extremely low cortisol levels

[mamawolf01]

I am new to this site and would like recommendations on what I should do next concerning salivary hormone test result. I am concerned about my cortisol levels. I am trying to decide what type dr I need to see or if I need to go any further. I have seen gyno who prescribed current hrt and additional vitamin suppliments. My levels are listed below:

Cortisol Morning 0.4
noon 1.5
evening <0.3
night <0.3

Along with the following hormone levels, which were also extremely low:

Estradol <1.0
Progesterone <10.0
Testosterone <6.0
DHEA <10.0

I am now taking bio identical horomones containing estrogen/progesterone/testosterone. I am having symptoms of adrenal insuffiecency, actually most all but weight loss. I was at 119 prior to June and am now at 144.

Please let me know any recommendations concerning if I should see a dr other than my gyno.

Mamawolf01

[John Kenyon, CNA]

Hello --

I'm rather surprised that your doctor has instituted this replacement therapy based on salivary hormone testing. If your cortisone levels truly are as low as the salivary test indicates, you really need to have a cortisol stimulation test done to determine if you truly do have extremely low cortisol and to determine where, exactly, the problem really lies (pituitary, adrenal, etc.). The test, a blood test, measures the pituitary's response to stimulation by ACTH. An endocrinologist should administer this test ideally, or at the least an internist. While gynecologists do see a good deal of this, they are not endocrinologists, and other than dealing with the usual spectrum of female hormone imbalances, are not generally anywhere conversant enough in the subject to make this sort of determination.

There are enough possibilities that you really do need an endo workup to determine just what's really going on and to see if you're on the appropriate replacement therapy (it would seem you're not).

I hope this is helpful to you. Good luck with this and please do follow up with us here as needed.