Advice on adrenal and thyroid test results please

[Xanthe]

I’ve recently had my adrenals and thyroid re-tested to check progress, specifically to judge whether my adrenals have recovered sufficiently to withstand the rigours of surgery which I may need in the next year or so. Note that Genova changed the reference ranges in 2015 – which doesn’t help interpretation!

I take one Dr Wilsons Adrenal Rebuilder capsule and 5mg Hydrocortisone daily as well as iron, selenium, vitamins D, K, and B complex as well as a multi vitamin and mineral supplement and fish oils (EPA & DHA). I’ve recently added 25mg 7 keto DHEA. I’m not on any thyroid support. My energy levels have improved slowly but surely over the past 3 years but I still feel “draggy” and unrefreshed in the morning when I wake up.

Adrenals

2013 2014 2015

sample1 6.2 (12-22) 9.8 (12-22) 8.7 (7.5-32.6)

Sample 24.0 (5-9) 4.5 (5-9) 4.0 (2.8-11.3)

Sample 32.1 (3-7) 2.3 (3-7) 3.4 (1.4-7.5)

Sample 40.5 (1-3) 0.3 (1-3) 2.8 (0.8-3.9)

Total Cortisol12.8 (21-41) 16.9 (21-41) 18.9 (no range given)

Dhea10.42 (0.2-0.7) 0.21 (0.2-0.7) 0.17 (0.25-2.22)

Dhea20.22 (0.2-0.7) 0.13 (0.2-0.7) 0.17 (0.25-2.22)

Dhea/cort ratio2.5 (0.6-3.0)1.01 (0.2-0.7) 0.026 (0.015-0.18)

Short Synacthen Test 20132015

Base cortisol 402357

30 minutes 635729

60 minutes 684822

Thyroid20132015

TSH 2.14 (0.4-4.0)3.84 (0.4-4.0)

FT4 12.4 (10-22)14.0 (11.5 – 22.7)

FT4:FT32.5 (2.0-4.5)2.9 (2.0-4.5)

rT3 0.38 (0.14-0.54) 0.42 (0.14-0.54)

TG <20 (<35)<20 (<40)

TPO 11.7 (<30)72 (<35)

I’d be very grateful for any feedback or advice.

Xanthe

[Xanthe]

Sorry everyone, the formatting on my post was corrupted once it was sent, so it's tricky to read, I can re-send if someone can explain to me how to keep the layout I typed it in originally (in Word)

Xanthe

[helvella in reply to Xanthe]

You cannot keep the formatting. Multiple spaces, tabs, etc. end up as one single space.

If you use fancy characters such as em-space, you can achieve a better layout. But that is not trivial. (Can be done in Word and copied and pasted.)

[Xanthe in reply to helvella]

Thanks Helvella, sounds complicated. I'll keep my fingers crossed that folks can get the gist of the numbers.

[Hidden]

Xanthe,

All your latest samples although low, are now within range indicating improvement .

Sample one of your cortisol test results show post awakening & peak adrenal function and yours are still low but improving.

Sample two shows the adrenals adaptive response to the demands of the first few hours of the day and again yours are low but improving.

Sample three shows adrenal fatigue in relation to glycemic control (so many hours after eating.) Cortisol issues may point to blood sugar problems.

You can help to control with regular meals including fats, protein & low GI carbs. I snack on pea protein smoothies and have excluded sugar from my diet (most of the time ! ).

Sample four is taken prior to sleep and indicates the baseline adrenal gland function which should be the lowest of the day as yours is.

I can't remember what the cortisol:DHEA ratio should be but you are looking for a set balance.

If you have sleep issues, eat a low GI carb or protein snack before bed. Many use the adrenal cocktail. ( see link below).

TGAb (thyroid antibodies) is negative but TPOAb is positive indicating Hashimotos Disease. This could account for your raise in TSH and T4. TSH is variable and highest in mornings but as both have risen together you should ask your doctor to retest thyroid hormones in 3 months time.

With Hashimotos good gut health is vital for nutrient & iron absorbtion and a stronger immune system. Address any gut issues such as Candida and supplement Betaine HCI for low stomach acid.

I think your sups are excellent. (I take some of Dr Wilsons products) but there is no B12 supplement ? Have you had B12 levels tested ? It is possible to be deficient even with high blood serum levels.

Also no Vit C ? ? The adrenal glands stores the highest concentration of Vit C in the body and is used in the production of all adrenal hormones and most notably cortisol. Low cortisol should be aided with Vit C which is used up rapidly when the body is stressed (ie with low cortisol).

I take a Vit C with bioflavonoids thought to aid absorbtion. If you supplement Vit C, then taking with iron with help increase absorbtion of iron.

Flower

Adrenals & Thyroid connection

chriskresser.com/5-ways-tha...

Adrenals & Vit C

ncbi.nlm.nih.gov/pubmed/156...

Adrenal Cocktail

rejuvinstitute.com/why-do-i...

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Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

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[Xanthe]

Hi Flower,

Many thanks for your reply: i'd come to a similar view myself, but it's always good to have an outside view of things. I have a very good diet and advice from an excellent nutritionist which I'm sure has helped, but it's interesting that it's taking years to sort out (although this improvement comes after a major crash ).

I take so many supplements that I forgot to include the B12 which I inject twice weekly, 500mcg a time, and vitamin C, in powder form, 5-7g/day (amazingly I get no problems in going as high as 15g!) I've recently added 7 keto DHEA.

Not surprisingly an endo I paid to see about all this said "no problem" - that my adrenals needed no supplementation and they would withstand surgery fine. Looking at the ASI results and the baseline levels in the synacthen test I wasn't sure! I'll continue with the good diet and supplements and put off the surgery for as long as possible.

I bought some cream of tartar recently to try the adrenal cocktail: I'm a bit surprised that they are using orange juice, because of its high GI, but I'll give it a go.

Thanks once again for your feedback!

Xanthe