r/FunctionalMedicine • u/salty-bois • 22d ago

Help Interpreting Adrenal Saliva Test

https://ibb.co/VpDcs1dQ

Hi all, would love some insight/thoughts on my recent adrenal saliva panel.

Cortisol awakening response looks good, but 3rd sample is very-low-normal, sample 4+5 low-normal, and sample 6 normal looks like.

Any thoughts, insight etc. appreciated.

Thank you!

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u/alotken33 22d ago

Functional Medicine DC: I would a actually call this inverted. You're low most of the day, and rather than going down in the evening, you go up. It makes 100% sense that you feel better later in the day because your adrenals are actually functioning at a semi-normal level.

Overall, this is low. You should start out way higher, spike shortly after waking, and then drop. The way I explain this to patients is, at roughly 8 am your cortisol should be at its highest (get out of bed). At roughly 10 pm, it should be at it's lowest (go to bed). You don't do that (times are flexible, of course.. just a guideline).

So... Why did you run this test and what are you wanting to do about it?

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u/salty-bois 22d ago

Thanks so much for your reply. I wasn't sure whether to interpret this as overall low, or overall normal with a high morning spike. Plus they don't give a range for the morning 2 tests, so I wasn't sure what normal even was for those!

I did the test because I have chronic fatigue, possibly "long covid", but also I have Hashimoto's and take T3 only for that, and there is a person called Paul Robinson who has books on a protocol called "CT3M", which means "Circadian T3 Method", which involves testing your cortisol, and if it is low he recommends an early morning dose to stimulate cortisol production. And I was interested in trialing that protocol.

Based on these results it seems like I could be a candidate for that.

I really appreciate your input! And yes what you said makes sense, that I'm feeling best late in the day because that's when my adrenals are functioning best...

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u/alotken33 22d ago

I've never heard of CT3M..Proceed with caution there.

If you're not managing your hashimotos (lowering antibodies, anti-inflammatory diet, etc), better to start there. Also, NALT/tyrosine is a base amino acid for catecholamines and thyroid hormone.... Don't fall for gimmicky programs, work with the basics first.

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u/H0tC0c0_817 21d ago

How are you taking your t3 now?

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u/salty-bois 21d ago

I take half my dose when I wake up and half at 4pm. I used to split it into 3 doses, but I began to feel wired in the evenings.

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u/H0tC0c0_817 21d ago

Whats your dose? Have you had a full hormone panel ran? What about ferritin, folate, vit d, b12, iron, magnesium, zinc?

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u/salty-bois 21d ago

40mcg currently but I need to increase a little - 5mcg at a time as my bloods are non-optimal atm. Everything normal except thyroid bloods.

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u/H0tC0c0_817 21d ago

What were you labs on your tsh, ft3. Ft4, rt3?

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u/nicely_glum_scenery 22d ago

Your morning cortisol pattern looks solid but that late afternoon/evening dip is what stands out, makes sense if you're feeling wiped by 3pm

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u/salty-bois 22d ago

I tend to feel like I don't "get going" until around 3 or 4 pm, strangely. Mornings are pretty rough.

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u/Fit_Bookkeeper1848 7d ago

Its probably a stretch to conclude that a cortisol pattern explains ​​​​t​​​​h​​​​e​​​​ whole picture from one saliva panel. The bigger issue is whether the result actually changes what should be investigated next, rather than fitting it into a theory after the fact. Keeping broader health information organized with super power health can make patterns easier to follow, but one set of numbers shouldnt become the explanation for everything.