High Cortisol in the morning, T4 medication and Vitamins

[Said321]

After doing my saliva cortisol test, I have very high cortisol level especially in the morning and depressed DHEA, probably that is why I have low testosterone level, low vitamin D, low folate, somehow low B12, I might have low stomach acid and bad absorption of vitamins and minerals . Main Symptoms are low temperature, total hair loss, poor digestion and probably poor absorption. I am on T4 medicine due to goiter and thyroidectomy for 17 years and doctors refuse to consider changing the medicine? My problem could be that my body does not transfer T4 to T3 but properly rather to RT3.

My doctor advised me to take the following vitamins for the Adrenal Stress Index (ASI) Test which shows in the below results as I have high cortisol level especially in the morning and I have depressed DHEA-S. I have low Vit. D and low Testosterone (becuase of depressed DHEA probably. Kindly advise your opinion of the below Vitamins. He advised me to take one tablet daily for 3 months and then make the Cortisol Adrenal saliva test again after 3 months.

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PANTOTHENIC 50 mg

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PYRIDOXINE 50 mg

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CHROMIUM COMPLEX

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ASCORBIC ACID 1000 mg

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FREE FORM FLAVONOIDS 500 mg

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NATURAL Vitamin E 400 IU

my test results are below:

TAP Cortisol rhythm (Saliva)

06:00 – 08:00 AM 35 Elevated 13-24 nM

11:00 – 01:00 PM 6 Normal 5 – 10 nM

04:00 – 05:00 PM 8 Normal 3 – 8 nM

10:00 – Midnight 3 Normal 1 – 4 nM

Total Cortisol Output 52 22 – 46 Nm

DHEA Dehydroepiandrosterone [DHEA + DHEA – S] (saliva)

Single Collection 2 Depressed Adults (M/F): 3 – 10 ng/ml

My lab test results on the 5th of April 2017 were as follows:

Glucose 107 mg/dL70 - 110

Potassium 4.3 mmol/l3,5 - 5,5

Sodium 144 mmol/l135 - 153

Iron Serum 105 mg/dl45 - 175

Ferretin 137 ng/ml22 - 322

Vitamin B12 585 pg/ml211 - 911

Folate 4,8 ng/ml4.0 - 13.2

TIBC 272 mg/dl250 - 450

Transferrin 227 mg/dl220 - 400

Cholesterol 166 mg/dl125 - 200

Triglycerides 50 mg/dl<150

Iron Saturation 38,603% (Normal 20-50%)

TSH 0,50 mlU/ml0,4 - 4,5

FT3 3,55 pg/ml1,8 - 4,2

FT4 1,29 ng/dl0,8 - 1,9

Antibodies TG <15,0 U/ml 0 – 60

Antibodies TPO <28,0 U/ml 0 – 80

Vitamin D 25 hydroxy 21,2 ng/ml

Daily Average Temperature are the following:

27/3 36.5

28/3 36.2

29/3 36.3

30/3 36.6

31/3 36.5

[Clutter]

I'm sorry you've had no replies, Said321.

TSH is low-normal and FT3 is in the upper third of range so you are a very good converter considering FT4 is less than halfway through range.

We all have rT3 as a proportion of T4 converts to rT3 as a brake on converting too much T3. It is very unlikely you have high rT3 as your FT4 is not high in range.

Your thyroid antibodies are negative for autoimmune thyroid disease (Hashimoto's).

Vitamin D is deficient. Optimal vitD is 40-60ng/ml. You could supplement 10,000iu D3 daily x 6 weeks then reduce to 5,000iu daily and retest in August. Vit D should be taken 4 hours away from Levothyroxine.

B12 is good but folate is low in range. You can improve folate by eating more leafy green vegetables or supplementing a B Complex vitamin which will contain folic acid or methylfolate.

Your lab results 5th April appear to be within range but I'm unable to comment on iron and cortisol. Feel free to post those in a new question for advice.