Adrenal fatigue? Please Help!

So i've been on a 3 year journey of struggling and numerous doctors appointments. I believe I have adrenal fatigue. I have seen several MD's and have an appointment with an Endo but it is not for a while. I wanted to post my backround, labs, and symptoms and see if someone can give me some feedback. This has been a real struggle for me these past few years and its so hard to find a doctor that will take you seriously unless you have Addisons or Cushings.

[B][U]Labs:[/U][/B] All labs have been done by Quest Diag.

I did the saliva cortisol test based on my personal sleep schedule.

Morning: 0.20
Noon: 0.03
Evening 0.04
Night: 0.03

Range:
8am-10am: 0.04 - 0.56
4-6pm: < or = 0.15
10-11pm: < or = 0.19

Based on Quest's range I am "normal". However other sources show this:

Morning: 0.25 - 0.60 mcg/dL (30 mins after awakening)
Noon: 0.08 -0.20 mcg/dL (right before lunch)
Evening: 0.04 - 0.13 mcg/dL (right before dinner)
Night: 0.02 - 0.07 mcg/dL (right before bedtime)

This makes more sense because there is no lower limit for the later parts of the day. So I could be at 0 and that be "normal". Also my cortisol goes from .20 and then drops way down to .03 and levels out for the day / night. My noon level shouldn't be the same as when I goto bed. So using the ranges above, I am low across the board. But at least my morning cortisol isn't extremely low.

Here is what is confusing:

24hr Urine Free Cortisol: 59.0 Range 2.0-50 mcg/24hr HIGH
Creatinine Urine: 2.75 Range 0.63-2.5 g/24hr HIGH

The urine contradicts the saliva and my symptoms. Is it possible for me to have weight loss and hypoglycemia if I have HIGH cortisol? Also, my creatineine has been tested in blood numerous times and never been high. Could it be a lab error? I did have to use a second pee jug instead of the normal single jug for the test.

Aldosterone: 6 Range: < or = 28 ng/dL

Once again no lower limit but from my research 6 is a fairly low number.

Cortisol, serum: 17.3 Range: 4.0-22.0

TSH: 1.11 Range: 0.40-4.50 mIU/L
T4, Free: 1.2 Range: 0.8-1.8 ng/dL
T3, Free: 2.9 Range: 2.3-4.4 pg/mL

Dihydrotestosterone: 100 Range: 16-79ng/dL HIGH
DHT Free: 8.37 Range: 1-6.20 pg/mL HIGH
DHEA-S: 559 Range: 110-510 mcg/dL HIGH
Progesterone: 1.7 Range:<1.4 ng/mL HIGH

Testosterone, Total 687 Range: 241-827 ng/dL
Testosterone, Free 109.2 Range 46-224 pg/mL
Androstenedione: 136 Range: 50-220 ng/dL
Estrone: 60 Range: < or = 68 pg/mL
Estradiol: 30 Range: , or = 39 pg/mL
FSH: 4.3 Range: 1.6 - 8 mIU/mL
LH: 5.2 Range: 1.5 - 9.3 mIU/mL

Cholesterol, Total: 119 Range: 125-200 mg/dL LOW
HDL: 41 Range: > or = 40mg/dL
Triglycerides: 54 Range: <150mg/dL
LDL: 67 Range: <130 mg/dL

Vitamin D: Low
B12: Was low now normal with supplements
Ferritin: Low end of range 47 Range: 20 - 345
[B][U]Symptoms:[/U][/B]

[U]Hypoglycemia[/U]- This is probably my worst symptom. My fasting glucose is always normal in my labs but it seems to be more of a reactive hypoglycemia for me. I have a glucometer so I check my Sugar often. It dips into the low 60's and I don't let it go below that because I just feel too crappy. It never goes very high even right after eating. Maybe the highest is has gone is 110. I ate 5 smaller meals a day. I eat low glycemic. I do all the things you are suppose to do as far as diet is concerned and it is still an issue. Up until a few years ago I could eat whatever I wanted with zero blood Sugar issues.

Also any kind of exercise makes the hypoglycemia worse. If I go for a light paddle on the kayak I can feel my blood Sugar dropping. I try to eat before and after but it doesn't help so much. Once again this has never been an issue for me.

[U]Sleep Issues[/U] - I don't have much problem falling asleep but staying asleep is a problem. I wake up numerous times throughout the night and wake up feeling not very refreshed. Many times I can tell im being woken up by the low blood sugar so I have a low GI snack and instantly fall back asleep. The food is like a sleeping pill for me. I have had a sleep study done and they found now sleep apnea just a "disturbed sleep pattern".

[U]Fatigue[/U] - When this all started I was DEAD tired all the time. Since removing stressors, eating better, taking vitamins, ect its not so bad. I still have crap for energy though. My 65 year old father has more energy than me and im 25. I assume its from getting a poor nights sleep. Also if my cortisol is low then I assume that would make me tired as well. It is not a struggle for me to get out of bed though. I wake up still tired but I can get up. Im assuming because my morning cortisol is not super low.

[U]PVS's aka Heart Palpitations[/U] - Since this all started I have had daily PVCs or heart palpitations. I have done a 24hr heart monitor and as I said they showed up as PVC's. I believe they are caused by the lack of sleep and fatigue. This can cause PVCs. The doc was not concerned about them but they still aren't comfortable.

[U]Low Libido [/U] - This one is pretty self explanatory. My libido is pretty low for a 25 year old. My testosterone levels are normal so I'm not sure if low cortisol can have an affect on this?

[U]Weight Loss[/U] - I am not losing weight currently but I am down about 5-10lbs from what I have always been. This was one of the first things I started getting comments from people about. They would say how skinny I looked. My diet had not changed what so ever. I ate as much as I can without making myself sick and I can't gain weight. Like I said, its not dropping which im happy about but I don't look a healthy weight.

[U]Excessive Thirst[/U] - I drink a ridiculous amount of water each day and in turn urinate frequently. Sometimes I feel like I just cannot quench my thirst. I am assuming this has something to do with my low aldosterone? I also don't seem to tolerate the heat well.

[U]Muscle Cramps and Injury[/U] - Any time I try to do light physical activity I end up getting muscle cramps and or injuring myself. One time I injured a muscle in my ankle simply from jumping up and down. I don't know if aldosterone can cause these kinds of issues. I know electrolyte imbalances can as well as dehydration and aldosterone is tied into that.

[U][B]Background:[/B][/U] I will try to be brief. I have always been very healthy and very active and in great shape. My only issue was some G1 Problems that weren't ever really diagnosed but eventually cleared up on their own. 3 years ago I found out I had mono and was very fatigued. I should have rested but couldn't. I pushed my body very hard and was under tremendous amounts of stress. The fatigue continued and I started to eventually get low blood sugar symptoms. I was eating lots of simple carbs and sugars. A traumatic family event changed it all. My sleep went down the drain and hasn't been the same since. The low blood sugar and fatigue got worse. Heart palpitations began. Anxiety was horrible. Libido was in the drain and my muscles were sore everyday for no reason. I was having sensitivity to the light and my hands always were shaky. My heart rate would elevate easy and I had shortness of breath.

It was all written off as stress. Well I graduated college, finished my internship, and all other stresses went away. I fixed my diet and began to take care of myself. Several symptoms went away but my body stayed in this "stress state". It is as if a switch had gotten stuck in the "ON" position. I have seen many doctors and the most recent conclusion is that I probably have adrenal fatigue. I have the causes, symptoms, and what seems to be the lab tests. I am still confused on some things though.

Why do my saliva and urine cortisol contradict one another?
Why is progesterone high but cortisol and aldosterone low?
Why is DHT high but test normal?
If adrenals are fatigued why is DHEA high?

Someone please give me some insight. As I stated above, I have an appt with an endo but it wont be for some time. I appreciate any help in advance. Tweet