I am a 24-year old man and have poor health symptoms which might indicate thyroid and/or adrenal fatigue conditions e.g. severe fatigue, muscle weakness, brain fog. I believe they were caused by side effects from a GP-prescribed medication which I stopped 6 months ago and has also contributed to other symptoms e.g. sexual.

Hopefully I will get some advice on this from the Community in confirming or denying these conditions and treatment. For the past 2-3 months, I have drastically altered my diet and am set to increase my supplements to address these conditions.

Examples of my blood test results:

(i) TSH and T4; 4-5 months ago are relatively low at ~1.3miu/l and 10.7pmol/l albeit in the "normal" range and so not progressed by GP.

(ii) Cortisol; ~5 months ago was 210-257 nmol/l

(iii) Vitamin D; 77.7 nmol/L ~2 months ago (after GP-prescribed supplement - was even lower ~5 months ago)

29 Replies

  • Welcome to the forum, Userotc.

    TSH 1.3 is euthyroid (normal). I can't tell whether FT4 10.7 is particularly low without seeing the FT4 range (figures in brackets after results). NHS doesn't diagnose hypothyroidism unless TSH is over range (usually >5-6) or FT4 is below range.

    I can't comment on Cortisol, hopefully another member will.

    Vitamin D is replete 75-200 and most people are comfortable around 100. I would continue supplementing D3 until April when ultraviolet levels are high enough to stimulate natural vit D.

  • Thanks Clutter.

    The normal ranges that I previously found (and their sources) are shown below:

    (i) TSH: 0.4 - 4.0miu/L (

    (ii) T4 free: 9-25 pmol/L (same source)

    (iii) Cortisol: 193-772 nmol/l (

    Hence I think I am low/borderline for (i)-(iii).

    I have ordered Vitamin D3 and plan to dose at 2000IU/day indefinitely.

    Re hypothyroidism, I understand your comments re NHS but I think I read last week on the Thyroid UK site an expert comment that the TSH/T4 readings may be misleading (?) so I may have the condition.

    Do you think I may have thyroid/adrenal problems?

  • Userotc,

    Labs use ranges recommended by the manufacturer of the analysis machinery they use and the local population samples taken. You can't compare your results with any range other than the range your lab uses. Your GP practice or the hospital lab pathology dept should be able to tell you what ranges your lab uses.

    TSH 1.13 rules out primary hypothyroidism but without seeing where in range FT4 10.7 is it isn't possible to rule out secondary hypothyroidism.

    While it is likely that symptoms may precede abnormal thyroid results by months, perhaps years, NHS diagnoses on abnormal thyroid levels, not borderline levels or symptoms.

    I don't know enough about cortisol to comment usefully other than to say you need to find out what your lab's range is as above.

  • Clutter, I must confess to not understanding all of your response but my experience with our GP suggests its a waste of time asking them for the details you suggest.

    Any other advice as to how I might find out if I have thyroid/adrenal problems or not? Whilst Ive seen an endocrinologist and found him not very useful (he tested my testosterone and related measures only), I could try him if you think it's useful.

  • Userotc,

    Either ask your GP receptionist or practice manager for the ranges the lab used for your results or order your own private thyroid labs. Blue Horizon Thyroid Plus 11 is quite comprehensive and tests TSH, FT4, FT3, thyroid antibodies and ferritin, vitamin D, B12 and folate.

  • Thanks Clutter. Since I can see my results online, I can also see the "Normal Range" alongside which are:

    (i) TSH: 0.3 - 5miu/L

    (ii) Serum-free T4: 10 - 18.7pmol/L

    (iii) Serum cortisol: No range shown

    (iv) 25-OH Vitamin D: 50 - 250nmol/L

    Hence the comment in my original post that my TSH and T4 are (just) in the "normal" range at ~1.3miu/l and 10.7pmol/l resp. Is that enough to say I dont have adrenal fatigue/thyroid isues? I repeat that I think I read on Thyroid UK that blood readings may be unreliable?.

  • Userotc,

    TSH 1.3 is low-normal but FT4 10.7 is low in range. Results are currently euthyroid (normal) because they are within range but I think you should retest in 6 months in case FT4 drops below range. If it does without TSH rising your GP should consider secondary hypothyroidism due to pituitary dysfunction. Thyroid blood tests are a snapshot in time and there is no reason to think they are unreliable. What may happen is that symptoms will precede abnormal blood levels by months/years.

    I don't know enough about cortisol or adrenal fatigue to venture an opinion.

  • Many thanks Clutter. I do indeed plan to ask for a retest for TSH and T4 (and T3) plus others Vits B, C, E, folate, ferritin, Mg, Ca. That will be next month so let's see then.

    I think it's good that you qualify T4 as low despite being "in-range". My GP and endocrinologist don't want to know if in-range.

  • Userotc,

    Unfortunately most doctors find anywhere in range acceptable whereas most thyroid patients on Levothyroxine will need TSH low and FT4 high in range to feel well.

  • Clutter,

    Since my last message, Ive had further tests with the results shown below which I think indicate an improvement in possible thyroid condition with FT4, PTH, TSH higher than ~6m ago (almost doubled for the last two). Can I now relax?

    The additional tests seem to indicate an higher than normal iron level although the GP is totally unconcerned. Note, however, that Ive just read that tests could be affected by various factors including my use of B-12 supplements

    Serum free T4 level: 11.5 pmol/L (10 - 18.7)

    Intact PTH: 2 pmol/L (0.8 - 7.7)

    Serum TSH level: 1.96 miu/L: (0.3 - 5)

    Male Testosterone: 17.3 nmol/L (8.4 - 28.7)

    Serum inorg. Phos: 1.31 mmol/L (0.8 - 1.5)

    Serum vitamin B12: 725 ng/L (170 - 730)

    Serum folate: 24 ug/L (3 - 19)

    Serum iron level 20.4 umol/L (8 - 32)

    Sat. Fe binding capac 46.4 umol/L (Not shown)

    Unsat Fe binding cap 26 umol/L (27.8 - 53.7)

    Transferrin sat index 44 % (20 - 50%)

    Serum ferritin 130 ug/L (22 - 320)

    Corrected serum Ca 2.29 mmol/L (2.2 - 2.6)

    Serum bilirubin level 37 umol/L (3 - 20)

    Footnote: 3 out of range, 1 borderline/near out of range.


  • userotc,

    TSH has risen to stimulate better production of T4. FT4 has improved but is still low in range.


    Other results are within range (normal).

  • Clutter, thanks. Is my increased TSH (and PTH) a good sign though?

    Ive now asked my endo to check FT3 as my GP couldnt/wouldnt do. Im not confident my endo will either but let's see.

  • Userotc,

    Rising TSH isn't desirable. It means the thyroid is being flogged to produce adequate T4 and T3.

    I doubt there is any significance to PTH rising to 2.0.

    NHS rarely tests FT3 unless TSH is suppressed <0.03. They are looking for evidence of high T3 in hyperthyroid patients not low FT3 in euthyroid or hypothyroid patients.

    Blue Horizon Thyroid Profile Plus 6 tests TSH, FT4 and FT3 or Thyroid Profile Plus 11 adds thyroid antibodies and some vitamin and mineral results.

  • Clutter

    Which of the test options would you recommend bearing in mind that I already have TSH, FT4, Folate, B12, Vit D, serum Ferritin and Transferrin saturation index data?

    If ultimately diagnosed, Im reluctant to take a drug (a drug is where I started 14mths ago - see my original post 25 days ago) but I understand it may difficult to get NDT from physicians?

  • Userotc,

    I would opt for Thyroid Plus 6 then but if you recently had thyroid tests it probably isn't worth retesting for 12 months.

  • Clutter, Im unsure what you mean re "thyroid tests". Ive had various blood tests including those listed but no physician has diagnosed me with a thyroid condition. Are you now saying there's no point getting the Blue Horizon tests done for another 12 months?

  • Userotc,

    TSH and FT4 aren't likely to change quickly so the only reason to order a thyroid test within 12 months is if you want to know what your FT3 level is.

  • Clutter, so is the quickest/easiest thing to just get FT3 tested or are the antibodies also important?

  • Userotc,

    It's useful to know whether antibodies are negative or positive. If positive it is likely you will become hypothyroid but it probably won't get you a hypothyroid diagnosis or treatment any sooner. Blue Horizon Thyroid Plus 11 includes FT3 and thyroid peroxidase and thyroglobulin antibodies.

  • Clutter,

    As you previously advised, Plus Six seems to be a more focused/better option including: TSH, FT4, FT3, TT4, Thyroid Peroxidase Antibodies, Thyroglobulin Antibodies. Agree? Only TSH and FT4 would be "wasted"/repeated and maybe BH would be willing to reduce the cost if these are not done?

  • Userotc,

    Plus 6 doesn't include antibodies. Plus 11 has TSH, FT4, FT3, TT4, Thyroid Peroxidase Antibodies, Thyroglobulin Antibodies.

  • Clutter,

    According to the link that you sent and the Blue Horizon PDF, Plus 6 just has the tests that you listed with Plus 11 having more eg ferritin, folate etc which Ive had. I'll recheck by calling BH.

    Before I order tests, do you have any views on:

    (i) My use of sea kelp supplements at 150mcg/day (100% NRV) for past ~3 months.

    I note paper

    (ii) Ive now stopped taking vitamin B Complex and multivitamins following my last tests which showed relatively high vit B (725 ng/L) and transferritin saturation (44%), under-range Fe binding and over-range serum folate (24 ug/L).

  • userotc,

    Plus 6 does not have thyroid peroxidase and thyroglobulin antibodies.

    I personally would not supplement Kelp which has high iodine content unless I had tested and found to be iodine deficient.

    I suggest you write a new post asking for advice on transferrin saturation and ferritin binding results, I don't know much about them.

  • Clutter,

    For your information, I ordered Plus 6 yesterday from Blue Horizon and it includes thyroid peroxidase and thyroglobulin antibodies, as per spec given on their weblink. Ive also ordered an iodine test.

  • Clutter

    Please see below my BH results for 22/12. Any advice appreciated including:

    (i) Should I now stop my 150mcg kelp supplementation?

    (ii) Do any of the results (and/or changes) indicate a thyroid problem?

    (i) Iodine: 46 ug/L (40-80)

    (ii) TSH; 0.96 miu/L (0.27-4.2)

    (Change since June = -34%, since 2 Dec = -51%)

    (iii) FT4: 14.4 pmol/L (12-22)

    (Change since June = +35%, since 2 Dec = +25%)

    (iv) TT4: 68 pmol/L (59-154)

    (v) FT3: 4.4 pmol/L (3.1-6.8)

    (vi) Thyroid perox'se; 6 (0-34) (vii) Thyroglobulin; <10 (0 - 115)

    Footnote: Ive never been diagnosed with a thyroid problem so not on any medication.

  • Clutter, as you haven't replied to my last post. I must assume that you think I should continue with iodine supplementation but that my thyroid is Ok.

  • Us3erotc,

    That would be an incorrect assumption. I hadn't seen your post of 4 days ago and happened upon your recent reply when I was scrolling through Newsfeed. If you used the green Reply tab underneath my reply to you I would have been sent email and onsite notifications that you had replied to me.

    TSH 0.96, FT4 14.4 and FT3 4.4 are euthyroid (normal) and don't indicate thyroid dysfunction. Thyroid antibodies are negative for autoimmune thyroid disease (Hashimoto's).

    Iodine 46 is within range so not deficient. I personally would not supplement kelp unless I was iodine deficient but 150mcg is not an excessive dose if you want to supplement.

  • Clutter, thanks for the reply. Must be a comms problem as I did press the green reply button (unsure what else I could do other than start a new post?). Anyhow, Re your answer it's good to know I am now eurothyroid despite continued symptoms that may indicate otherwise -including (but not restricted to) a return of sinus problems in past few days. Is it possible/likely that symptoms lag bloods so symptoms may now start to ease? By the way, I've never understood meaning of "positive" antibody indications for thyroid - do mine confirm no problem just because they are within the normal ranges given? Much appreciated.

  • Userotc,

    You are biochemically euthyroid so I think any symptoms are likely to be non-thyroidal.

    Thyroid peroxidase antibodies are <34 and thyroglobulin antibodies <115 which means they are negative for Hashimoto's. A few people can be sero negative for Hashimoto's (no antibodies) but may be diagnosed with Hashimoto's due to typical Hashimoto's damage seen on an ultrasound scan.

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