Advice for next step Hypo/Hashis/High cortisol

[Dannia]

I need help with advising my friend what her next step is. (We live in Bulgaria and there are no good endo's here, but she has been prescribed T4 and we can get T3)

These were her results 6 weeks ago and she started on 50mcgs T4 only.

TSH 13.509 (0.2-5.50)

FT3 3.34 (2.3-4.2)

FT4 1.06 (0.89-1.76)

AntiTg (TAT) 16 should be <40

Anti-TPO (MAT) >1300.0 should be <60

These are results now..I am guessing she isn't converting well.

TSH 3.572 (0.2-5.50)

FT3 3.01 (2.3-4.2)

FT4 1.4 (0.89-1.76)

AntiTg (TAT) 19 should be <40

Anti-TPO (MAT) >1000 should be <60

Other results

B12 280 (246-911) I realise this is very low.

Ferritin 72.6 (6.0-159.0)

Serum Iron 18.3 (6.0-26.0)

TIBC 52.2 (47.0-77.0)

Glucose 8.3 (3.3-6.0)

Awaiting Vit D3 result.

She has also high cortisol all day.

She is feeling a little bit better, not much energy though and keeps crashing, I think due to adrenal surges when she becomes quite stressed out.

Any advice welcomed/appreciated. Thanks

[shaws Administrator]

Someone will comment on the other blood tests but her TSH is still too high and T4 should have been increased now by 25mcg and again in another six weeks until she feels better. It does take a while to improve and one of our Endocrinologists recommends:

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l. "

Of course some people may feel better with a slightly higher TSH. It does take around 6 weeks for T4 to build up in your system and with an increase it is a gradual process, unfortunately, to feel better.

Regards

[Maddie]

If the glucose is a fasting glucose test then the result is high and your friend should speak to her GP. This link will explain a little more;

diabetes.co.uk/pre-diabetes...

This link will show you the symptoms;

diabetes.co.uk/type2-diabet...

Maddie