Query Levels: Serum Cortisol, B12 , Ft4, Ft3 & TSH.

1. A recent result of a serum cortisol test showed: 288 nmoI/L (250-700).

The reference interval applying to specimens taken 7-9AM.

(My specimen was actually taken 11.45AM, although the Lab result form states that it was taken 2.13PM)

The form further advises:

At this level, adrenal hypofunction cannot be ruled out. Consider steroid therapies (including intra-articular, intra-muscular, inhaled and topical).

Suggest repeat pre-9am Cortisol. If again low, consider short synacthen test if clinically indicated.

Specimens taken outside of the period 7-9am are of limited value because of diurnal variation.

My sleep patterns are terrible..I wake up at 2-3am every morning after 3-4 hours sleep.

2. My B12 result: >1475 pmoI/L (170-600) HH

Folate result: >31.4 nmoI/L (> 8.0)

I have been on Vitamin B12 replacement therapy now for 2-3 years, after a low serum level of 85.

The Lab Report advises: Found in B12 replacement Therapy, in liver disease and in myeloproliferative neoplasms. A blood count is recommended.

Is my high B12 something to be very concerned about?

3. My latest thyroid results, taken at the same time as the above:

FT4: 10.7 pmoI/L (10.0-24.0)

FT3: 4.7 pmoI/L (0.40-4.00)

TSH 2.5 mIU/L (0.40-4.00).

I still have hypothyroid (Hashimotos) symptoms, such as insomnia, carpal tunnel, dry eyes and rhinitis. Any comments would be appreciated.

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Hello mongolia1

Low cortisol can cause disrupted sleep patterns but it is widely considered that a blood cortisol test is uninformative as the levels of this hormone fluctuate naturally throughout a 24 hour period. Obviously to conduct blood tests at different times in a 24 hour period is not usually viable so people use a saliva stress level test. This consists of spitting in four tubes at different times of the day, freezing them and posting off to laboratories. The results are plotted on a chart giving a clear and consise assessment of what is going on.

Unfortunately these tests are not always recognised by conventional doctors.

I would not recommend taking steroids on results from a blood test not only taken at the wrong time of day but also only giving a round about total of your daily cortisol output.

Low cortisol is very difficult to treat, takes a long while to recover and treatment differs depending on when the cortisol spikes and dips are.

I would recommend you read a book called "Your Thyroid and How To Keep It Healthy" by Dr Peatfield. Remember knowledge is power.

Others will comment on your other results.