Apologies, I have edited the post to include my diagnosis and treatment. I'm ordering tests to guide me (not an NHS gp).
BH adrenal saliva is discounted w any purchase over £50 and I'm already ordering a full thyroid panel w rt3. It looks like the BH test is cortisol only whereas the Genova saliva test is cortisol and dhea.
I see that Genova have a urine test that also looks at urinary t3 levels as well as dhea and cortisol. gdx.net/uk/product/adrenal-...
I have Hashi's and am taking 75/100 levo and 100 t3. My symptoms are extreme fatigue and brain fog despite thyroid/nutritional results looking pretty good. My temp is usually low and I have to be quite overmedicated for it to reflect in my pulse/temp. I'm looking to find out if there is an adrenal issue that means that I still feel hypo even though I appear to be on the right dose of meds.
Also in the running are the possibility that the t3 isn't doing its job and/or is being excreted (thus the the rt3 and urine t3 tests). Tbh I'm not even sure how that works and I don't know if I have the means to research it I'm so out of sorts.
Sorry to moan but if I had a penny for every minute I spent lingering slack-jawed over testing options online I could buy us all a round for sure. This is why my self-treatment proceeds at glacial speed.
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puncturedbicycle
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I had the Genova saliva thyroid test and a seperate cortisol test about 2 years ago.
The cortisol test shows high levels all day, peaking at night, but my GP didn't really seem interested.
The urine thyroid test clearly shows that my T3 is not converting to T4..but my NHS blood tests showed I was in range.
GP states she cannot treat high antibodies. mine are 1000+. Have seen 2 GPs and same story. She states until NICE amend ranges that will be the case. Apparently they are reviewing the ranges, but unlikely it will be changed. Money probably being the motivation. for not doing so I suspect.
I have an autoimmune disease they agree. But which one? Been tested for Lupus, Graves etc. Dr P doesn't think its my adrenals.
Recently gone gluten free, but all early days. Vitamins and probiotics have helped. But in the last few days I've started to get visual disturbances again.
I found the tests easy to follow and Genova very quick to respond and send tests out. The results are well detailed with explanations.
Glacial progress. good way to describe it. Good luck with everything. I just do as much research as I can as no one in the NHS can do anything to help so have to help myself.
I see Dr Lowe mentioned this article in a post, unable to search for it at the moment as not near PC to read his opion.I have come across this article. I see its dated 1972. Will be interesting to see if things have changed since then.
Yes, I agree, I gave up long ago on the NHS solving this particular problem. At least I have a diagnosis, it must be a terrible struggle if you have a collection of indicators but no one knows how to interpret them. Good luck to you too.
I think I will have to bite the financial bullet once again and see another private consultant. Waste of time endlessly trying to find aninformed and sympathetic GP. Must have spent over 1k on seeing a private endo and tests. I don't think Dr P is very well at the moment? I have the list from Thyroid UK of doctors. Thanks for advice.
puncturedbicycle My opinion only and I've had the cortisol/DHEA saliva test with Genova, and I've had the thyroid urine T4/T3 test with them too but it was not a combined test.
I think it's important to have DHEA tested as well, treatment depends on where both levels are. See Dr Myhill's articles
As for the urine thyroid test, I found it useful to know what was happening to T4 as well as T3, and as I've done it a few times now it's interesting to see how each one differs with the change in doses of Levo and T3.
Hezziet As far as the urine thyroid test is concerned, I don't think it's any good for diagnosing Hypothyroidism, but I think it's useful for seeing what's getting through to the cells. Some people think it's a useless test and has no value whatsoever, but having tested a few times now after adding T3 and reducing Levo, and tweaking doses as necessary, it is plainly obvious in my test results what is happening and shows how T3 wasn't getting through before (showed below range) but now is over half way through range. It doesn't *directly* compare with blood test results, but the blood tests have also shown a shift in FT4/FT3 and FT4 has reduced and FT3 increased. Of course, NHS doesn't do this test so won't accept it.
I don't know whether NHS does, or accepts results from private, saliva Adrenals tests. I think they like their standard ones.
I took the tests as I was seeing Dr P. From memory he said that my lack of conversion means I am basically hypothyroid which could be down to a enzyme..cant remember the spelling at the mo.
My blood tests for TSH and T3 T4 and free T3 show I am in range. But I have many symptoms of thyroid issues. As far as I am aware I don't have a thyroid issue but an autoimmune issue with high TPOs and symptoms. GP said this is not Hashimotos. She also admitted that blood tests are very scattergun.
Showed her the results purely to demonstrate I have an issue. Also had bowel tests. .showed lack of 2 gut flora now helped by probiotics. My high cortisol and high blood pressure that doesn't seem to respond well to medication are my main worries. GP just asks for readings them nothing happens.
SeasideSusie so it looks like that means the first test I order should be the full thyroid/nutrition/rt3 bloods, then if everything there looks good I should go for the Genova adrenal stress saliva test so I know what my dhea and cortisol are like - ?
I know there have been adrenal issues and I have been treated w dhea in the past but I didn't seem to respond to it. I do have to keep plugging away though, I can't live like this.
puncturedbicycle It's hard to know what to suggest and in what order. I did a shed load of tests virtually all at the same time (£££ouch) but I wanted to know what was going on. You have Hashi's, I don't, but my TSH has always been suppressed, FT4 over range (sometimes scarily so) but FT3 never more than mid-range. I knew less then than I know now.
The private tests I did (not in order but within a short time) included
BH Thyroid Plus Eleven - showed nutritional deficiencies (now optimal), plus not particularly good conversion
Urine Thyroid - confirmed poor conversion
Candida - negative
Iodine - nicely mid-range
Cortisol/DHEA - problem
Sex hormones - problem
I needed my sex hormone test interpreting so I consulted a private hormone specialist who suggested supplements to address my particular problem.
It's only very recently that I have been able to arrange a blood draw (now that BH offer home nurse phlebotomy service) so I could get rT3 test done. I think it may have helped if I could have had that done sooner.
If I remember correctly, Dr P advocates starting to treat adrenals before thyroid.
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Sorry to hear you're in the same boat. 
Adrenal stress test - is the Secretory IgA part important?
Genova adrenal stress saliva test and Urine Thyroid Hormones T3/T4 - advice
Which cortisol test?
Adrenal test results
Genova adrenal stress test
