Long time stalker, first time posting. I can't find information that pertains to my saliva cortisol test results, and am going a bit crazy over it. I sought out an integrative MD after years of severe fatigue and difficulty losing weight post pregnancies despite a real food diet and tons of exercise. I'm 29.
Here are the results:
6am-8 am >110 (range 13-24)
11am-1pm 86 (range 5-10)
4pm-5pm >110 (range 3-8)
10pm-midnight >110 (range 1-4)
Cortisol Load total: 416 (range 22-46)
The ">" is because the lab only measures up to 110, so it could be higher and we have no way of knowing. I am seeing an integrative MD who at first called the lab because she thought there was some kind of mistake. There wasn't. Her practice, which also contains Naturopaths, have never seen results this high. She said absolutely no exercise beyond light yoga. My DHEA is 8 (range 3-10) and I'm rated as (2) Adapted with DHEA slump. My fasting insulin (range 3-12) and non-fasting insulin (range 5-20) both came back at <3, rated as "depressed." My morning glucose levels vary between 94-107, and the last time I dared venture into frozen yogurt land I ended up with a headache and a glucose reading of 153 two hours post ingestion. My salivary SIgA (immune system) came in at a 10 (range 25-60) which is severely depressed.
Vit D - 31 (32-100)
B12 - 251 (180-914)
Iron - 38 (10-291)
All of my thyroid tests came back completely normal, though a stool test showed very low stomach acid (0.6 with a range of 1.3-8.6) as well as possible gut dysbiosis, with a complete absence of e.coli and low bifdobacterium.
My doc is pretty confident that I have Celiac, though I have been strictly gluten free for 17 months due to a breastfeeding daughter who can't even handle gluten in my diet. Both her and her 3.5 year old sister are suspected of having Celiac due to their violent reactions to gluten. (So violent they can't even consume it to be tested, but a gluten allergy test came back negative, leaving Celiac as the likely culprit.)
I also suspect some cross-reactivity issues as I can't seem to tolerate any grains at all. I've been mostly paleo for about 7 months now.I plan on requesting a test for MTHFR mutations, considering my son carries one mutated copy. Doc also wants to do food intolerance testing.
Current supplement intake is as follows:
B12 injections - 1,000 mcg twice weekly + 500mcg daily by mouth
Iron - 25 mg a day
Vit D - 10,000 IUI a day
Cortisol Manager - 1 pill/twice daily
Claritin (daily for inflammation)
Vit C - 1,000 mg a day
ANY words of wisdom or thoughts would be truly appreciated.
Edited to add: Also dealing with severe bloating that causes me to look 7 months pregnant. Tried AIP and did not help. I have been unable to pinpoint what causes it.
asked byluxi18 (5)
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on June 03, 2014
at 07:14 AM
One questions and three comments:
1. How did you test your cortisol levels?
Did you have to take four separate blood tests during the day?
Also, how about your cortisol in urine?
2. Since you are fatigued, I would also test your insulin and glucose both fasting and 2 hours after a meal.
In the morning, get tested for insulin and blood glucose, then after the test is done, eat some breakfast with carbs (no gluten, of course) and then take a second test for both insulin and glucose.
3. There is a reliable test for gluten sensitivity. Did you take it?
Before you make any conclusions, you definitely have to take other tests.
4. There is a SIBO breath test. Don't take just the hydrogen, use both hydrogen and methane. Even if you have SIBO and take antibiotics for it, if you don't take care of the underlying problem (high cortisol), it is bound to come back.
1. As far as I know, saliva tests for cortisol are not very reliable. Your blood and urine tests are more accurate where the blood test is considered "the gold standard" by doctors.
2. There are other ways of testing gluten intolerance, without ingesting gluten.
3. SIBO test has nothing to do with your stool test since SIBO bacteria resides in small intestine, not in your colon. I mentioned SIBO because you wrote about being severely bloated. Only the breath test results provide accurate results, nothing else.
4. Your fatigue might be related to insulin-glucose issue. Since your insulin is so low, I do not know how to interpret the results. I see you are into naturopathic doctors, which is great, but seeing a reputable endocrinologist would help you to get the whole picture.
Other tests to check when fatigued - Epstein Bar, candida antibodies in blood, thyroid, etc.
But my gut feeling says that you need to explore the blood glucose issues further. Have they ruled out diabetes?
If you do indeed have the celiac disease, then the solution is very easy: Paleo all the way, heavy on bone broth, liver, etc. Celiacs feel better within weeks if not days. If you are still fatigued on a very strict Paleo, you need to explore your health issues further.
Although, in my experience, a very very strict Paleo is the answer to everything. Well, almost everything
I wish I were a doctor so I could help you! On second thought, no, I don't. I hate doctors. I was misdiagnosed FIVE TIMES!!! And took the wrong medication for six months.
Since your blood glucose is so high, I would get checked out for diabetes just in case. It does not hurt to rule it out.
Three basic things I have learned on my medical journey: 1. extra testing never hurts. Get tested for just about everything, you will be unpleasantly surprised. 2. Doctors know very little and don't see the whole picture. They treat person as a bunch of parts put together. WRONG!!! 3. Strict autoimmune Paleo is your friend.
When you mention baked goods on Paleo, I was like... WHAT??? Try autoimmune Paleo - it sounds fancy, but it is actually simple. I can tell you want works for me:
meat / fish / poultry + vegetables. NOTHING ELSE. NO EGGS, NO NUTS, NO DAIRY.
I don't tolerate coconut or olive oil and... I am doing just fine without them. Once in a while, when I need a treat, I eat berries, but very little. They keep me regular.
Try it. I know, it sounds restrictive, but it might work, who knows. For bloating you can go FODMAPS, etc.
For SIBO testing, ask your M.D. Don't take just the hydrogen one, take the methane-hydrogen with lactulose: http://www.siboinfo.com/testing1.html
As for gluten intolerance, genetic testing is the best. Sorry I cannot provide the link, I lost it, but you can get genetically tested for gluten. My doctor gave me some test that had nothing to do with gluten, I forgot what it was though. I came out as gluten tolerant, although I was practically dying every time I had any gluten. He missed my SIBO though and that caused my gluten intolerance. Five months after the treatment I can eat pretty much everything (except that my insulin response to carbs is horrible, so I have keep my carbs low. But if I accidentally gluten myself, nothing bad happens.)
Also, if you suspect that you are gluten intolerant - just drop all gluten PLUS all gluten cross-reactive foods, including coffee, corn, etc. Autoimmune Paleo works well.
If you have SIBO but don't want to be treated, then you need to explore FODMAPS. That will make your diet even stricter.
ONCE AGAIN, I suspect there is something with your high blood glucose levels. This cannot be normal, I am sure. Seek and you shall find. I am sure you will find something if you keep digging. Self-cure is not that hard if you go for the root cause of it all.
on June 03, 2014
at 09:46 PM
I think medical definition of normal thyroid numbers are quite unreliable.
30 years ago normal for TSH was 10 and now it has been lowered to 3.
There are scientists who think it should be below 0.4. Diagnostic ranges
are mostly based on data from people with health issues, not healthy people.
You need to measure Ferritin level and Transferrin saturation index to
know your total iron storage. Serum iron level is not a reliable indicator of
iron storage. Excess iron can increase oxidative damage.
on June 03, 2014
at 06:12 PM
While I do like Naturopaths, I am currently seeing a MD. I mentioned naturopaths because my MD is part of a large practice that also has NDs. I have seen an Endo in the past, though not in the last 2 years. Previously the Endo chalked my sugar level issue up to part of my PCOS and wanted me to take birth control to "fix" my cycles. I declined, and it turns out going Paleo has given me normal cycles for the first time in my life.
Epstein bar test not needed, I know it would be positive. I had a horrible case of mono when I was 18, so there's that. A blood candida test..I hadn't thought of that yet. All 4 of my blood thyroid tests came back perfectly normal.
Where would I do a breath test for SIBO?I also can't handle any "paleo" baked goods, despite using honey, or coconut sugar, or no sweetner at all. I thought this was from a coconut intolerance, but maybe it's SIBO? And what are the tests that don't involve ingesting gluten? All the options that have been presented to me involve biopsies or blood tests that involve ingestion to produce antibodies. Right now we are going off of my nutrition deficiencies, history of mouth ulcers and rashes, and the fact that my daughters both show strong signs of celiac.
My doc doesn't seem terribly worried about my glucose levels, even though they are terribly high for me. Four years ago my fasting sugar was consistently 65-70, borderline hypo. My reproductive Endo at the tjme found that very strange, since PCOS usually equals high fasting glucose. My current doctor thinks my high glucose is due to high cortisol. The blood cortisol test I did was only a morning test and it was also very high, but not high enough to indicate an adrenal tumor, which was the concern.
I have been around the doctor block. Will an endo be able to help even though my thyroid is normal? I'm getting extremely discouraged. Thank you so much for your advice. This is the most information I have been able to find.
on June 03, 2014
at 03:02 PM
The gluten sensitivity test require you to eat gluten for the 2 weeks leading up to the test. I currently can not do this because my daughter is breastfeeding and vomits for 24 hours if I eat even a single bite of gluten.
I do not have SIBO, my stool test came back as low on good bacteria and negative for bad bacteria growth.
The cortisol test was a saliva test. Since my levels were so high I did have a blood test done also, to check for signs of a tumor. (It was negative.) Doctor does not think a urine test is needed since the saliva test is more accurate.
I have not had a lab test done for glucose levels, but I have a blood glucose monitor at home and check it every day. My next round of lab work will include a fasting glucose draw. High cortisol can cause elevated blood glucose (glucogenesis), so my doc is not terribly concerned yet.
on June 03, 2014
at 06:51 AM
Oh and BTW, with regard to the gluten testing, check out enterolab.com they have a gene swab test that is super easy esp for kids, I recommend it to patients all the time. Also, there is a video on Amazon Unlocking the Mystery of Wheat and Gluten Intolerance
Dr. Thomas O'Bryan
that cites the dangers of being gluten sensitive and eating it anyway, also detailing the predominantly chronic neurological consequences vs. gastric (majority of people with the sensitivity genes "don't feel sick" and will suffer from ataxia etc. in their 50's) SCARY STUFF! Most people think they will have classic GI distress if they are intolerant. Super not true! Both of my parents are suffering with severe autoimmune disorders in their 60's-70's and never knew they were gluten sensitive until recently. My brother and I are both on GF diets. The scariest thing the video brought to my attention were studies showing decreased blood flow to parts of the brain showing up as "white spots" upon scan, in the brains of kids, that then were restored to normal after a GF diet was given. My best recommendation is to test your kids genetically and don't wait for all the "measurable and testable" responses that a body will develop in response to prolonged exposure! Give them the chance you and i didn't have and put them on a Paleo, or at least GF diet! How barbaric that standard for diagnosing celiac was (and still is with some doctors) positive tissue samples from a destroys bowel! A footnote on that approach is that simply genetic testing and then eating according to YOUR GENETICS (the Paleo mantra yes?) is not only by far less costly to your health, but is far less expensive monetarily than testing for every subsequent immune response, and resulting allergy, or disease. You can spend years and thousands of dollars doing this even without any effective treatment! Unfortunately for you and I due to decades of exposure, there is damage to the point of severe hormone and metabolic imbalance, so testing and treatment are essential. Happily if you get great guidance and are persistent, healing is possible!! Do investigate Dr. Kalish! I have found his treatment to be invaluable and I am GRATEFUL beyond words.
Another BTW: as I discovered, most gluten sensitive people should not eat ANY grain (no argument from you Paleos!) because it is the PROTIEN in the grain (called prolamines) that we are allergic to! Gluten is only one TYPE of prolamine.
Hope all this helps!
Best of health to you and your family!
on June 03, 2014
at 05:57 AM
Wow! I really feel for you! I would suggest reading Dr. Kalish's book ( on amazon ). I have 2 health degrees, have lived a clean life, gotten consistent excellent chiropractic care, no prescription drugs, been GF for a few years and Paleo for almost one year, made major lifestyle changes for last two years (lowered stress major decrease in workload) good sleep, etc. AND I WAS STILL EXHAUSTED WITH MIGRAINES ALL THE TIME! Once I went on Dr. Kalish's protocols after being tested, it's like the switch flipped and I am getting my energy and LIFE back! Try it and see! Good luck! Hang in there, and NEVER give up!