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Thyroid and Adrenal test interpretation required please!

Hello All, further to my post 3 weeks ago, i have received some more results and would really appreciate some advise please.

My main symptoms i want to deal with is delayed fatigue after moderate amount of exercise (fatigue and Brain fog kicks in after 24hour hours). I have cut out Gluten, grains, almost stppoed dairy. I have just started easing into a ketogenic diet although i find this too difficult being vegetarian. I really need to get well as i'm finding it very difficult to hold down a job - if i lose this things will really get from bad to worse!

Adrenal stress test (Cortisol and DHEA) results:

Sample collection: June 23rd 2017

Sample 1 at 9 am: 13.35 (2.68 - 9.3) - HIGH

Sample 2 at 1 Pm: 30.57 (0.75 - 2.93) - OFF THE CHARTS

Sample 3 at 5 Pm: 1.30 (0.36 - 1.88) - NORMAL

Sample 4 at MIDNIGHT: 0.77 (<0.94) - NORMAL

DHEA sample (AM) : 1.72 (0.25 - 2.22 NORMAL

DHEA : CORTISOL RATIO : 0.13 NORMAL (0.05 - 0.32

I am usually a little stressed and anxious most mornings ( actually i remember i didnt go to work that day due to anxiety). At 1pm was out shopping for food and nutritional supplemnts and remember being very stressed and tired. But this result seems to be way off.


VIT B12: 669 pg/ml (197-771)

FOLATE: >20 (>2.9)

FERRITIN: 119 ug/l (30 - 400)

C reactive protein: <0.6 (<5.0)

TT4: 88 nmol/l (59-154)

TSH: 0.94 mIU/L (0.27-4.2)

FT4 17.9 pmol/l (12-22)

FT3 4.4 pmol/l (3.1-6.8)

RT3: 25 ng/dl (10-24) *** high/out of range

TGab 105.5 IU/ml (0-115) *** high/out of range (i know i have hashi's)

TPab 220.3 IU/ml (0-34) *** high/out of range (i know i have hashi's)

I am currently on 100mcg Levo since last week, ( but i did do a few weeks on 125mcg before that when the brain fog got really bad)

Since the tests i have also started taking:

1. BIOCARE multi vits

2. multi minerals including Vit D and B12

3. Hemp oil

4. Naicinamide

5. Seleno cycteine

6. gingko biloba sometimes

7. co q10 sometimes

8. Vit c/ascorbic acid sometimes

9. trying to low carb to high fat diet.

The advice i am looking for is:

1. What does the morning high cortisol levels mean - and what should i be doing about this. Ie. i have read that increasing thyroid meds is not a good idea until and adrenal issues have been sorted out. So do i need to do anything before i change my thyroid meds?

2. Should I be worried about the High rT3? My understanding is that it is high because i've probably got enough fT3 in my cells already and my body is blocking any extra getting into the cells. Or does this mean something else?

3. I have received an order of Thiroid - is there any point in me switching from Levo? If so how much should i be taking? At the tie of the blood test i was taking 125mcg, but i have gone down to 100mcg the last 7 days.

4. could my while situation be sorted by just increasing iron, even though its in range?!

Really appreciate any feedback and wisdom and thanks in advance. Thanks to those who have responded in the past and really appreciate your feedback again!

2 Replies


B12, folate and CRP are good. Ferritin is optimal half way through range so you could supplement iron with 1,000mg vitamin C but ferritin >100 is likely to be adequate. If you do supplement iron it should be taken 4 hours away from Levothyroxine or Thiroid.

TSH 0.94 is low-normal, FT4 is just over half way through range and FT3 is below half way through range. rT3 is mildly over range. Reducing Levothyroxine to 100mcg should reduce rT3 but will probably reduce FT4 and FT3 too. It might be an idea to switch to Thiroid now as it will reduce the T4 you are taking and give you some T3 direct. I would reduce Levothyroxine to 50mcg and start with 1 grain Thiroid. After a couple of weeks you could drop the Levothyroxine and increase Thiroid to 1.5 - 2 grains. Hold at 2 grains for 6-8 weeks and have a FT3 test before increasing further.

There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.



I can't help with cortisol/adrenals. Please write a new post asking for interpretation of cortisol results.


The key to this would seem to be more adrenal than thyroid. High Cortisol can both cause anxiety and also be a result of it. Were you generally more hyper-active & anxious or more calm and laid back before becoming ill?


There are two distinct Thyroid issues showing here: Hashimotos and Poor conversion.

For both Thyroid and Adrenal issues a high fat high protein, low Carb diet is worth a try - I found it helps with both. There is emerging evidence that ME, Thyroid and high Cortisol can be influenced by Dysbiosis of the bowels a good quallity Probioitic may be worth trying.

For the hashimotos DO NOT supplement Iodine. The Cysteine is good and I would also want to see you taking sublingual Glutathione since its generally effective for inflammation. I would also be tempted to try a Gluten free, Organic diet many people find that helps.

The two things researched for over production of rT3 are high Cortisol and high inflammation. Too much T4 can also cause that.

The relationship between Cortisol and Thryoid is discussed in one of Paul Robinsons books - I would suggest you have a quick nosey on Amazon for that.

I found NDT (e.g. Thiroid) and/or pure T3 are much better but would be inclined to sort diet and Cortisol out first given your extreme results. Given your results, you need to take whichever you use with evening meal or mid afternoon - you will need to experiment a bit to know.

Would you post normal range for Folate please?


At night I found Phosphatidyl Serine (lots of research for that one) and Holy Basil effective both reduce Cortisol this will help both your imbalance and sleep.

For any inflamation I would be inclined to take Vitamin C (1g twice a day min) - when you are taking enough you will have no cravings for sugar or sweet foods. I would also add Vitamin A and Vitamin E. If you post again make us aware of any inflammation even if its only Excema or itchy bum!

Best of luck


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