Thyroid UK
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High a.m. cortisol and low iodine results, could anyone help please?


My Dr has prescribed Levo, I haven't started yet due to being concerned about the adrenal info, so have taken saliva test and the a.m. result is high at 20.50 (2.69-9.30).

I'm wondering if anyone has any advice please on whether I should start treatment for thyroid and i'ts that which is poss causing the high cortisol or whether I need to treat the adrenals first, as this could be putting stress o the thyroid and once corrected may not need thyroxine?

I also did a urine iodine test and this was very low at 18 ug/l (range 100-199) so do you think I should supplement this prior to treatment to please?

Ive been following your great advice and have gotten treatment for a b12 functional def (monthly inj.)., am continually trying to raise ferritin levels, have raised low vit d (altho haven't rechecked recently-on to do list!), am about to take folic acid due to low in range.

My results have been jigging around during last few years

tsh varying from 0.42, to over 6 last summer, now 4.58 (a.m. testing, pm test is 3.53) range is 0.35-3.50

FT4 from 17 to 13 (range 8-21)

Ive checked antibodies and theyre ok. cortisol came up high at drs last year, but was advised I was stressed at having the test.

I still believe the b12 is running out before I have the next injection, so also have the poss of taking supplements alongside injections? I usually perk up after the injection, and some symptoms are gradually improving, but I'm still feeling far from right and obviously have not got to the bottom of things yet!

I appreciate it'sprobably a matter of try and see, but would really appreciate any advice please...

Many thanks once again :)

4 Replies

Hi there

Apologies, I can't help you with most of that and there are better qualified people on here in regards to the cortisol.

However, i was just looking into iodine deficiency as a possible cause for my mum and am going to get her the antibody tests to check is a possibility. Just to be sure, have you checked both types of antibodies - Antithyroid Peroxidase Antibody or TPO Ab and Antithyroglobulin Antibody or TG Ab?

I suppose theoretically, (in my opinion) if you are not showing antibodies, then iodine deficiency is a possibility as is the number one cause of hypothyroidisim in the world - just not in this location.

You would have to ask others for advice in regards to the cortisol but if you are feeling okay and are trying to get all your levels up, then I don't see the harm in testing again once they are good for a while? I know I would have probably done this if I was in the same position as I'm always hesitant to take meds lol. If your tsh was higher, I might say differently. However, I would add that I have not looked into whether thyroid issues caused by iodine deificiency can be reversed or any other facts of these cases as have Hashis and never looked into it much.

Maybe others on here might have good reason to disagree.

Maybe check the reliability of the iodine test as well and the significance of those results as I don't know much about these yet?

Any idea why your nutritional levels aren't the best? Maybe this is worth looking into and resolving also. Do you have a good diet/stomach issues etc.

Good Luck whatever you decide to do :-)


I would add, I get the impression that you are a little hesitant like me and you will always wonder what if, if you don't lol. Might be worth talking to your doc about the iodine though to make sure tried properly as I don't think it's one of those ones you want to take too much in either :-)


Thanks Saggyuk for your help and time. Yes, have checked both antibodies once. Havent spoken to dr abut iodine yet, am presuming the iodine urine test is reliable? I'm not feeling great,and really quite poorly a lot of the time but some symptoms do improve after my b12 injection and I get some energy back.

I was diagnosed with IBS years ago, so guess absorption could be a problem. Don't really have the usual symtpms of it, but was found to have excess mucous during a colonoscopy test and told it must be ibs...

yes just worried as to whether I need to correct anything else before assuming this is directly thyroid...:)

I hope you soon get to the bottom of your Mums health problems....good luck and thanks again :)


Ah, my mums easy, she doesn't eat at al so it's either that or genetics which the antibody test should decide lol.

I would agree that possibly something else with your tests results being all over the place like that. Has your tsh been lower than 6 since last summer? If so, I would say you have time on your side to resolve the rest first but depends on how you feel :-)

Yes, would be good to look at stomach issue especially if you still don't feel better after levels are normalised on the supplements. I was diagnosed with IBS many years ago, turned out to be gluten and if I eat gluten now, my tsh climbs to 30-50 after six weeks! It also caused a lot of nutritional deficiency in me, a sleep disorder and inflammation amongst millions of other things lol. Gluten is a common culprit with gut issues and brain fog etc. Coeliac disease causes vitamin deficiency and can be completely silent (no stomach symptoms) so might be worth a test to rule out although endoscopy is kind of required as blood tests can be false negative. I test negative for coeliac but have been diagnosed with NCGS.

You could try gluten free for a couple of months even if just to tick off the list but would have to 100% gluten free and for long enough. If this doesn't work, try a complete elimination diet and see if your energy levels change with different foods - this would at least rule out food intolerances as being the issue and you could look at something else after?

Sorry not sure I have much else to suggest apart from keep trying things and ruling them out. Hope you get to the bottom of it :-)


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