Quick back story is that I've been hypo since age 21 (now 38) have TPO antibodies so I'm assuming hashi's. Saw an endo for the first time in April who agreed to me trialing 10mcg of T3 with my 125mcg of levo which has made no difference. That endo wouldn't prescribe a higher dose of T3 as I had surpressed TSH so I saw an endo in London last week and also had an ACTH stimuluation test as I took along my saliva results from Genova which suggested low afternoon/evening cortisol.
He ran the following bloods and he's emailed me the results today but I'm not sure what they all mean so if anyone can help me interpret here they are.........
the results of the blood test undertaken are now back, which shows:
Normal renal function
Normal Short Synacthen test results (cortisol of 262nmol/L at baseline with peak of 505nmol/l – normal peak >450 and incremental rise >200)
Free T4 / Thyroxine of 16.3pmol/l (normal 9-23), free T3 5.6pmol/l (normal 2.5-5.7), TSH 0.02mIU/L (normal 0.3-4.2)
Prolactin 161mU/L (normal 100-500), LH 4.9IU/.L, FSH 5.6IU/L, Oestradiol 92pmol/l
Vitamin D 84.8nmol/l (normal 70-150)
Haemoglobin 144g/L, MCV 83.4fL, White count 8.6x109/L, Platelets 416x109/L
Not everything on there has ranges but I'd really appreciate any comments anyone has to help me interpret them.
The basic message seems to be that nothing has shown up on the adrenal test and he's suggesting as the next move that I have an an overnight dexamethasone suppression test to check for excess cortisol as I do also have possible symtoms of cushings - moon face, weight gain around the middle, purple marks on stomach. He's asking my GP to do the dexamethasone test so they'll probably say no and I'll have to trek back to London for it!
Anyway what I did like was that he said that 1 in 10 people don't feel well again on Levo (he's the first person that has ever admitted that!!!) and of those people you can improve things by getting a balance of synthetic T3/T4 or switching to NDT (again the first time someone has ever said that to me!!)
The plan is to increase the T3 gradually and decrease the T4 and keep retesting to see how I feel and if there's still no improvement then I can make the choice to switch to NDT and he'll monitor me. He also thinks my Vit D is still too low given that I'm having 1600iu on prescription daily.
Overall I felt it was a good appointment as I've never had anyone admit to me before that levo doesn't work for everyone so that felt like quite a milestone in itself!!!!!!!