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Completely exhausted. Noticed low salivary cortisol. Have non-restorative sleep. Serum testosterone-9.8 and Estradiol-1.9. Guide?

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General & Family Physician
Practicing since : 2007
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I've been chronically exhausted for 10 years, can't work, can't exercise, it's a bad scene. I was a marathon runner and all around highly physically active person with a great career. This began in my early 40s, now I'm my early 50s. Last year I did a 24 hr salivary cortisol and it was low out of range am and noon, barely in range evening, and normal at night. I have non-restorative sleep also, plus a laundry list of other symptoms I won't get into now. I just did another 24 hr saliva test and it was XXXXXXX high in the am; 11 (3.0 - 11 ng/mL), and low out of range for the rest of the day and evening. DHEAS was measured (saliva) for the first time and it is high 11 (3.0 - 11 ng/mL). Testosterone (saliva) low normal 50 (23 - 120 pg/mL), and recent serum testosterone 9.8 (4.5-26.6). Estradiol is within range 1.9 (0.80 - 6.6). I've had many thyroid tests over the year and always told it's normal, last test was TSH 1.2 (.35 - 4.94, Free T3 5.3 (2/6 - 5.7), Free T4 14 (9 - 19). Is there an answer in here somewhere?
Posted Fri, 16 Aug 2013 in General Health
Answered by Dr. Lohit K 1 hour later
Hi thanks for using XXXXXXX

1. Cortisol is a hormone which is released into blood depending on stress and blood glucose levels. its concentration will be varying in blood depending on your stress level.

2. After looking at your reports, your hormone levels are in normal range, need not to worry for it. Even other hormone levels in your blood test is also with in normal range.
Need not to worry for its position in the given range as these values will be always fluctuating with in the given range to maintain homeostasis. Usually cortisol level will be maximum in AM.

3. Your weakness could be something else. In non marathon runners the following should be considered like overwork, poor sleep, worry, boredom, or lack of exercise. or it could be due to electrolyte imbalance like low levels of potassium levels in blood.

In addition to the above fatigue myopathy, post over training syndrome, depression should be considered in athlete and sport personnel. There is an entity called Chronic Fatigue syndrome. A muscle biopsy will be considered by some clinicians. It is possible to evaluate these with the help of Rheumatologist, Sports Physician and Psychologist.

If you have access to them please ask them about these.

Feel free to ask me if you have any further queries or doubts and I shall be glad to help you out. Please accept my answer in case you do not have further queries.
Wish you good health. Take care.

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