Am I sitting in the waiting room for disease?

Would appreciate any help. History of HGH treatment for adrenal insufficiency from age 10 to 14 y.o. Have not felt well since stopping HGH. Im 21 y.o. now. Saw endocrinologist 3 months ago for low mood, anxiety, brain fog,

poor memory, don't feel good until after 2 pm. Did labs at 7:30 am

TSH-2.92 (0.40-4.00)

FreeT4- 0.8 (0.8-2.3)

FreeT3- 3.4 (2.5-4.5)

Thyroid Peroxidase antibody- 9.9 (0.0-8.9)

Ferritin-80.6 (24.0-336)

B12- 535 (180-933)

Folate- 19.6 (>= 5.9)

Vit D 25 hydroxy 39.5 (30.0-100)

Prolactin 19.9 (2.6-13.1)

Dr repeated TSH, Prolactin and tested for thyroglobulin antibody

Labs repeated 2 weeks later @ 3:00 pm

TSH-0.98 (0.40-4.00) Is this relevant since not done early morning like first TSH test?

Prolactin-6.9 (2.6-13.1)

Antithyroglobulin- <0.9 (0.0-3.9)

Endo said my lab results are fine. I asked if he could do the ACTH provocation tested that diagnosed my adrenal insufficiency when I was younger, he said the test is too costly and I do have adrenal insufficiency, but nothing to warrant treatment, but I should wear a medic bracelet. Here I am, still with my symptoms..very frustrating.

4 Replies

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  • I think you need to find an Endo who knows about Pituitary disorders as it clearly is not the case here. I am puzzled why he would not treat your adrenal insufficiency but tell you to wear a medic bracelet...presumably because he thinks you may end up with adrenal crisis at some point.

    Can you try and get a second opinion from someone who has more idea than this guy i.e. Pituitary Specialist of even a functional medicine doc?!, because this is your life and at 21 you need your life back.

  • Thanks for pointing me in the right direction, I will check out both of your suggestions.

  • jws95,

    TSH is highest early in the morning as your results demonstrate. In the UK you wouldn't be diagnosed until TSH is >4.0 although some doctors still insist on >10 before making a diagnosis. FT4 is bottom of range. One would expect to see higher TSH with such low FT4 so it is possible you have some pituitary dysfunction preventing TSH rising adequately. Your endo should be considering secondary rather than primary hypothyroidism. You should certainly insist that FT4 and FT3 are always tested because if you have pituitary dysfunction TSH becomes irrelevant.

    Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

    chriskresser.com/the-gluten...

    thyroiduk.org.uk/tuk/about_...

    Adrenal insufficiency - pituitary.org/knowledge-bas...

  • Thank you for helping me sort out which direction to go. I will post any news.

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