I myself wouldn't worry about the blood serum test result as this measures both the active and inactive cortisol giving a total amount your adrenals are "supposedly" capable of producing in only a snap short moment when we "supposedly" able to produce the most.
However, long term under treated hypothyroidism (& other illness) messes everything up and the cortisol circadian pattern can alter drastically. Therefore, the HB might have possibly reduced a high am (as can be very powerful) but increased a low pm ( who knows ? ? . ) ... Do you have recent saliva test results to post ? ? ...
You advised of a reduction in meds 3 months ago. Is this why thyroid hormone levels have dropped ? ? ... Are you still medicating 75mcg T4 and 20mcg T3 ?
TSH is fine. Many need a lower TSH to function well and the medicated T3 can be sensed by the pituitary that then sometimes stops producing. This is normal for many. T4 level is not so important when medicating additional T3 but your T3 levels are too low for many to function well.
This will be stressing your adrenals further. You previously advised of elevated RT3 so need to be cautious when adding further thyroid hormones but if this were me I would increase T4 to 100mcg and supplement 100-200mcg selenium known to aid conversion before adding anymore more T3 which may have been the cause your hot flushes.. Low & slow is better.
Selenium is the base of the 5’-deiodinase enzyme and helps make the enzymes that remove the iodine molecules from T4, making T3. It also regulates and recycles iodine stores, helps glutathione production and protects the thyroid gland against oxidative damage caused by the hydrogen peroxide required to make hormones.
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