Thyroid UK
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Need Levothyroxin but cannot take because adrenals are not working enough... what to do?

Hi I have been diagnosed with the auto immune problem Hashimotos, or thyroid disease. My tests started in December with a TSH reading of 5.7 and T4 or 12, which then dipped the next month to TSH 6 and T4 11.2, I had other tests done over the following 8 weeks that included ferritin (24) Vit D (25) B12 and folate were normal but at the low end of the range. I also asked for adrenal function test and got cortisol (380) the range of cortisol cuts below 450 to start looking into adrenal insufficiency. My TPO antibodies were 966!!! My problem is that although I have taken many suppliments to try and heal naturally - Selenium, Zinc (found out that was low too), Magnesium, Vit C, Iron, B complex, D3, E, Kelp (x2), L Glutamine for stomach repair, L Glutimate, Omega and some homeopathic remedies..... I waited another 6-8 weeks and had tests again... which showed improvement in the Iron and B12 (they wouldn't test for Vit D yet) but unfortunately the TSH was the same as was the T4 (12) and FT3 was around 4.5 which I hadn't had tested originally. However the cortisol levels had dropped to 200 which shows that the adrenals are really messed up, and without these I cannot take the Levothyroxin or it could cause them to crash further.

Symptoms wise, I still have a few symptoms but not quite so many or as aggressively - am feeling the suppliments and gluten free diet are helping as this is clearly a multi system problem and needs approaching a number of ways but can anyone help me with the TPO results that have gone up to over 1000 and the dropping cortisol? I'm really confused about this whole matter and may just want to take Levo but right now cannot because cortisol so low.. I have an endocronologist appointment in late May on NHS but its a very long time to wait for any help !!! :(

4 Replies

Is it possible to call for a cancellation appointment with the specialist? It is a long time to wait for low cortisol, especially as it seems to be dropping.

It isn't a great idea to take thyroxine when your cortisol is low because your body won't be able to use it well and it will put more stress on your adrenals but your hypothyroidism is also putting a strain on your adrenals. If your doctor told you not to take your thyroxine it is probwbly best not to.

I hope you manage to get an appointment soon!

Carolyn x


Thanks Caroline, you are right - the Endo have said to keep appointment (yikes) but to do a Synacthen test next week to determine level of adrenal state if disfunction.... though not sure how that info will really help...


That's good. The synacthen test will help the doctor to know what he is dealing with. Depending on the results your doctor may be able to do something before you see the specialist or maybe refer you more urgently. I imagine if then synacthen test shows that your adrenals are not able to respond adequately he may start you on medication before you see the specialist.

Hope it all goes well.

Carolyn x


thanks Carolyn - the synacten test nearly finished me with dreadful reactions and chronic fatigue - I've not left home in 4 day s and car barely find the energy to wash up or cook for my son. maybe it crossed over with a virus in my system as was a bit up and down in the days leading up. But wasn't expecting a wipe out with gastric horrors, near fainting and complete lethargy. Turns out my cortisol levels went from 370 to 800 and must have used what little i had in reserve.... maybe that whack took T3 into RT3 as a kind of emergency reaction I don't know.

Although it rules out Addisons, which is no bad thing (at the moment) it shows adrenal fatigue and so I'm still unsure what treatment would be right... don't think the endo offers NDT and am not sure if they even factor in adrenal insufficiency - all v borderline but I'm desperate to feel well and energised again. ITs really miserable being so debilitated. I don't think I needed the synacthen test as although my cortisol reading was 200 it was taken at 11am where all others were taken at 9am and were around 300 - 380.... still low but consisitent. So I wouldn't recommend doing that test if you are feeling weak and have low cortisol... probably the saliva test which I sent off for the day before - is safer.... and less invasive... and probably more informative as it measures the free cortisol not the total.

Thanks for your reply - I hope I get what I need soon - its been a long painful wait (4 months) of guesswork but at least I've managed to up my Vit B, D mag and iron levels in the wait and taken in zinc and selenium which mostly absorb I think. Gut is super sensitive still and food tricky - but its a process...! x


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