes an Acth stim test would be a great follow up to the test you recently had run.

I looked at your results and they mimic an upside V when they should look more like \. You have low levels in the morning (not good) and spikes in the mid day (could be stress...remember the snap shot I alluded to) and a good level for getting to sleep in the evening.

What time do you get sleepy....how is your circadian rhythm?

Fatigue sucks and what's worse is that its hard to nail down.

Some docs that I've read say androgens lower cortisol while others say that they don't.

I think as with everything it's case dependant.

Good luck my friend....keep an eye on my trt anxiety thread as think my fatigue is in direct relation to my cortisol. It may eventually be filled with useful information

[AnabolicDoc]

Not not the same test at all.

The 24hr cortisol test measures your total cortisol level metabolites found in your urine. It's a picture of your total output.

The Acth stimulation test measures your cortisol levels in RESPONSE to the cortosyn (Acth mimicking hormone) in effect determining whether your primary or secondary.

Primary means adrenals are at fault for low levels (meaning the Acth didn't cause your adrenals to secrete cortisol because they simply can't)

Secondary means that your pituitary is at fault because cortisol levels with rise after the cortosyn has been administered. Your capable of making cortisol but the signaling hormone (Acth) isn't being sent from the pituitary.

There are wide gray areas as well which is where adrenal fatigue falls.

^ x 2

[AnabolicDoc]

So out of the tests you had done. Would you say that the ACTH Stim test is the most comprehensive test to determine if you have a Cortisol problem or not?

The reason I ask is that sometimes it is like pulling to teeth to get my Primary Doctor to order tests. If I ask for one test she is more likely to order it.

Thanks!!

Cort stim test is done to confirm an abnormal morning cortisol screening test to verify low cortisol levels. 24 hr urine cortisol test has largely been replaced by the am screening test. If the screening test is high, then a dexamethasone suppression test is done to confirm.

The basics of endocrine diagnoses is you attempt to stimulate to verify low levels and attempt to suppress to verify high levels.

[test-one]

Cort stim test is done to confirm an abnormal morning cortisol screening test to verify low cortisol levels. 24 hr urine cortisol test has largely been replaced by the am screening test. If the screening test is high, then a dexamethasone suppression test is done to confirm.

The basics of endocrine diagnoses is you attempt to stimulate to verify low levels and attempt to suppress to verify high levels.

^
In effect working from both ends of the adrenal scale and thereby seeing more than just a snap shot.

Good stuff.....now go make your sales pitch to your dr and let us know what she and the results speak.

[jwh7699]

Thanks guys!

I will ask her about it next week.

I tend to go to bed around midnight. I was taking Melatonin for several months. For the last month I was noticing extra tiredness, so I stopped taking it and I have noticed a difference. I only take GABA now and it has been working good. It relaxes me enough to get a good night's sleep.

[test-one]

I dont mean to pry, but why 12 as your chosen bed time?

When do you rise for the day?

[jwh7699]

I'm more of a night owl. I tend to get a second wind after 6 pm.

[jwh7699]

Got my on-line lab results back regarding my Testosterone level. 745 That's the highest it's been in quite a while.

[test-one]

Got my on-line lab results back regarding my Testosterone level. 745 That's the highest it's been in quite a while.

That's a great number by it's lonesome but what about your other levels?

It's been a few days....your fatigue subsided yet?

[jwh7699]

Haven't had a comprehensive set of Blood Work run in awhile.

It comes and goes, but it has improved.

[kelkel]

Consider an Iron Panel as well if you're fatigued.