Thyroid UK
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Be careful - is adrenal exhaustion your real issue?

Today a private endocrinologist saved my life.

6weeks ago I was admitted to hospital with abdominal pain - suspected cyst torsion. I complained of cloudy urine and terrible smell and was told tests are all clear and no infection!!! I was given antibiotics and sent home. Just after this I had fertility blood tests and was advised I had underactive thyroid and hashimotos (TSH 18.1 (range <3) and TPOAB 612 range <9). I was put on 50mg of levothyroxine. Here's the kicker - over the last six weeks I've Become increasingly worse . Prior to being told about the thyroid I wasn't having any extreme symptoms. I was more tired in the afternoon and evenings, had noticed hair loss when shampooing, intolerance to gluten and bouts of depression and anxiety. But in the last six weeks I've barely been able to get out of bed, extreme myalgia and weakness. I kept going back to my dr saying something is not right. Nothing makes sense. I proposed adrenal fatigue but was ignored. Until last Monday when I was told my TSH is now 4.7 - just within range <4.8 my dr was all smiles and all I could say is why then do I feel so dreadful she agreed something wasn't right and sent me for cortisol test. This was "normal" By Friday I couldn't walk unaided, I could barely sleep and lost my appetite only eating because my partner made me I couldn't stand up without dizziness and was feeling nauseated. This morning I went to see a private endocrinologist - I collapsed as I arrived in his office. He gave me lots and lots of water and based on the history my partner was able to tell him he diagnosed I was in adrenal crisis and highly likely suffering with Addison's disease

He gave me a hydrocortisone shot and within 30mins I was sitting up, could speak, had a clearer head and the muscle pain had significantly reduced. The thyroid medicine, without treating the adrenal glands is highly likely to have caused the swift decline in my health.

We are all individual and have different causes/ symptoms but if you KNOW somethings not right then keep fighting. Today it saved my life.

8 Replies

how high was your cortisol a private test l had came up normal it was 532 and cut off was 536 feeling awful like yourself any advice grateful, l also have high calcium tackling the docs Monday should be interesting............

1 like

Mine was 130 and tested at 9.30am (queuing for test) so a little late as should really be tested around 8am. GP said it was normal - endo took one look and said its low. Online we've read that below 100 is serious below 400 could still be sign of adrenal issue. Hence the intervention. I'm seeing my GP on Monday to request an emergency appt with NHS endo / if they won't do it I'll have to continue private but self funding :0/. If this hadn't happened I was going to ask for T3 test as I've heard that could explain lack of improvement in symptoms.. Wishing you luck and speedy improvement.


What time was your cortisol done? The best time for cortisol to be done is between 8-9am. Serum [cortisol]: 09.00 h, 171‐ 536 nmol/L which would suggest that you are well within the range.


The NHS value is usually based on a 9am sample, at least that was what it said on my daughter's results, 100-400 being low and 100 being seriously deficient.


Gemgems77's result of 130 is below the 171-536 range you've stated.


If that's the range then 130 was obviously low and I don't know why GP said it was normal. You need a short synathcen ( can never spell it) test and you should be referred to an endo for this. Did you get a print out with the ranges, plus your blood should be taken at 8am for cortisol so might have been even lower.

If cortisol low then yes taking thyroid meds not a good idea, they interact in a complex way, and it would certainly explain why you got worse.


If you want information on how adrenal investigations should be done, this will be helpful :

Page 66 is a good place to start, but I'm sure there must be other parts of the document that could be helpful.


Re your thyroid alone (in the absence of anything else eg Addison's), you haven't been on enough levo for long enough to feel better. A lot of us feel worse before we feel better, but you're on a starter dose and are currently undertreated. On treatment your tsh shouldn't be just within range, it needs to be lower (at least under 2 if not under 1). With a tsh like that after only six weeks on levo I'd expect you to feel pants. You also need to know your t3 and t4, tsh is only part of the picture.

Once your adrenal stuff is sorted out you may want to find a different gp. Recovering from thyroid problems can be a long road.


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