Cortisol result

I know virtually nothing about cortisol and my sons blood test has come back 65 nmol/L Abnormal Pt to follow agreed arrangement. was this result expected? If not - suggest urgent referral to Consultant Endocrinolgist .... We have an appointment on Monday ..does anyone know where we may be heading .... My son has had a recent diagnosis of Hashimotos,. b12 and Vit D deficiency

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  • I think they will probably refer him for short synacthen test to assess the adrenals' ability to produce cortisol when stimulated but of course check this with GP.

  • Most of us have had poor outcomes with both endocrinologists as well as GPs. This area of health is not well acknowledged by either. First, I think you should see someone who knows how to treat a child as their levels will be different from adults.

    A blood test for cortisol is not as definitive as a saliva test as that involves active cortisol. Here is bit from Dr. Lam about the connection between thyroid and adrenal glands.

    When the adrenals are exhausted, the ability of the adrenals to handle the stress associated with normal bodily functions and energy requirements is often compromised. To enhance survival, the adrenals force a down-regulation of energy production. In other words, the body is being metabolic down-regulated to slow down in order to conserve energy as the body needs to rest. Lower energy output reduces the workload of the body. In times of stress, this is exactly what the body wants. As the thyroid down-regulates, production of thyroid hormones T4 and T3 is reduced. The down-regulation also leads to an increase in thyroid binding globulin (TBG) level. As a result of increased TBG, more thyroid hormones are bounded on a relative basis and less is released to the body cells where they work. This leads to reduced free T4 and free T3 levels in the blood if measured (while total T3 and T4 levels may be normal). In this well orchestrated systemic down-regulation to enhance survival, the body also shunts some of the available T4 towards the production of the inactive reverse T3 (rT3) which acts as a braking system and opposes the function of T3. This reduction in T3 combined with an increase in rT3 may persist even after the stress has passed and cortisol levels have returned to normal. Furthermore, rT3 itself may also inhibit the conversion of T4 to T3 and may perpetuate the production of the inactive rT3. If the proportion of rT3 dominates, then it will antagonize T3 and possibly leading to a state called rT3 dominance. This results in hypothyroid symptoms despite sufficient circulating levels of T4 and T3. The body therefore has multiple pathways to down-regulate energy production to enhance survival under the direction of the adrenal glands.

  • Thanks for your reply ... I should have pointed out my son is 21 sorry for any confusion... The Endo we have has so far been very good so I'm hoping he will know how to treat...

  • Lanvere, please don't count on it. Hashimoto's is an autoimmune condition and sometimes gluten is the reason behind it. I'm glad he's not a child so he can do some research on his own. I've been here for quite a while and see the mismanagement but once in a while a reasonable doctor comes along. It's just the system that holds them to a poor standard of treatment.

    This is a good explanation of how thyroid and adrenals work together and what he needs to do to make them healthier. Adrenals regulate so many areas and so many hormones, it really is important to keep them functioning well.

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