Cortisol Test

[Polly2501]

Hi everyone, so my referral to the endo has finally been picked up! The hospital has asked my doctor to do some blood tests in anticipation of being seen, including cortisol. I was tested around 9am in the morning and it was fasting. My vitamin levels are all quite low and my cortisol was also low. I've detailed some of them below:

B12 - 295 (range 150-900)

Ferritin - 15 (range 15-300)

Folate - 16 (range <3.0)

Cortisol - 169 (no range supplied)

TSH - 0.07 (0.35-5.50)

T4 - 16.5 (7 - 17)

Total white cell count - 3.8 (4-11)

IgA - 2.88 (0.80-2.80)

She has prescribed iron but I'm going to take the gentle iron and she has reduced my Levo by 25mcgs to 125mcg.

The hospital had told her that if my cortisol level was below 300 then they would want to do more tests including a short synacthen test. I wondered if anyone knew what to expect and what a low level could indicate?

Thank you in advance.

[silverfox7]

Not brilliant with this but as no one has come in will share what I know. I think it's best done fasted but thechidpital will take a blood test which will give your baseline and then give you an injection which may give you slight side effects and after a period of time they takexabirger blood test to se how you have reacted to the injection and that tells whether l you are ok or need treatment.

Sorry that sounds sketchy but its a very broad outline of the procedure and not so nuch the reasoning behind it but if little increase could point to adrenal issues I understand.

[Polly2501 in reply to silverfox7]

Thank you so much for the reply! Makes sense - hope they're not bad side effects!

[humanbean]

For information on how you should prepare, what to expect, and how SST tests should be carried out and interpreted, read pages 68 - 70 in this document :

imperialendo.co.uk/Bible201...

One of the things I've read is that often they won't test ACTH. Make sure they do it. The test can't be properly interpreted without it.

Try and remain as calm as possible before the test, move fairly slowly - no running. Go to the hospital allowing plenty of time. Talk as little as possible. Don't read anything exciting.

[humanbean]

For interpreting blood tests you should also keep this link bookmarked to refer to in future :

labtestsonline.org.uk/

***

B12 - 295 (range 150-900)

Ferritin - 15 (range 15-300)

Folate - 16 (range <3.0)

***

It's difficult to say whether your folate is okay. It might be, but I much prefer ranges which have an upper limit. When I've had tests for folate the range was 3.9 - 26.8 ug/L. But I've seen other people with ranges where the top was in the 40s or the 60s.

I think your B12 is too low.

For better info on B12 and folate, join the Pernicious Anaemia Community on HealthUnlocked :

healthunlocked.com/pasoc

and post your results for B12, folate and ferritin.

***

Your ferritin is abysmal. A good doctor would suggest giving you an iron infusion. But such offers are rare in these cash-strapped days. The alternative is taking iron supplements. I see you've started taking Gentle Iron. Eating a decent-sized portion of liver once a week is a good idea too. It will speed up your improvement.

You need to get your ferritin level up to mid-range or a little bit over if you can i.e. up to about 160 - 180.

It is a bad idea to go too high in iron because it is poisonous in overdose. For a proper test you could ask your doctor to give you an iron panel after a couple of months of supplementing. If he refuses you can pay for them privately without the involvement of a doctor. The best test I know of is :

medichecks.com/tests/iron-s...

It's a finger prick test, done through the post.

With such a low level as you have I imagine it will take you a long time to raise your levels. But ferritin isn't the only important thing iron-related, and you need to keep tabs on the other things as you supplement to make sure none of the levels go crazy.

[Polly2501 in reply to humanbean]

Thank you so much for all the information humanbean, the doctor said she will check my iron again in 3 months along with my thyroid. I'll have a look at the links you sent and make sure they test the ACTH too. Thanks so much!