I assume from your wording that you are referencing a morning salivary or serum cortisol test? Except for a few very specific purposes, salivary or serum cortisol testing is pretty worthless in making an initial determination if you have a total cortisol problem. You see, a salivary test (and serum test) basically just take a "snapshot" of what yoyur cortisol levels are right at that moment.
And since your cortisol levels vary significantly during the day (in a daily cycle pattern... but which is different not only from person to person to some extent, but even to some extent within the same person on different days... depending on things like how hard you worked out the day before, if youd had any even slight stress recently, etc., etc.)
What you need to have performed is a 24-hr UFC (Urinary Free Cortisol) test done. Basically you collect your urine over a 24 hour period in a special provided container and then turn it in for analyzation. It is a much, much more accurate test for this purpose than either of the other two.
Now if we can assume that this was a valid representation of how cortisol secretion was for you over a 24-hr time period, then you "could" be looking at a milder case of elevated cortisol, but not necessarily hypercortisolism. With hypercortisolism something has created a dysfunction with the HPA Axis and the adrenal glands aren't getting the right signal to fully close down or reduce cortisol secretion. Hypercortisolism is generally that when one's overall (24-hour) numbers are anywhere from 1.5 to 3 times the maximum of the test range... or higher.
Simple elevated cortisol (especially mildly elevated cortisol) can be from a number of reasons. Chronic overtraining for example. Or some chronic stress going on at work or on the homefront.
Mildly elevated cortisol levels will generally respond to not only any number of various "anti-stress programs" (or backing off on training if it's overtraining), but also will respond well to various OTC anti-cortisol supplements. Relora is one of the better known examples (though many don't know that the active ingredient in Relora is Magnolia Bark Extract). Some other good examples are Rhodiola Rosea (one of my favorite adaptogens), Holy Basil, Ashwaganda, and the amino acid combo of NAC and Glutamine. Some also say that Siberian Ginseng is one that can be added to that list. I know that Panax (Asian) Ginseng is a no-no as raised cortisol levels in a couple of tests that were done (which could be good for someone who was starting to get adrenal fatigue).
BTW, severe hypercortisolism can CAUSE hypogonadism but TRT will not cause elevated cortisol... in fact, I have read a number of items where it was shown that increased testosterone was actually quite positive in reducing MILDLY elevated cortisol.... so definitely wouldn't worry about TRT and cortisol from that angle.
Now if your sample of cortisol was actually one of your LOW samples, and your regular daily output was actually much higher than that, then there could be a hypercortisolism issue... and possibly a clue to what caused your hypogonadal state. But generally you would have a number of other symptoms that would also be a clue as to hypercortisolism (I only gave a partial listing on mine!).
Either way, since you have a clue that you "might" have some elevated cortisol to some degree, I think that a 24-hr UFC test would be in order.
Larry
Larry,.. Im not very familar with hypercortisolism. My morning cortisol readings have been consistently slightly above the normal range.... my most recent test was 639 nmol/l (range, 120-620.) Is this anything to be concerned about? I am on TRT.
thanks.[/QUOTE]
