Saliva cortisol test

A couple things: having shots of adrenaline in the morning is common for us so I wouldn't worry it's screwing anything up.
Second, take the samples at the designated times. If you're having a surge that's ok, it's good to get the reading on it. Those will show how your cortisol is fluctuating throughout the day

Hi, Lightlife,

I have had the same thoughts as you about this. An endocrinologist might look at your results only, but an LLMD will listen to your experience as well. If you are feeling these surges each day (as many of us do) then clearly they are happening, no testing needed, and can be addressed with adaptogens to even out production and other practices to break your body's rhythms. If you are thinking of addressing them in some more serious way, like through steroids or adrenal glandular supplements, then it does make sense to know how much cortisol your body is producing and when. You can feel a huge surge but still produce too little cortisol the rest of the day and have overall low levels, making the surges feel so dramatic. Or you could have high cortisol all day, which would require different treatment. Hope that makes sense.

Is this test just morning samples? Or various points throughout the day?

I don't know how long it takes exactly for cortisol to show up in saliva, but I think it's pretty fast, and likely would have dissipated in the three-hour time window you mention. I'd really recommend talking this over with whomever is ordering the test.

Low cortisol symptoms tend to involve fatigue, anxiety, insomnia, etc. Stuff most of us deal with. The odd thing about having a low cortisol baseline is that a small spurt of cortisol production is experienced as a jolt to the system, so what you feel as a spike might just be a little blip relative to a healthy person's production. Another thing to note is that, if you have HPA axis dysfunction (which not all doctors know how to assess or address), normal cortisol levels don't mean your body actually uses all the cortisol it makes for the things it's supposed to. Your hormone systems (thyroid, reproductive, adrenal) can borrow from one another to ensure basic survival functions, even when one system is underperforming, so ideally you would have all those levels tested, not just cortisol in isolation.

Dr. B has ordered cortisol testing for me, yes, in addition to other hormone tests. He ordered multiple four-point cortisol tests (four samples collected in one day) as well as thyroid labs and reproductive hormone tests collected over the course of a month. For me, it was key to test all of those things at once.

While I like knowing what's actually going on, inasmuch as tests represent that accurately, the testing didn't make much difference in my treatment plan. I had to try a few adaptogens before I found one that did not make me feel absolutely insane. Lots of trial and error, even if you know your test results, because everyone reacts to each adaptogen differently.

In terms of hormone stuff, it's also key to make sure you are getting all the nutrients that are precursors to hormones, like minerals and omega 3 fatty acids, and managing stress (which of course is easier said than done!).

Agreed, running wild - this is an issue for a lot of us, and quite often I feel physically anxious in a manner devoid of any psychological component. Those flares have tended to happen in the morning for me, sometimes waking me up, but usually forming patterns (like always at the same time on the clock) that I could interfere with to break the cycle. Sometimes, though, if something did take place in the morning that ordinarily would cause some psychological nervousness, like a doctor appointment or my dog waking me by barking, then during those times that my system has been primed to feel anxious, such stimuli would be more unmanageable. (Ugh, so miserable. Just remembering a visit to a doctor one morning that involved driving through a tunnel in rush hour traffic, and shaking terribly!)

I'd also like to know more about the interplay of the hormone systems and neurotransmitters. I suspect people don't have a solid understanding of how exactly they interact, but we know that they do (serotonin and estrogen, for example, have an obvious relationship). It makes sense, as you say, to ask whether we're dealing with a hormone issue or a neurotransmitter issue, or both.