AM cortisol test will not be helpful if it is a blood test. Blood cortisol is bound and not the free portion available to your tissues. Think Total Testosterone and Free Testosterone. A normal or high-normal test. level is meaningless without knowing your Free Testosterone, and everyone knows it is the Free Test. that is what actually is available to your body for use.
-Do a 24 Hour Saliva Cortisol test. Amazon, Life Extension or your PCP.
How about taking adrenal cortex? For example Thorneās ACEā¦ Does that also suppress the adrenal glands?
I seem to have no benefit from TRT due to low cortisol (all four times). I also canāt treat my thyroid before fixing my cortisolā¦ I did a leaky gut test and waiting the result currently.
@TRT_Phoenix
Can you name some of them? Also pls see my question aboveā¦
I donāt recommend Adrenal Cortex either. It does not matter that the Thorne brand has the adrenaline component removed if that is what you read. Adding Hydrocortisone or adrenal extracts does not help for those with a problem that is causing low cortisol. You would just be adding a stressor to your body when your body is already taxed because of an underlying cause.
For those with low cortisol, the root cause MUST be fixed.
Excellent on the Leaky gut test. Work with a Naturopath and get the Genova Comprehensive Diagnostic Stool Analysis test done to check your microbiome. If you have taken antibiotics in the past, you will need Fecal Microbiota Transplants to fix your gut-brain axis to fix the low cortisol. Research what Iām telling you. Stay away from TRT, drugs, etc. Hormones only make things worse for you with low cortisol levels as exogenous Testosterone suppresses Glucorticoid (Cortisol) output. Thyroid will not work either and only make your inflammation worse within your body.
Panax Ginseng is one, it stimulates cortisol production. There are several herbs that help your body function better. NONE will FIX you unless you remove the problem causing the low cortisol. Where are you located? I know a fantastic doctor that saved my life with herbs because of low cortisol and the non-function of my body brought on by TRT/thyroid use. Added strain to my body, (As you now see is happening to you).
Thanks for the detailed reply!
I do know TRT does suppress cortisol but not sure to what degree it doesā¦ Is quitting TRT really necessary? I mean isnāt it possible to find and treat my root cause while on TRT?
I did but maybe 2-3 times in my entire life. Is that enough to trigger it?
How do i know/test if iāve inflammation in my body other than CRP which is always below 1.0 for me? Iāve heard high ferritin is also a marker for inflammation but thatās not the case for me either.
I live in Istanbul and while i know we have microbiome tests available at pretty much every lab i donāt know about the CDSAā¦ Is that a must? Or is regular microbiome and leaky gut test enough?
@TRT_Phoenix What was your root cause for low cortisol? How did that doctor fix it? What usually is the root cause other than pituitary or addisonās for low cortisol? Where should i be searching to find the root cause?
Canāt you fix it with letās say glutamine , broth and other leaky gut āhealersā along with avoiding what causes it in the first place? I donāt think we have that transplant available here anywayā¦
Yes, hormones (testosterone/thyroid, etc) will only hurt you right now. TRT will only make things worse until your low cortisol problem is fixed. It has ZERO benefit, so what is the point in taking it just suffer more? Also, exogenous testosterone or any steroid for that matter suppresses the immune system. This makes bacteria/fungi overgrow even more, making your intestinal dysbiosis even worse.
Yes. A single course of antibiotics is enough to trigger it.
CRP lab marker will not reflect the dysbiosis.
Yes, you need to see your bacterial diversity with a comprehensive stool analysis. There are others besides Genova that offer it. A leaky gut test does not tell you your bacteria strains, so you still need to test for the bacteria with a comprehensive stool test.
The root cause is likely your microbiome. This is why it is vital you get your microbiome (bacteria in large intestine) tested to confirm.
You cannot fix intestinal dysbiosis once it has become bad enough that your cortisol is very low.
Glutamine and broth will not fix it. You have bacteria constantly releasing toxins/LPS damaging your intestines. They must be removed and replaced with good bacteria. Proiotics will not work as they are transient and will NOT colonize your intestines which is what you need to happen. FMTās WILL colonize your intestines as they will be human strains that do colonize and reside there. The only way is to reset it by taking antibiotics and following it with Fecal Microbiota Transplants. You would do them with enemas in your house using stool from a healthy donor.
@kemosi hereās an instructional video on how it all works
I, too, enjoy playing with other peopleās shit.
Is this really a real thing?
Its early in the moring and i almost fell of my chair reading this one 
LOL
Yes, seems to be effective in treating many gastrointestinal issues caused by microbial dysbiosis. Many clinical studies are ongoing in disease like Crohn disease, inflammatory bowel disease, irritable bowel disease.
A Prof of mine teaching clinical nutrition used to say that the best thing to treat any bowel disease is poop of a breast-fed infant.
Southpark is way ahead of medicine.
That is wild, but interesting nonetheless.
when I have my consultation with my provider, Iām going to ask about adrenal and cortisol related items that have been mentioned in this topic. Do traditional hormone replacement providers deal with these things as well? Or is another specialist typically brought in for these issues, if they are in fact the issue?
Also, i Donāt believe itās been mentioned on this thread. What contributes to adrenal fatigue and/or low cortisol?
It has been mentioned. It depends on the ROOT cause that has taxed the body into being unable to produce normal cortisol levels. Stress, trauma, injury, virus/bacteria/fungal overgrowth, etc. The truth is that most people have taken ANTIBIOTICS in their lifetime and this IS the ROOT cause behind the low cortisol levels. I donāt like fecal transplants any more than the next person. But, getting tested and treated for the REAL problem is the answer. Science has come a long way in recent years in regard to the human microbiome and its dependence on every facet of our health.
A patient with ulcerative colitis (bacteria dysbiosis) wrote a book called, āThe Power of Poopā. and he explanins how Fecal transplants saved his intestines from being surgically removed and he lives a normal life now.
Labs are below. As you can see, big improvement in labs, but I feel no change. Still low libido, bad sleep, and moativation/mood/energy is bad. Body composition not improved, but the general timeline would suggest that would come later. Looking for answers on what the reason for this is?
Current protocol is .40ml Testosterone Cyp 200mg/ml. /40IU HCG 2x per week + 2grains Armour/30mcg Cytomel daily.
My provider suggested Testosterone cream applied daily on the scrotum would be the thing to try. Said this would improve libido, but the other benefits would be the same as injections. I would prefer to stick to injections.
One provider suggested that my lab numbers are inflated given my last testosterone injection was 48 hours prior to lab work, and I took my thyroid medication 2 hours prior to labs. Holding off on these medications was not mentioned by my current provider.
Either way, it looks like my lab numbers are heading the right direction. However, why am I not seeing any benefit from this? Is there cases where numbers need to remain is a good range and the TRT benefit timeline begins to occur, just later? If I continue the same protocol, am I going to see benefits eventually, or if Iāve seen no benefit yet, does something need to change?
I appreciate any feedback and experiences.
Labs from 2/17/20
Total Test - > 1500 (264-916 ng/dL)
Free Test - 41.9 (8.7-25.1pg/mL)
Estadiol sensitive 42.8 (8.0 - 35.0)
SHBG 57.9 (16.5 - 55.9)
Free T3 - 4.7 (2.2-4.4)
DHEA 150 (31 - 701)
Labs from 11/12/19
Total Test - 623.6 (264-916 ng/dL)
Free Test - 7.5 (8.7-25.1pg/mL)
Estadiol sensitive 7.9(8.0 - 35.0)
SHBG 91.1 (16.5 - 55.9)
Free T3 - 2.4 (2.2-4.4)
When did you get your labs done in relation to your shots?
The HCG is likely whatās showing you having higher Testosterone giving you a false impression that you are where you should be. Many folks feel much better without HCG (T only). Sounds like you may be one of them. Itās best to start with Testosterone only and then once you get to a place that you feel optimal you can add in HCG if you want. Itās almost impossible to dial in both at the same time.
Your Testosterone dosage is very low. Most of the guys with higher SHBG require higher dosages (150-200mg). At your current 80mg I canāt imagine you ever feeling ideal. If you cut out the HCG and doubled your Testosterone Iād bet money it would be a night and day difference from how you feel currently.
My labs were done 48 hours after my last injections
Remaining fertile is very important to me, which is why the doctor has me on HCG. Of two providers I asked about if HCG was casuing any issues with me not feeling better, both said certainly no, and they always do TRT+HCG for anyone wanting to remain fertile, then simply remove TRT/add clomid when trying to conceive. Suggested HCG now is important. The difference one provider told me in relation to the other was injection frequency. One said 2x per week, one said daily smaller dosage.
At this point Iām not sure what is going on. One test I have not done is a saliva cortisol test. I have almost all of the symptoms of high cortisol. If I do have high cortisol, would I still not be seeing a benefit from TRT? My thoughts are getting this test, and if high cortisol is confirmed, backing off on training and remove stressors the best I can for a period of time. Unsure how long that would be needed to fix the problem, if that is infact the problem.
Your docs are speaking in absolutes like everyone will not show negative symptoms on HCG, if you search this forum you will find that not everyone responds positively to HCG. Some are choosing fertility over wellbeing.
Fertility can be dealt with later, but if not actively trying to have children, you can remove it from your protocol for now and see if it makes a difference.
Being fertile is important to me too but so is living my best life. HCG is likely causing your issues.
The 4-point saliva test is worthless.
Are you saying youāre injecting T 2x a week or once? Your post isnāt clear.
How many milligrams are you taking per week? Thatās the way we typically look at it and try to standardize all the different possible injection frequency combinations