T Nation

Cortisol,Testosterone and Adrenal Fatigue


#1

So as i have made the journey in the past few months regarding my well being and problems related to low T and other markers for hormonal health, i find very unambiguous and confusing information about Cortisol and adrenal fatigue.

I have read high Cortisol is bad, i have read low Cortisol is bad, i have heard middle range cortisol is bad. It’s difficult to soak in information about the same.

My cortisol is 18.28 (6.2-19.4) at 9 am(Straight after getting up) in only one measurement that i have tested. Now, what i understand is this is good as the cortisol peaks in the morning and a high morning level indicates good adrenal function.

I see information on the WWW of how high cortisol is a testosterone killer and a recipe for hormonal wreck and i have read the same for low Cortisol. The information about Adrenal fatigue is also confusing and difficult to take in my stride.

My DHEA-S, Progesterone are also strong (Mid-high Normal). Only things that were obviously wrong with my multiple blood work was low FT and highish E2. Adrenal fatigue evaluation is like a nightmare, i hear normal is not normal, high is not normal, low is not normal. There is no base for an accurate evaluation other than symptoms which correlate with T and E2 issues that i am facing.

Can someone elaborate how Cortisol works and what is bad or good?


#2

In order to get the full picture of your cortisol, you need to test at multiple times during the day. You are correct that high cortisol in the AM is good as cortisol peaks in the morning.

You need to elaborate on your symptoms and add your stats like age, weight, etc. along with lab work with ranges to really get help here.


#3

Thanks for your reply, i am not necessarily applying this to myself even though i have been involved. I have found it interesting to read about these issues since i had been reading all about sex hormones since being diagnosed. I am 23.

I am getting a 4pm cortisol done as well tomorrow to get a look. I have all the symptoms of low T. I was also estrogen dominant. I am 1 and a half week into TRT. I have primary/mixed hypogonadism.

This thread is just about understanding how Cortisol works and what’s optimal and things that help in determining adrenal function/fatigue since there’s contradicting information on what an optimal level of cortisol among other adrenal markers should be.


#4

Ok, got it. Seems like adrenal fatigue is even less understood than thyroid problems and low T. Imagine how little is understood about how these things might be related!

I had a very traumatic accident in my late 20’s. I spent 6 months in an in-patient rehab facility and had two very significant back surgeries. I had a partial spinal cord injury and still have leg weakness 25 years later. There is no doubt in my mind that this event stressed my adrenals. I’ve also had HTN for a longtime and have avoided salt for many years, so I’m pretty sure my thyroid is off a little. Did these things lead to the low T, or are they coincidental?


#5

Well it’s difficult to know with your case, in theory there’s thousand’s of reasons why one can have developed hypogonadism but unfortunately life is as it is, we cannot factor in everything.

I have been completely healthy all my life, well clinically atleast! I have had 2-3 episodes of high stress situations, i have been prone to mild depression for a long time. What’s the cause and what’s the symptom is unknown. Best practice seems to be rule out something bigger than hypogonadism and treat what you have.

Since the symptoms of low T, hypothyroid, adrenal insufficiency are all so similar,you want to see what;s the problem. I also find the thyroid obsession to be a little unhealthy for people with low T with the anxiety and vulnerability it brings. My thyroid labs are good. Temps vary, but i don’t think it has as much to do with thyroid function as we think it does here. For example, when i am active and work, go to the gym and in general on the move, i see my temps are good, when i’m in bed all day which is more common in the past month or so i have a little lower reading, i have stopped recording as i don’t want to turn into a hypochondrial mess and obsessing about how my temps were on a particular date.

In sum, i have a pretty good understanding about T and other androgens and estrogens now after so much reading so i am prepared to tackle the issues when they arise. Same to a lesser extent with Thyroid, but adrenals i’m not so sure about. There’s confusing info out there, that’s what i’m trying to figure out a little.


#6

And honestly, all I care about is feeling better. I’ve been on TRT for 4 months. There was a brief period during that time when I felt great. I’m now fighting to get back to that spot. Hoping once I get my E2 down I’ll return to that good feeling.


#7

When did you first feel the effects of T taking place? I’m young but I barely remember how it feels to have a normal energy level and sex drive and not be an emotional wreck. I am with you on the feeling well, I don’t care about with either TRT something less involved


#8

I was given an Rx for 200mg T cyp/week, 1 mg anastrozole and 250 iu of hcg E3D. I thought the 200mg/week was too much so I adjusted the dose to 100mg/week. I reached out to my doc after about six weeks to let him know I wasn’t really feeling better. He was not happy that I wasn’t injecting 200mg. So he convinced me to try the 200 and almost immediately I felt great. More energy, libido like a teenager, raging morning wood. So I continued injecting 200mg in divided doses for the next couple of months. Slowly I began to lose the positive effects and decided to run some labs. No surprise, my TT and FT were through the roof and my E2 was 35. So I’ve decided to lower my T cyp injections to 120mg/week while keeping the Adex at 1mg/week. This should reduce my FT and get my E2 back to 22. That will hopefully be my protocol moving forward. I’m still using the hcg as well. I’m also slightly increasing my Adex temporarily to speed the drop in E2.


#9

I see very ranging time frame for people to start feeling the effects. I’m doing 100mg a week 50 subq 2 x week. Haven’t felt anything yet. Have my follow labs tomorrow morning. Hopefully I’ll start feeling a little better. It was a big decision to start TRT at my age.


#10

For sure, I’m 54 so it was a no brainer for me. I’m convinced I’ll get back to feeling good once I hit the E2 sweet spot. I just hope I can cruise after that. I’m not a detail oriented person, so constant dose adjustments will be a struggle for me.


#11

Yes, I don’t want to turn it into a science experiment. Hopefully I’ll find my zone soon.