The normal values for urinary cortisol are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what’s normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.

Cortisol level in a 24-hour urine sample Adult
Normal: Less than 100 micrograms (mcg) or less than 276 nanomoles (nmol)

High values
* One cause of Cushing’s syndrome is Cushing’s disease, a condition caused by a noncancerous tumor of the pituitary gland (adenoma).
An adenoma causes the pituitary gland to make too much of the hormone adrenocorticotropic hormone (ACTH), which in turn causes the adrenal glands to make too much cortisol.
* ACTH can be made by other conditions, such as cancer of the lung. This high ACTH level causes the adrenal glands to make more cortisol.
* The adrenal gland can develop tumors (benign or cancerous) that make cortisol and cause Cushing’s syndrome.
* A high blood cortisol level can be caused by severe liver or kidney disease, depression, hyperthyroidism, or obesity.
* Conditions such as recent surgery, illness, injury, or whole body infection (sepsis) can cause high cortisol levels.

Reasons you may not be able to have the test or why the results may not be helpful
* Having physical or emotional stress.
* Being pregnant. This can cause urine cortisol levels to be high.
* Having low blood sugar (hypoglycemia).
* Eating, drinking, or exercising before the test.
* Taking medicines, such as estrogen, amphetamines, or corticosteroids.
* Not collecting exactly 24 hours of urine.

There have been spontaneous reports of adverse events occurring upon discontinuation of Sertraline hydrochloride and other SSRIs and SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.

Patients should be monitored for these symptoms when discontinuing treatment with Sertraline hydrochloride. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.

Chiropractic might be very helpful too, but you need to be very careful about who you see — some use unproven energy medicine techniques that may be too subtle and others may want to over-treat you to make more money. Chiropractors that do not teach you exercises and stretches and just want you to lie on the table and receive passive care are also bad news.

If you have run out of medical benefits for the accidents, I suggest finding a warm (NOT hot/Bikram) yoga class. Ice your back in the traditionally sore places for 20 minutes afterwords every time to reduce inflammation! Gentle warm yoga is probably a good idea even if you do have medical benefits left.

For your adrenals, I recommend good quality SLEEP: 7.5-9 hours per night. Get up before 9AM every day. Be in bed by midnight (10-11PM is better). Avoid stimulation for 1-2 hours before bed. Reading or soft music is OK, but nothing electronic (TV/Internet/games). Make sure your room is very dark and quiet (use earplugs if there is noise). Avoid all stimulants like coffee/tea/colas after noon.

Also you can try a good herbal adrenal support supplement. Something with some or all of the following: Ashwaganda, Holy Basil, Rhodiola, & Shisandra. Vitamin C and pantothenic acid (B5) are also good adrenal nutrients. Find a good supplement store near you and talk to an experienced staff person. Keep your supplements simple though! Just like passive care (massage or chiropractic adjustments), alone, they will not make you better. You can try them for 2-3 months and then reevaluate.

THIS IS KEY: Also develop awareness about your “identification” with the health issues. If you are repeating to yourself and others things like: “I am a sick person” or “I am an injured person” or “this is terrible” or “I am a victim of these multiple accidents”, it can make it MUCH harder to find and stay on a recovery path. Remind yourself MANY times a day that you are more than your medical condition, and firmly place your mental focus on positive events and steps toward recovery–and step away from the victim path.

What can I do to keep myself healthier. I do the exercise, eat well, no sugar or caffeine, and use prayer for meditation. No doctors can help me because they say I am healthy but I want these symptoms to stop. There has to be something else I can do while I am in trama to help my adrenals. Any suggestions?