Thyroid UK
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Adrenal Fatigue??

This Adrenal issue has suddenly risen above my horizon. Not, I may add, as a result of any professional medical diagnosis or even as a proposed line of investigation. I have been tramping down the Thyroid path for several years and together with Bloods I have persuaded my GP's to do, as well as Blue Horizon, I have all but removed Thyroid issues as a cause of my "switch offs". So, I guess, this may be an issue worthy of investigation. The symptoms seem to fit, i.e., Exhausted on waking, swings of energy usually higher in late evening, expanding "middle", "foggy," often dizzy, weakness and fatigue, sore joints and muscles, etc. If Doctors won't pursue it, is this a B H possibility again, if so what tests?

14 Replies

reelingenious Probably the best test is Genova's 24 hour adrenal saliva test -

"Adrenal Stress Profile (ASI): Cortisol/DHEA

Specimen requirements: Saliva

Cost: £77.00 (Discounted Price for TUK only)

Order Code: END01

Turnaround time: 7 - 10 days

This saliva test can detect imbalances in the daily circadian secretions of the stress hormones cortisol and DHEA. Imbalances in these hormones can indicate an inappropriate response that can negatively impact energy levels, emotions, and many other health complaints. These include anxiety, chronic inflammatory conditions, allergies, chronic fatigue syndrome, insomnia, depression, migraines, headaches, recurrent infections, menstrual difficulties and infertility."

As Genova don't deal directly with the public you'll need to order through ThyroidUK (as your 'practioner') -

It might also be an idea to do their 24 hour urine T4/T3 test to see if you are converting well enough - END08 - at some point.

Current thyroid test results?

What about your vitamins and minerals, it might be worth repeating these considering your previous results seem to be over 12 months old? Low nutrients can cause lots of symptoms and your B12 and Vit D weren't optimal back then. You didn't put the ranges so I've no idea if Ferritin was optimal, and what about Folate?

You said you were going to ask about getting antibodies tested, did you get them done? Blue Horizon or Medichecks are probably best for that as they do both types (TPO and TG), NHS usually only does one (TPO).

A BH Thyroid Plus Eleven or Medichecks Thyroid UltraVit covers everything to do with thyroid, vitamins and minerals.


Thanks for the reply. Yes i did get the B H +11 including antibodies. All normal. Vit D now 151, Vit B12 659, Serum folate 44.22, all at upper end of ranges but not OTT. TSH 2.16 (0 .27 - 4.2), T4 Total =74 (64.5 - b142), FT4 13.63 (12 - 22), FT3 4.23 (3.1 - 6.8), CRP 1.7 (up to 5), Ferritin 237.8 (30 - 400), Anti-Thyroidperoxidase 8.9 (up to 34), AntiThyroglobulin Abs, 13.6 (up to115). That's the lot!


Well, I wouldn't call your TSH 'normal'. It shows your gland is struggling a bit. Your FT4 is rather low, and your FT3 is under mid-range. And, don't forget that one negative antibody test does not completely rule out Hashi's. :)

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reelingenious I agree with Greygoose, free Ts too low, TSH could be lower, and a repeat of antibodies some time would be useful. From those results your conversion looks OK but your total T4 shows there's not much of it. So yes, it does look as though your thyroid is struggling.

How do these thyroid tests compare with any previous ones?

Vit D is perfect, ferritin and folate fine, B12 isn't too bad but optimal is recommended to be 900-1000.

So you could get the saliva adrenal test done. What about sex hormones? They're all connected. I did all these tests last year which showed in range but high cortisol, extremely low DHEA and virtually non existent sex hormones.


Hi - sorry to butt in here - but I wanted to know if I should stop taking adaptogens before an adrenal saliva test and if so, do you have any idea how long for? Many thanks


helen_m I don't know the answer to that. I want to repeat my adrenal test in the not too distant future and I take adaptogens.

I suppose there's two ways of looking at it, the same as supplementing with some vitamins and minerals. You continue to take them (but not on the day of the test) to see whether your supplement is working and keeping you the level you wish to be at. Or you leave them off for a while to get a base line which will tell you what you're holding on to and if you still need to supplement.

Maybe put a new thread up and someone may know the answer :)

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Hi helen_m

I did Genova's Adrenal saliva test, expecting cortisol to be low - as I can't handle extra stress; but cortisol results were high and DHEA was 'NR' - (non-reportable), "because it was above the maximum value that can be measured accurately", by that test.

Then I realised that I'd recently taken adrenal glandulars and DHEA supps. - although they had run out a couple of weeks before the test.

So I'd say no adrenal related supps for longer than 2 weeks - as I feel I wasted my money on the test.

I've just bought another Test and I'm not taking any adrenal or DHEA supps.

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PS - dizzy, fatigue, sore joints and muscles, all these could be symptoms of low nutrient levels.


Thanks again. I get a bit confused., i.e., OPTIMAL B12 IS 900 - 1000! On the BH readout it indicates that with a B12 0ver 725 you should consider reducing your dose! I'm seeing a "general" consultant next week so will present him with the results and see if it promotes any response. I've seen him beforehand he's a decent bloke.

Previously (27/06/15), TSH was 1.82, FT4 was 14.4 and FT3 WAS 4.2.


reelingenious Yes, BH does say that, it's their doctor's comments and they are sticking to ranges, just like GPs do.

They also say, when FT4 is over range and TSH is suppressed, that it is 'borderline hyperthyroidism' - I've had it on my test results - but if you're hypothyroid it's impossible to be hyperthyroid. You can be overmedicated but not hyperthyroid.

It's often said on here that B12 should be at the very top of the range, even 900-1000 has been quoted as being recommended by the Pernicious Anaemia Society. As I said, your B12 at 659 isn't too bad. You can stick to that or you can aim for optimal. You can always pop over to the PA forum here on Health Unlocked and ask what they recommend

Optimal levels are always quoted here. In range doesn't mean anything. For thyroid hormone to work, our own or replacement hormone, vitamin and mineral levels need to be optimal.

Take ferritin for example. The BH range (on my print outs as a female, males appear to be different) is 20-150. I would be in range at 20 and I would be in range at 150. However, at 20 I would be very ill with, probably, severe fatigue, hair loss, and other things that low ferritin brings. Unfortunately, this is what doctors go by. So if I went to my GP with my ferritin at 20 in a range of 20-150 she would say there is no problem as I am in range, but I'd still be very ill.

Optimal ranges quoted here, in addition to B12, are

Vit D - 100-150nmol/L

Ferritin - Half way through it's range

Folate - At least half way through it's range

As for your thyroid results:

Previously (27/06/15), TSH was 1.82, FT4 was 14.4 and FT3 WAS 4.2.

Currently TSH 2.16 (0 .27 - 4.2), T4 Total =74 (64.5 - 142), FT4 13.63 (12 - 22), FT3 4.23 (3.1 - 6.8),

Were the ranges the same for the June results as the current ones?

Were both tests done under the same conditions - same time for blood draw, fasting or had you eaten or drunk anything other than water. They're only properly comparable if conditions were the same.

However, whatever the range for the original TSH it does appear to have increased - a sign the thyroid could be struggling. Along with current low FT3 and FT3 this does seem as though it could be the case.

Your total T4 is very low, you're not producing much at all.

And as mentioned, one negative antibody result doesn't rule out autoimmune thyroid disease. As mentioned in your reply below to CharButterfly, you are now 'on' again after being 'off' for 7 days. Wax and wane, fluctuations that are typical of Hashimoto's. Further testing of antibodies at some point would be a good idea, particularly during an 'off period' when the antibodies could be attacking and making you feel unwell.


PS - in order for a member to know you have replied to them specifically, they only get a notification if you reply within their message box directly under their reply. Alternatively, tagging them by putting @ directly in front of their name (no space) and choosing their name from the drop down list of suggestions that will appear, clicking on it so it highlights in blue, also sends a notification that they have been mentioned, as I have done with your name at the beginning of my above message :)


Have they done vitamin D levels. This causes joint pain and fatigue.. Though testing cortisol won't harm. My daughters 14 with hashimoto's and symptoms of addisons disease, (bloods due 5/1/17) the same issue ie autoimmune reaction to add reanalysis glands and thyroid glands makes body destroy em.

Her body behaves hyperthyroidism but bloods report hypothyroidism.


Charbutterfly.........see above. This whole concept of "optimal" and "within range" I assume are very personal concepts? I seem to be "on the edge" of a switch off permanently. After 7 days of "off", today I'm "on" again, just got back from the gym and feel great after that week of everything being an effort. It is very depressing.


Can't remember the timing of the June tests. The ranges were, FT4 14.4 (11 - 26), TSH 1.82 (0.35 -4.50), FT3 4.2 (3.1 - EITHER 6.8 or 8.8. Print is a bit poor) . Not entirely sure why the ranges should be different! The difficulty with getting a test done in an "off" is all in the timing. I could book the draw when unwell and by the time the appointment arrives I'm up again!! I will talk to Dr Mike about the possibility of "same day" blood tests. Thanks again for your time.


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