Question for Board Veterans on Saliva testing..........
- 06-04-2007, 05:41 PM
Question for Board Veterans on Saliva testing..........
Guys, just wanted to know which Lab is the best for the testing of adrenals, thyroid, test, etc.......via saliva testing............Is that the most accurate way to go via adrenals and thyroid???? I have read Great Smokies Lab and a few others, just want some current info from the Vets.........Thanks in advance........
Also, does Dr John prefer saliva testing or is it mainly bloodwork through Quest Labs?????
- 06-04-2007, 09:37 PM
- 06-06-2007, 08:54 PM
06-06-2007, 09:03 PM
24hr urine then?? i hope my doctor knows how to this and tell me...i have no clue
06-06-2007, 10:09 PM
WOw, thanks Dr John.........glad I waited on ordering the saliva tests until I visited your clinic on Friday.........Its very confusing with all of the information out there, but I am going to let you handle my case.........It will be nice to not have to add my 2 cents for a change.........I get frustrated trying to get my doctors to keep up with research..........I appreciate you commenting on this thread Dr J...........Peace
06-07-2007, 06:29 PM
Dr. John, what then do you recommend for all those with cortisol and adrenal issues? and how important do you think they are? I havent seen you mention them that much, which has led me to be hesitant to switch to your services from my current doc. I KNOW i have cortisol/adrenal issues, and that the only way my armour has been able to increase to 2.75 grains from .5 grains without exhessive build up or pooling is with takin HC. but im now at 42.5mg of HC and would not like to go any higher.
06-07-2007, 06:55 PM
Some of the self tests seem very good for checking adrenal fatigue. For instance the pupil test gives a clear indication of poorly functioning adrenals and a sodium/potassium imbalance. I would imagine the saliva tests would confirm this for cortisol and dhea-s along with complete bloodwork
06-08-2007, 05:03 PM
for example, my serum morning cortisol has ALWAYS been high. even higher than average. but i know from experience that cortef is one of the only things helping me these days.
ill set up an appointment right now, and drive down to lansing if you think you can fix me up...especially getting me back into the gym and exercising in the next month or so. its been 4-5 of playing games and im sick and tired of 'slow' progress.
06-08-2007, 05:20 PM
thanks. i read that. and my question still remains unanswered..or at least unclarified. are you saying that if my serum looks normal or even HIGH, than the cortisol medication is incorrect? im not going by saliva testing either...my saliva tests were started after i began isocort (OTC cortisol supplement) so i dont think they would be 'accurate' even if they did work. what i do know is that I could not handle .5 grain of armour until increasing my cortef dose and even know, my temp still fluctuates especially when i get stresssed out. and i am now on .1mg of florinef and 42.5mg of cortef. The question is....i really dont know where to turn. ive had batteries of labwork done.
so the question is: I know TRT is your baby, and if that were my only issue I would ONLY go to you. But adrenals are something else. So, can you talk abit more about adrenal therapy from Dr. John's persective?
06-08-2007, 05:27 PM
well, I had pretty much all of those...and have gotten better on a number of them since starting the cortef/HC. Especially all the cyclical energy patterns....and the horrible insomnia if i dont get to bed by ten.
we have started to treat those...but now, im up to 42.5mg of HC and still feel funky at times. Is it just a patience issue? just waiting to take time. And should i be able to exercise or not once i get the right cortef dosing. I know 20-25 is the general standard. so im almost double that now.
i had an appointment scheduled with you before, then had it cancelled becasue family wanted me to stay with a doctor who 'handles this stuff' more locally. well, im not too confident in him and now thnk im about ready to make the drive to lansing....i just wanted to know your EXPERIENCE and results with adrenal issues.
06-08-2007, 05:38 PM
No stim test. went to get one done at a couple different labs and they didnt have the equiment or some bs. I have had at least 2-3 serum tests.....one while on HC and one or two without. And my morning fasting cortisol was around 28 or so. also had one done randomly midday and it was around 16-17.
i definetly have the toughness waking up. i get 10 hours of sleep and could always sleep more. also, ive mentioned this before but i get a weird crazy red facial flush that no one has been able to account for or even really look into. it gets worse when i feel worse, adn better/less noticeable when i am taking my meds and feeling good.
for instance....my tests way back in end of august had am cortisol at 29.4. then mid october (non-fating non-am) they were at 17.4. my most recent while on at least 35mg of cortef was in the high 20's again i believe....despite stopping all strenuous activity and getting tremendous amounts of sleep and not trying to stress.
06-09-2007, 12:40 PM
06-09-2007, 12:51 PM
it alleviated all your symptoms? Im up to 42.5mg and still have a number of problems going on. Especially with the stomach/bowel movement stuff, and thats with taking a lot of soluble fiber, magnesium citrate, stool softener and florinef and it still is hard and problematic.
also on 2.75grains of armour. that and the general tiredness, coldness (even while visiting here in AZ, at least indoors) and all the other bs.
06-09-2007, 01:36 PM
As Dr. John mentioned above, symptoms are the most important indicator of Adrenal Fatigue. Labs confirm the symptoms. I have used metametrix for saliva cortisol labs before, and they were fine http://www.metametrix.com/content/Home . I would not do saliva testing for anything else besides cortisol. I highly recommend the book:
"Adrenal Fatigue: the 21st Century Stress Syndrome" - James Wilson
I noticed that you have a thread with your latest labs. I will respond there to your other lab results.
06-10-2007, 06:39 PM
06-10-2007, 10:32 PM
I'll have to check with him if I can get in touch with him and see for sure, but I'd say that he had at least ten or eleven of the listed symptoms. What are those, like 15? And yet he had extremely high cortisol levels (both serum and urinary). I mean we are talking levels like 4 - 5 times the normal range maximum! He has some kind of disorder that causes the adrenal glands to secrete too much cortisol.
It's ironic that he would have many of those same symptoms yet not have adrenal fatigue, but just the opposite, adrenal hypersecretion!
I know he made a convert out of me. I went through some deals with salivary testing (not just on cortisol but also thy and Ts and Es) and basically ended up throwing my money away IMO. Like I was told, some tests pretty much demand a blood draw in order to show specifically what a level is right then, while for others a urinary is better as it is not only accurate also but that it shows a total output for a set time period - for example 24 hours.
06-12-2007, 10:49 AM
These symptoms match me almost exactly yet my morning serum cortisol was 16. When I tried 5mg cortef it just made me feel worse. Only thing I've found to help me is coffee so far but I think long term use has made me worse. It's odd that I have all these exact symptoms yet the cortef made me feel worse. Ofcourse I am a diabetic and I think it's contraindicated for diabetics. So what else helps if I can't take cortef?
06-12-2007, 10:54 AM
06-16-2007, 09:27 AM
I know I came into this late, but I have to completely disagree with the statement about saliva tests. They have been very well validated over the years. I have my patients test before beginning HRT (mostly women) and during HRT when adjustments seem to be needed and the tests have become invaluable to me. I am sure, like anything, there are limitations and positives/negatives to weigh, but for ease of use, cost, and being albe to get a free hormone level I feel they are hard to beat
06-18-2007, 02:23 AM
I have seen/heard most of those arguements before, and some seem to have validity. As always I have much to learn as well. Most difficult for me to understand is the results post transdermal therapy. I'll freely admit I can't explain those immediate fluctuations, however given proper timing after a dose the results seem to be come back in line. I do believe that ultimately blood is be best place to test hormones. The problem I have most often seen though is drs who simply will not take the time to do what you have, which is learn what and how to test. The vast majority of drs are either unaware or unwilling to test properly (eg testing only FSH or LH to "diagnose" menopause). Also, cost and availability of the proper tests seems to be an issue in our area according to local drs.
As to "practicing medicine", most states now have collaborative practice aggrements that allow pharmacists to work under protocols with a dr and have limited prescriptive authority (essentially the dr outlines criteria and what he allows to be prescribed). In addition, many states allow patients to self-order labs, so no dr/pharmacist order is needed. So, no, I do not think I am a dr. However, I do think that I am much more educated in bioidentical HRT than most of the drs I work with, so my patients certainly benefit from the arrangement we have (I consider all of what you might call "customers" my patients, which is why I use that phrase). I highly respect the work you do and your opinions on all of these subjects. If only 10% of the practicing physicians would put forth the effort you obviously have to gain knowledge is the subject of HRT I would be thrilled. As always, I reserve the right to be wrong and have no problem being corrected by someone more edcuated than myself.
06-18-2007, 02:04 PM
Dr. John, Do you know anything about the blood spot testing that ZRT and others are using? Just curious, because I don't know anything about the pros/cons or accuracy of this type of testing.
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