Can I ask for some advice on my test results?

Hi all,can I have some advice please,in regards with my blood test results?Endo says she can't figure out what's going on with me,she only ran a scan on my thyroid and saw alterations that weren't there at the last ultrasound I had last time,2 months ago,so she diagnosed sub clinical hypothyroidism and prescribed 25mg levothyroxine

Potassium 5 (3.5-5.1mmol/L

Sodium 140 (135-145mmol/L

B12 1010 (211-911pg/mL)

Serotonin 1.71 (0.22-2.05 μmol/L)

Aldosterone (standing) 309 (40-310pg/mL)

Renin 3.8 (1.5-5.7 ng/ml/h)

24h urine cortisol 89 (20-130μg/24h)

In my previous labs,that was in November,24hr cortisol was 131 with the same reference range.Now it is aldosterone that's gone up. Meanwhile I have hyperthyroidism symptoms but my lab tests are coming back as hypo.

Last test TSH was 4.67 (range 0.2-4.2mUI/mL)

Ca was 10.1 (8.5-10.1mg/dL)

To cut a long story short,I asked for a T3 test as well,after having read plenty of posts on here but endo said it is useless to take such a test and that I should just take the levo and let her know if I am doing ok after a fortnight or so,and to keep an eye on my hormones and adrenals. Also she said that what I am showing is that I am bouncing between Addison's and Cushing's and,to be honest,I feel exactly this way .As if I had both those conditions.

I would appreciate immensely any suggestions or advice . Thank you

11 Replies

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  • do you supplement B12?

    if not may be worth investigating why levels are high.

    in some people high levels in blood can cause a functional B12 deficiency - lots in blood but not getting through to cells. looking at MMA and homocysteine levels can help identifyif this is going on.

  • Thank you for replying. I don't supplement,only last year I had Articlox injections because I had a huge drop in my levels but I stopped supplementing in April as my labs came back good.I am afraid I don't know what's an MMA so I don't know what to look for .

  • MMA and homocysteine would be further tests that could be done to clarify whether you have a B12 deficiency at the cell level.

    Do you know what caused the drop in your levels before you had the injection? You probably have an absorption problem and just loading you up with B12 isn't going to be enough - so you are probably at the point where you need more despite the high levels in your blood ... however can be really difficult to get most doctors to recognise that.

    Would strongly suggest that you ask your endo to look into functional B12 deficiency and get the MMA and homocysteine tests done - if it is then the treatment is extremely easy - though seems counter-intuitive - load you up with B12 again.

    Unfortunately B12 absorption problems aren't something you can treat based on scores in serum B12 test and it really does need to be treated on the basis of symptoms

    Would also suggest that if you aren't there already you join the PAS forum on HealthUnlocked - at least read through the pinned posts

    healthunlocked.com/pasoc

  • Thank you so much for your reply.I don't have the slightest idea what caused the B12 drop last year and none of the doctors that I had asked knew or cared to answer that. All I can say is that at the same time I had experienced rapid weight loss after a couple of years of mysterious weight gain.I must admit it's the first time I hear about B12 absorption at cell level,nobody has mentioned that as a possibility.Thank you again.

  • you may get lots of blank stares when you talk to endo - unfortunately vitamins don't feature very high on the medical syllabus.

    symptoms of B12 are very far ranging as it is used in a lot of the bodies processes - you should also get your folate levels checked and please do take a look at the PAS forum if you aren't already a member.

  • Thank you for your suggestions and the time you took to reply,I am already following the PAS forum but thought the B12 problem was solved and didn't read further.

  • 24h urine cortisol 89 (20-130μg/24h)

    In my previous labs,that was in November,24hr cortisol was 131 with the same reference range.

    I'm struggling to understand why your endocrinologist has decided that you are bouncing between Addison's Disease and Cushing's Syndrome.

    Middle of the range for the cortisol range you've given is 75 ug/24h. Both your results are above that. So you don't have a shortage of cortisol, and I can't see how you could possibly have Addison's Disease.

    labtestsonline.org.uk/under...

    According to the above link you would have insufficient aldosterone if you had Addison's Disease and yours is right at the top of the range.

    If you want to look into Cushing's Syndrome then you could start here :

    labtestsonline.org.uk/under...

    -------------------------------

    Please be aware that I have no medical training.

    I think a much more likely scenario is that you are hypothyroid (your TSH is far too high for good health), and you have been left untreated for far too long.

    Thyroid hormones are used by the body to control the metabolism of cells. When the metabolism is low and slow people feel sluggish, brain fogged, exhausted, cold. Every cell of the human body needs thyroid hormone and the list of possible symptoms is very long.

    In order to maintain some kind of normality the body will substitute cortisol and adrenaline for thyroid hormones when it has to. If the thyroid fails to produce sufficient thyroid hormones for long enough the production of cortisol and adrenaline may be maintained indefinitely.

    There are some people whose bodies cannot maintain the excessive production of cortisol and adrenaline and they eventually end up with low thyroid hormone levels, low cortisol and low adrenaline.

    But some people just keep on producing cortisol and adrenaline in high amounts, seemingly for ever, and turning off the tap can sometimes be damn near impossible.

    I would say that, for now at least, it is likely your adrenal glands are doing what they are supposed to do in someone who doesn't have enough thyroid hormone. If you are lucky then taking sufficient levothyroxine will slow down the cortisol tap to normal levels.

    If you have thyroid antibodies - and your endo hasn't even bothered to find out - then this could be why you feel as if some process in your body is not going right and you are bouncing from one level of ill health to another.

    In an ideal world you would have a full thyroid function test including thyroid antibodies, and since being deficient in nutrients is a common side effect of long-term untreated hypothyroidism you need to find out what your level of vitamin B12, folate, ferritin, and vitamin D are. They are all essential in healthy thyroid function and without good levels your body won't be able to make good use of the levothyroxine you are giving it.

    If you are lucky, then your adrenal function will return to normal without any further help. It is something to look into if you still don't feel well after being on the right level of levo for a while. Most people get well without giving their adrenal glands a thought. The ones who don't end up on sites like this one.

    If you are prepared to pay for the right blood tests then you can find out how to do it here :

    bluehorizonmedicals.co.uk/T...

    bluehorizonmedicals.co.uk/W...

    thyroiduk.org.uk/tuk/testin...

    Good luck. :)

  • I wonder if your endo thinks you have Addison's Disease because of the high in range potassium? Your other blood results don't support the diagnosis of Addison's. There are other reasons for high potassium :

    mayoclinic.org/symptoms/hyp...

    One thing you haven't mentioned is what meds and supplements you take (if any). It would be helpful if you listed them in case they are relevant.

  • The three links connected with blood testing in my first post above are specifically about testing without involving doctors.

    I would have edited my post to specify this but I can't edit it, I keep getting an error message. :(

  • Thank you so much for the extended and enlightening response!

    I don;t take any supplements nor any other medication. I was prescribed a beta blocker in 2011 when my blood pressure spiked to 16/11 but then it dropped to a dramatic low of 70/45 and pulse of 45 and I was told to stop medicating. I am suspecting that I was hypo all my life but I was left untreated. The first time I fell extremely ill with the same condition as now was in 1991,but,as you say in your profile,it was early nineties and access to internet was a rare good. Besides that info was scarce and not abundant as it is now.So I was housebound for 8 years and I recovered a little in 2000,mid 2000 I had my boys,both autistic so pressure and anxiety started mounting again. It took me 4 years to get a diagnosis for their autism,meaning I got a diagnosis in summer of 2014,and in December same year I crashed for the second time in my life. Bad thing I was told that my symptoms were just anxiety and it was all in my head. Till April 2016 my TSH was 3 something.. not reaching upper limit. And,besides family history with Hashimoto's ,I was told to just take an anti depressant and not to think about it too much.The only thing that I had until now,or the only thing that showed up in the labs, was a low B12 of 109 but I treated that with Articlox shots,since then I never had a dive again,but I was still complaining of brain fog,depression,joint pains and other goodies also that sometimes I couldn't swallow,I was feeling that food was stopping in my throat. But doctors said that the labs were within range.I also suffered heart incidents with prolonged tachycardias. Endo says so because I am constantly complaining about extreme fatigue,cold extremities and lack of motivation .I am not a doctor. I am hardly the person I used to be. I am very new to thyroid issues and I am totally lost. I can feel my adrenals struggling but I can't tell if it is my adrenals that failed or my thyroid or both of them.Funny thing,endo doesn't know either.

    I insisted for Vit D ,folate and T3 blood tests but I was told that they are not necessary. That I would be fine on Medithyrox 25mg. For the antibodies,endo said that I will be tested for antibodies in February and that she is certain that it will be positive for Hashimoto's. II asked her why my adrenal hormones are going up and down like this and she said she has no idea.

  • The first thing you need is information. At the moment you have very little to go on and you have to start somewhere.

    If you can afford the test I linked to above (thyroid check plus 11 from Blue Horizon Medicals) then I strongly recommend you get it.

    You order the microtainer test either online or by phone (see the Thyroid UK link for ordering info).

    You get sent a testing kit as shown in the finger-prick guide I linked to. You have to prick your fingers to get a blood sample and drip it into the tiny test tubes supplied. The sample has to be posted back to the lab as soon as possible (wait until after the Post Office is not on strike and they've caught up with the backlog!)

    The results of your testing are sent back to you via email.

    Post your results on this forum in a new post and ask for feedback.

    If you know someone who can take blood for you from a vein in the crook of the elbow - a friend or relative perhaps - then you can order the vacutainer test instead of the microtainer test, although the procedure is just the same in other respects.

    Your blood sample should be taken between 7am and 9am, definitely no later.

    24 hours before taking the sample you should take your levo for the day. Then take your levo on the day of the test after you have got your blood sample. Also, don't eat or drink (other than water) before taking your blood sample.

    Your history of ill-health that has been ignored for decades is common on thyroid forums. But you can improve your health. It may take a long time, but you aren't doomed to feel as bad as you do now for the rest of your life.

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