I've wanted to reply to your message because it seems we have the same kind of ASI profile.
8:00 am 5.4 (Ref.7-10)
11:00am 1.7 (Ref 3-6)
5:00pm 1.0 (Ref.2-4)
10:00pm 1.0 (Ref less than 1.5)
In short I feel pretty awful, debilitating fatigue along with neurological issues.
I've been struggling with serious Adrenal issues for 4 years so I might be able to help with some of the questions you have. I've done SO MUCH to try and rebuild my adrenals you simply wouldn't believe it. I hope that your doctor was responsive to you in your requests, however I've found with my own primary care ( a woman Dr.) that she is sweet, willing to try and help, but completely clueless and I doubt even reads the stuff I print out for her or the books I buy for her. So.....I've had to try and fix this on my own (which I only got so far) , then sought Homeopathic Dr.s (which have helped somewhat) and now I'm a phone patient with the Clymer Healing Center in Pennsylvania. They've probably been more help specifically than anyone else but it's all out of pocket costs since my husband has Aetna HMO through work. I also saw 4 different Endocrinologists in the Houston area and got ABSOLUTELY no help, even AFTER I took my saliva test results in.
I've done short term hydrocortizone for 1-2 months (now this makes the 3rd time) weaned off, then tried to see if the adrenals were more active, but they are still not. So, I'm back on Cortef this time and also trying Isocort in various dosages with the Cortef. In short DON'T take any hydrocortizone or Isocort after about 4:30 p.m. or you won't sleep as well. It's normal for the cortisol to be bottomed out at midnight and at 2-4 a.m. it SHOULD be less than 1. It creeps back up (or supposed to anyway) in the early morning hours.
So I take about 2-3 mg. of Cortef (or the Isocort equivalent) with breakfast, then again at lunch then again with an afternoon snack at about 4-4:30. Remember also, frequent small meals will help raise cortisol in tiny amounts according to Dr. Wilson's book, so when you are already low, keep the food supply steady. If your Dr. won't prescribe Cortef or hydrocortizone then Isocort is a viable alternative. It is THE only product over the counter, available on the internet that contains any cortisol. But after I called Bezwecken (the manufacturer) and badgered them they told me that the dosage is not 'per pellet', meaning NOT standardized. The Clymer center says it's probably 1-2 mg. per pellet, Dr. Teitelbaum says 2.5. Since I've tried both Cortef AND Isocort I can tell you that they react differently in my body. I can elaborate more if you need.
I've had ASI tests WHILE using the Future Formulations products AND ACE (Adrenal Cortex Extract drops) AND Mil-Adregen and my cortisol numbers didn't change, which also shows that these products DON'T contain actual cortisol. I also called the makers of ADRENAL CORTEX EXTRACT drops in La Mesa, CA. and was told that they DON'T contain cortisol either, just the 'cells' that allow your adrenals to make what you need. I'm not saying they don't work, but it ALL DEPENDS on whether your own adrenals are up to the task. I valiantly tried many different products but at some point when your numbers are so low and you wonder where your energy went you sometimes have to look at other alternatives.
I do like the Future Formulations products because once I started taking them 2 years ago I have not had a single infection, and if I do get a cold it's gone in a very short time. Something miraculous in itself.
I'd be happy to share what I've learned in my multi-1000's of dollars quest to heal my adrenals. But, I have to say that if I catch the clue from your sign-off that you are a believer as I am that "all things work for good for those that love the Lord and are called according to his purpose" that there is a spirtual aspect to healing that can't be ignored by those of us in that category. I'm an older woman and I've spent the last 4 years studying what the Bible has to say about the subject of healing. I believe with all my heart that with God's leading I WILL heal, whether miraculously at some point or just being faithful to follow what I already know. I've endeavored to find out what is MY responsibility in this illness (short and long term changes I need to make) and what is God's responsiblity (fulfilling the promises he gives through the Bible).