StillAnotherGuest wrote:
riverdreamer wrote:In regards to the cortisol, the best is a 24 salivary panel. You collect at 5 different times during the day.
Virginia Hopkins has that stuff, but I can't vouch for any of those mail order outfits. I don't know if an accurate cortisol profile can be done with 5 tests (I think looking closely at the nighttime area there would be important. And can you simultaneously accurately measure sleep?)
Cortisol kit(s), an All-In-One, and all the rest of this stuff is going to be a ton of $$$, so
What are you looking for here? What are you going to do with the information?
SAG
I understand the reservations. The 24 hour salivary cortisol kit measures at midnight and again at 7 AM. There is a known expected curve, so if the cortisol is rising at 12 midnight, you could expect it to be off the rest of the night. But you won't be testing all night. Plus, I doubt they have expected ranges for the entire night. But you can see a pattern, and also what the total cortisol burden is.
One possible cause of the phase shift in cortisol is blood sugar issues. If blood sugar is bouncing between very high levels and very low levels, or just staying very low, you have jolts of cortisol. When the blood sugar levels go so low that the body feels threatened, the adrenals will release cortisol, which stimulates the pancreas to release glucagon.
Glucagon is an important hormone involved in carbohydrate metabolism. Produced by the pancreas, it is released when the glucose level in the blood is low (hypoglycemia), causing the liver to convert stored glycogen into glucose and release it into the bloodstream.
Wikipedia
So, first the blood sugar goes low, you get a jolt of cortisol (possibly causing panic symptoms, elevated heart rate, sweating, and arousal), and then you may be wide awake, wondering what happened, and why you are in a panic. This is most common in the early hours, between 2 and 5 in the morning. There may be repeating cycles, as the blood sugar rises, maybe too high, insulin comes on the job, but overshoots and brings it too low, and you are back to releasing cortisol. Diabetics call it the dawn effect. They will show very high morning blood sugar, when they otherwise believe their blood sugar is in control, because they can't maintain control during the night. Regulating blood sugar through diet, exercise, and medication, when necessary, will change that. This was one of my issues, though I am hypoglycemic, not diabetic. For months I had to eat protein before sleeping, and kept nuts and cheese by my bed to eat when I woke at night. Eventually my body was more in balance, and I could eat normally, but still have to be sure I don't go too long without food.
There are lots of other reasons for phase shifted cortisol. Inflammation, caused by infection or immune dysfunction, is another possibility. Cortisol can lower inflammation, so it starts as the body's attempt to help. However, if the inflammation goes on long term, everything becomes more unbalanced. They are finding more illnesses have inflammation as a component. Heart disease, high blood pressure, diabetes, and auto-immune disorders are just some of the illnesses shown to correlate with inflammation. Cortisol keeps rising in an attempt to bring the inflammation down. If pushed too hard, for too long, the adrenals may crash, and cortisol becomes chronically low..
Other possible issues could be total hormone imbalance, which might require supplementation and/or help with ridding the body of excessive hormone levels or partial metabolites. Sometimes a high cortisol level is due to another hormone being too low. DHEA and testosterone are likely candidates. Even women require small quantities of testosterone. Or maybe estrogen levels are too high. This is seen more and more with the large quantities of estrogen mimics in our water, air, and food. These chemicals are close enough to estrogen in chemistry, that they may block estrogen from binding to the receptors, leaving excess estrogen floating in the bloodstream, but not really doing the job estrogen is supposed to. Also, due to poor diets, some cannot rid the body of the estrogen once it has been used, and broken down into more toxic metabolites. Excess estrogen is a strong cause of body inflammation. Inflammation raise cortisol. As with all hormones, you have to have just enough. Too much is as bad as not enough.
There are lots of ways these imbalances can show up in people. It really requires an experienced doctor to help out with it. Unfortunately, endocrinologists, which is who you would expect to know, often do not have a clue. Many only focus on one aspect of hormone balance, like working with diabetics to balance insulin (another source of inflammation.) They do not always realize the impact it has on cortisol. So, just as with sleep apnea, you have to hunt down someone who knows what they are doing, and how to put it all together.
Didn't mean to preach! This is just an area dear to my heart. I am not a physician, but have a lot of general exposure to this info in my work. I have the broad picture, but not necessarily all the details. Enough, though, to bring it up as a possible cause for Bev's issues, or at least a contributor.