Cortisol-blood vs. saliva results

[Champ50]

Hey guys I'm being treated for adrenal fatigue and in my last test I had both blood and saliva tests done. Well the results were opposite ends of the spectrum the- Blood said I had more than enough actually just over top of range 22mcg/dL (range 5-21) and a free cortisol of .99mcg/dL (range .07-.93mcg/dL) while the saliva test came back as saying I was at the absolute bottom end of normal. Obviously I'm a little confused at getting such contradictory results and did a search on the forum where I found that Dr. John said saliva tests are worthless. I am inclined to believe him as I am no longer suffering from any of the symptoms I was displaying when the diagnosis for adrenal fatigue was made but I was wondering if anyone else had this experience with divergent test results?? My doctor said she had never seen anything like this before.

Concurrently my testosterone is down roughly 50% as well as e2 down to 20 from 38, dhea as measured by saliva down over 50%, DHT jumped from 38 to 55, cholesterol was down from 270 to 206.

I am grateful in that I feel infinitely better but overall I'm just at a loss as far as what the BW numbers came in at. Anything jump out at you guys?? Any thoughts or ideas are welcome.

[Scottyo]

ive always had HIGH values on my blood cortisol (never had free done though) and my saliva's have always come up bottom barrel...and I AM severely adrenal fatigued...and even on 42.5mg of CORTEF my urine cortisol levels were fairly midrange...so im actually on the right amount of cortef somehow.

[T800]

Yeah, I've seen the same disparity. Blood results look good, saliva look terrible.

I think at that point, how you feel has to be taken into account.

Last year, when I was initially treated for adrenal fatigue, my blood cortisol looked good, but saliva cortisol was low at every reading.

The disparity is discouraging, but if I remember correctly, Dr Wilson's book on Adrenal Fatigue covers why. It was something along the lines of the blood test showing the amount of circulating cortisol in the blood and the saliva showed the amount of 'active' cortisol. Maybe it's wrong (or maybe I remembered it wrong ), but it was something like that.

Sonny

[pmgamer18]

Dr. John is right most saliva test are no good but for cortisol levels doing a 4 x's in a day test is best. I see this with blood tests all the time when your not real bad. The tech. come at you with this big needle your cortisol levels shoot way up and you test is on the high side. The only time I don't see this is when the person is at stage 6 or 7 and a gun shot off next to his head would not get his levels up. We use the Canary Club to test Cortisol and the rest of the tests that some with this price for hormones are usless.
LAB WORK from Canary Club for special prices. The saliva test is for a full spectrum: thyroid (TSH, free T3, free T4), adrenals (cortisol and DHEA), estrogen, progesterone, testosterone. You can choose from two lab facilities–Diagnos Tech (saliva test for $144.50) or ZRT (saliva plus blood spot test for $199).
thecanaryclub.org/
Here is a FAQ's that was made up at STTM web site for Adrenals.
LAB WORK from Canary Club for special prices. The saliva test is for a full spectrum: thyroid (TSH, free T3, free T4), adrenals (cortisol and DHEA), estrogen, progesterone, testosterone. You can choose from two lab facilities–Diagnos Tech (saliva test for $144.50) or ZRT (saliva plus blood spot test for $199).
thecanaryclub.org/
Here is a link on the stages of it.
http://www.chronicfatigue.org/ASI%201%20.html

[Scottyo]

Dr. John is right most saliva test are no good but for cortisol levels doing a 4 x's in a day test is best. I see this with blood tests all the time when your not real bad. The tech. come at you with this big needle your cortisol levels shoot way up and you test is on the high side. The only time I don't see this is when the person is at stage 6 or 7 and a gun shot off next to his head would not get his levels up. We use the Canary Club to test Cortisol and the rest of the tests that some with this price for hormones are usless.
LAB WORK from Canary Club for special prices. The saliva test is for a full spectrum: thyroid (TSH, free T3, free T4), adrenals (cortisol and DHEA), estrogen, progesterone, testosterone. You can choose from two lab facilities–Diagnos Tech (saliva test for $144.50) or ZRT (saliva plus blood spot test for $199).
thecanaryclub.org/
Here is a FAQ's that was made up at STTM web site for Adrenals.
LAB WORK from Canary Club for special prices. The saliva test is for a full spectrum: thyroid (TSH, free T3, free T4), adrenals (cortisol and DHEA), estrogen, progesterone, testosterone. You can choose from two lab facilities–Diagnos Tech (saliva test for $144.50) or ZRT (saliva plus blood spot test for $199).
thecanaryclub.org/
Here is a link on the stages of it.
http://www.chronicfatigue.org/ASI%201%20.html

I think the doc and needle thing have NOTHING or very little to do with the inconsistency in levels. I think it is the free/bound or cortisol/cortisone thats affecting things. I have been getting shots/blood drawn for years....im usually half alseep and don't even flinch but my blood values are always sky high...and i am stage 6 (at least). But my urines are always low/normal, and my salivas were always very low.

Its something else..the doc needle scare explanation is bs in my view, just something to explain what they cant explain.

[rfish1966]

I just had blood taken for cortisol today..used to be an E.M.T and not even close to being afraid of needles so we will se what happens....going for a contrast MRI o saturday, should be interesting.

[pmgamer18]

I think the doc and needle thing have NOTHING or very little to do with the inconsistency in levels. I think it is the free/bound or cortisol/cortisone thats affecting things. I have been getting shots/blood drawn for years....im usually half alseep and don't even flinch but my blood values are always sky high...and i am stage 6 (at least). But my urines are always low/normal, and my salivas were always very low.

Its something else..the doc needle scare explanation is bs in my view, just something to explain what they cant explain.

This makes a lot of sense to me yet a lot of Dr.'s say this even in the UK.

How are you treating your stage 6 I am Hypopituitary was on TRT for 23 yrs. told I am Primary until 2 yrs ago when I added HCG to my shots and my T levels doubled. We looked back over my old labs and they all were screaming a Pituitary Problem. So now last yr. I started treating the things that were low normal Cortisol, Thyroid, DHEA and Aldosterone. I am on 25 mgs of Cortef a day 10mgs at 5am, 5mgs at 9am, 5mgs at 1pm and 5 mgs at dinner. I am doing 3.5 grains of Armour 1.5 grains in the morning, 1 grain at noon and 1 grain at dinner time I put the armour under my tongue.
I take 25 mgs of DHEA.
And for the low Aldosterone levels I take .125mgs of Florinef with 1 tsp of Sea Salt in a glass of water 2x's a day. After treating the low Aldosterone levels I finely started feeling better.

[JanSz]

This makes a lot of sense to me yet a lot of Dr.'s say this even in the UK.

How are you treating your stage 6 I am Hypopituitary was on TRT for 23 yrs. told I am Primary until 2 yrs ago when I added HCG to my shots and my T levels doubled. We looked back over my old labs and they all were screaming a Pituitary Problem. So now last yr. I started treating the things that were low normal Cortisol, Thyroid, DHEA and Aldosterone. I am on 25 mgs of Cortef a day 10mgs at 5am, 5mgs at 9am, 5mgs at 1pm and 5 mgs at dinner. I am doing 3.5 grains of Armour 1.5 grains in the morning, 1 grain at noon and 1 grain at dinner time I put the armour under my tongue.I take 25 mgs of DHEA.
And for the low Aldosterone levels I take .125mgs of Florinef with 1 tsp of Sea Salt in a glass of water 2x's a day. After treating the low Aldosterone levels I finely started feeling better.

Post your
FreeT3
FreeT4
T3
T4

I newer really checked if I can use T4 (Synthroid)
and have it converted to T3. Just keep on using Armour.

Now I added 50mg Levothyroxin (substutute for Synthroid)
rather than adding 1/2grain of Armour that I need, after my last blood test.
Will see how it will work.

I am assuming that working (if succesfull) from T4-->T3 conversion
should be more stable. My body temps are still vary more than I would like.

[Scottyo]

This makes a lot of sense to me yet a lot of Dr.'s say this even in the UK.

How are you treating your stage 6 I am Hypopituitary was on TRT for 23 yrs. told I am Primary until 2 yrs ago when I added HCG to my shots and my T levels doubled. We looked back over my old labs and they all were screaming a Pituitary Problem. So now last yr. I started treating the things that were low normal Cortisol, Thyroid, DHEA and Aldosterone. I am on 25 mgs of Cortef a day 10mgs at 5am, 5mgs at 9am, 5mgs at 1pm and 5 mgs at dinner. I am doing 3.5 grains of Armour 1.5 grains in the morning, 1 grain at noon and 1 grain at dinner time I put the armour under my tongue.
I take 25 mgs of DHEA.
And for the low Aldosterone levels I take .125mgs of Florinef with 1 tsp of Sea Salt in a glass of water 2x's a day. After treating the low Aldosterone levels I finely started feeling better.

Well...im in a similar boat, I know we've talked about this many a time at stopthethyroidmadness.com. Dr. John seems to think im leaning towards primary now, although when I added and was on just HCG my test went from 230 to 599 or so...but still very low. The last time we checked, it was just with RHeins and everything, test, estrogens etc. were either low or very very low end of normal.

Right now, I am on 42.5mg of cortef (and my rheins' show normal to normal/slightly high cortisol levels...on that high a dose). I am also up to 3.75 moving to 4 grains armour. I am on .1mg of florinef, 250iu HCG daily, 25mg dhea 2x daily, 100mg/ml pregnenolone cream and just added a few weeks ago some compounded t-gel...50mg/ml 1 ml am. Getting blood and urine work done this tuesday i think. So since everything is somehwat broken we thinking primary, although the hcg did have some effect.

As far as adrenal fatigue....i had one of the worst cases my old doc had ever seen. Im also on 50mg of iodine a day...which i think is very crucial and overlooked by many.

[JanSz]

Well...im in a similar boat, I know we've talked about this many a time at stopthethyroidmadness.com. Dr. John seems to think im leaning towards primary now, although when I added and was on just HCG my test went from 230 to 599 or so...but still very low. The last time we checked, it was just with RHeins and everything, test, estrogens etc. were either low or very very low end of normal.

Right now, I am on 42.5mg of cortef (and my rheins' show normal to normal/slightly high cortisol levels...on that high a dose). I am also up to 3.75 moving to 4 grains armour. I am on .1mg of florinef, 250iu HCG daily, 25mg dhea 2x daily, 100mg/ml pregnenolone cream and just added a few weeks ago some compounded t-gel...50mg/ml 1 ml am. Getting blood and urine work done this tuesday i think. So since everything is somehwat broken we thinking primary, although the hcg did have some effect.

As far as adrenal fatigue....i had one of the worst cases my old doc had ever seen. Im also on 50mg of iodine a day...which i think is very crucial and overlooked by many.

and just added a few weeks ago some compounded t-gel...50mg/ml 1 ml am.
------------------------------------------
Off hand sounds way to little testosterone, provide more details.

[MarkLA]

HCG my test went from 230 to 599 or so...but still very low.

Is that really low? I think 600 is about middle-range. I think we'd all like to be higher than that, but IMHO not "very low". I think 650 was about the average for 35 year olds according to something I read. The standard deviation was large, maybe 150 or so, so there is a lot of variability among individuals...

Mark

[Scottyo]

Is that really low? I think 600 is about middle-range. I think we'd all like to be higher than that, but IMHO not "very low". I think 650 was about the average for 35 year olds according to something I read. The standard deviation was large, maybe 150 or so, so there is a lot of variability among individuals...

Mark

im 24....not 35 or 50. And thankfully Dr. Crisler recognizes that. I had a past endo who thought I was ok or normal because I was at total t at 243 and the range was like 220-1100.

Also you have to take into account FT, SHBG, albumin etc. to get bioavailable test (plus estrogen levels)...mine was all piss poor.

[JanSz]

Is that really low? I think 600 is about middle-range. I think we'd all like to be higher than that, but IMHO not "very low". I think 650 was about the average for 35 year olds according to something I read. The standard deviation was large, maybe 150 or so, so there is a lot of variability among individuals...

Mark

I would say there are two desirable/acceptable testosterone levels.

Using dr Shippen's chart, post #41
Jan's BloodTest April13/2007

Natural-- FreeT ~160 (100 being bottom of possibly acceptable)

Supplemented-- FreeT(160-250)
(I got this from one of the members via PM, supposedly it is from dr Shippen)
-----------------------------------------

Lately, dr Delgado supports FreeT~300

I am aiming at 300.
-----------------------------------------
Note that TotalTestosterone is not mentioned above.
TT should be as need to acheive proper FreeT

[pmgamer18]

First let me say I ran out of Maca 4 weeks before this lab and I had added .5 grains of amour.
My Free T3 showed lower then when I was on 3 grains of armour but I was taking Maca at the time.
Free T3 342 down from last test of 382 range 230 to 420 pg/dl I feel it went down even adding .5 grains do to stoping maca.
Free T4 was 1.0 up from .9 range 0.8 to 1.8 ng/dl I am told this is low because my body is using up the T4 to keep T3 up.
I was going to add in some T4 only and am going to wait until I see my next test next week. If T4 is still low I am going to 4 grains of Armour if this does not do it the I am adding just a small amount if T4 to the armour.

Post your
FreeT3
FreeT4
T3
T4

I newer really checked if I can use T4 (Synthroid)
and have it converted to T3. Just keep on using Armour.

Now I added 50mg Levothyroxin (substutute for Synthroid)
rather than adding 1/2grain of Armour that I need, after my last blood test.
Will see how it will work.

I am assuming that working (if succesfull) from T4-->T3 conversion
should be more stable. My body temps are still vary more than I would like.

[Scottyo]

Do you think maca is that useful? and if so, please post brand again.....i hate using a whole cupboard full of supps but if its agoodie, ill add it back in..

[pmgamer18]

Now see I am told you can't test Cortisol when your on HC I feel maybe you can to tell if you have adrenal problems but if you know you have this probelm whats wrong with testing it to see if your shut down or not doing enough. I have been doing a morning fasting blood cortisol test no meds after 6pm the night before. My test comes back at 12 telling me I am not on to much. I don't have Dr. Jefferies book with me "Safe Uses of Cortisol" and he tested his people to see if they were on enough or to little.

I was having a dam big problem being Dehydreated and holding to much water. I have been on Dyazide/Triamterne 37.5 & 25 mgs 3 days a week for the last 15 yrs because being on TRT makes me hold water. Now I find out my aldosterone levels are dam low and start on Florinef up to
.125mgs a day in the morning. I started feeling so much better it was unbievable. Then I am adding in Sea Salt doing good for weeks. Then all of a sudden I am very fatigued and can't breathe again my Dr. checked me and told my I am holding to much water yet I am dehydreated. He told me to take the Dyazide/Triamterne every otherday. I did and was not feeling better. I ran out of it and had a refill last monday. Now I feel fine starting to day and am now able to cut back on the Sea Salt. I think the Pills I has were no good a generic brand yet the refill is also a generic but from a different lab. This does piss me off how can we be on the same med yet it does not work from lab to lab that makes it.

Well...im in a similar boat, I know we've talked about this many a time at stopthethyroidmadness.com. Dr. John seems to think im leaning towards primary now, although when I added and was on just HCG my test went from 230 to 599 or so...but still very low. The last time we checked, it was just with RHeins and everything, test, estrogens etc. were either low or very very low end of normal.

Right now, I am on 42.5mg of cortef (and my rheins' show normal to normal/slightly high cortisol levels...on that high a dose). I am also up to 3.75 moving to 4 grains armour. I am on .1mg of florinef, 250iu HCG daily, 25mg dhea 2x daily, 100mg/ml pregnenolone cream and just added a few weeks ago some compounded t-gel...50mg/ml 1 ml am. Getting blood and urine work done this tuesday i think. So since everything is somehwat broken we thinking primary, although the hcg did have some effect.

As far as adrenal fatigue....i had one of the worst cases my old doc had ever seen. Im also on 50mg of iodine a day...which i think is very crucial and overlooked by many.

[pmgamer18]

I know this works a friend tryed it with his armour and he went hyper had to lower his armour.
I get it by the pound and take a big tsp full mixed in some apple sause in the morning and a big tsp full in some yogurt at noon.
http://www.macaweb.com/?pid=products_dtl&pn=11-002

Do you think maca is that useful? and if so, please post brand again.....i hate using a whole cupboard full of supps but if its agoodie, ill add it back in..

[Scottyo]

have you tried adding either lugol's iodine or iodoral? that might be why your free t4 is lower....have you ever checked your total t3 and t4 to see if you just don't have the micronutrient reserves to make it?


also, how long does a 1lb bag last at that dosage?

[BigAk]

Just had my appt. with Dr. Crisler yesterday.. When I mentioned that I'm getting ready to have four point saliva test for cortisol to determine Adrenal fatigue, he dismissed the test as invalid and asked me to do an ACTH test. I don't know anything about the later test and would like some info from you guys.

[TJack]

Just had my appt. with Dr. Crisler yesterday.. When I mentioned that I'm getting ready to have four point saliva test for cortisol to determine Adrenal fatigue, he dismissed the test as invalid and asked me to do an ACTH test. I don't know anything about the later test and would like some info from you guys.

A very good friend of mine has been a patient at a major metro hospital (ranked 4th in the country) for a serious hypercortisolism problem that he has had for over five years. It probably started actually in the late 90s but he didn't recognize early symptoms until around 2002 and then very bad symptoms in 2004. The very advanced specialist doctor (highly published in his field and teaches at a major university in NE Ohio) always performed 24-hour Urinary Free Cortisol Tests to check my friends cortisol levels. Interestingly, when he was determined to have a serious hypercortisolism problem, to help determine what kind of problem it was and what was causing it, he had a number of really fancy tests done.

But he also had "Midnight Salivary Tests" done where he would collect saliva samples at Midnight and then mail them into the Lab. If they were above a certain level it meant one thing and if it was real low it meant that he didn't have the serious tumor related version. Then in late 2005 his specialist sent him to NIH Hospital in Bethesda, MD - the big government hospital that specializes in advanced research. He was there for either two or three weeks of around the clock testing on this problem.

What I found interesting, was that he later mentioned that the specialist at NIH used both Saliva Tests and Blood Draws at midnight to check his cortisol levels. Apparently levels start rising in the morning and then level off during the day and then gradually start dropping as evening comes on. And then as it gets to late evening the cortisol levels fall like a rock. In fact he told me that they explained how it was the low levels of cortisol and raised levels of melatonin that causes the body to fall asleep.

But the main point is that it appears there must be some validity to salivary tests for specifically cortisol just in the fact of its use by two major and advanced medical centers.

Now my friend has also emphasized that the salivary test - even the 4 x version - and the blood test version are both pretty useless in determining what your overall cortisol results are as those other tests are just taking a "snapshot" of what your cortisol is at the precise moment, and that it could be a little high, but okay, for right then, but be really, really high (or the low opposite) for the day as a whole) and that is why the hypo and hypercortisol experts consistently use the 24-hour UFC test as their "gold standard" in determining what overall cortisol levels are. In fact advanced doctors will most usually have the patient do like three 24-hr UFCs over a 2 week time period to get an even bigger picture.

:chick:

I also found the comments on Maca raising cortisol levels. I find that interesting and would really like to see any studies that show that to be the case (and not studies done by some university in Peru - where they grow Maca - that are funded by the Peruvian government which is trying for years now to get Maca established as a major cash crop). I find that anecdotal evidence can be interesting... but can never discount the fact that there isn't a certain degree of Placebo Effect in play there. most unbiased studies that I have seen concerning Maca shows that it is basically a small turnip or large radish - and has about the same "super" properties.

From one reputable site:

Today, dried maca root is ground to powder and sold in capsules as a food supplement and marketed to increase stamina (sexual and athletic) and fertility. Consumers bombarded with these marketing claims of hormonal balancing, thyroid stimulation (and resulting weight loss), sexual and athletic performance, and others need note: the indigenous uses to which marketers refer are in dosages by the ounce and pound daily-not just a few grams. No race of superhumans (with incredible sexual or athletic prowess) exists in the Andes, despite the fact that they eat, on average, five pounds of maca per week! When maca first made its debut in the press about 6 years ago it was touted to be the new "natural ViagraTM" for men - sure to increase testosterone and sexual performance. After brisk sales, the market decreased because it simply didn't work as it was claimed. Several years later, and soon after the national media had a field day with the reported negative effects of conventional estrogen replacement therapy, marketers of maca shifted strategies and are today marketing maca as the "new HRT alternative" for women - sure to increase estrogen and treat menopause symptoms. Once again, maca sales are strong again. Unfortunately, maca will not live up to this new marketing claim either. Make no doubt - maca is a wonderful source of natural vital nutrients. The synergy of so many amino acids, vitamins, and minerals in their natural states may increase the assimilation, uptake, and utilization of them in the body. Consumers however, shouldn't expect "miracle cures" with maca - its rather like taking a multi-vitamin supplement. Keep in mind that it is, in fact, a root vegetable and a main staple in the Andean indigenous diet

So in other words, Peruvian people eat this as part of their regular diet at the rate of five or moer pounds per week. Figures from the 2006 revision of the United Nations World Population Prospects report show that the overall (male and female) life expexctancy in the United States is 78.2 years of age. In Albania it is 76. 4 years of age. In French Guiana it is 75.9 years of age. In Jordan it is 75.2 years of age. In PERU? In Peru it is 71.4 (and much less in the rural areas where they eat little meat and high quality animal foods like dairy and eggs - but do consume apparently large quantities of Maca).

ose: