How does my daughter get diagnosed?

My daughter is experiencing the same adrenal and thyroid issues as I did many years ago. I have accompanied her to GP appointments who dismissed private saliva cortisol results -

Waking - 3.80 nmol/L. 6.00 - 21.00

12.00 - 3.74 nmol/L 1.50 - 7.60

16.00 - 3.23 nmol/L 0.00 - 5.49

before bed - nmol/L 0.00 - 1.99

Serum blood tests -

TSH - 4.62 mIU/L 0.27 - 4.20

Free Thyroxine - 15.08 pmol/L 12.00 - 22.00

Total Thyroxine (T4) 89.9 nmol/L 59.00 - 154.00

Free T3 4.09 pmol/L 3.10 - 6.80

Reverse T3 23 ng/dL 10.00 - 24.00

Reverse T3 ratio 11.58 15.01 - 75.00

Thyroglobulin antibody 11.950 IU/mL 0.00 - 115.00

Thyroid peroxidase antibodies 13.47 IU/mL 0.00 - 34.00

She has many of the symptoms of adrenal fatigue and hypothyroidism but GP will not accept the fact that she is exhausted all the time & feels lousy. She was diagnosed with Post Natal Depression about a year ago but now feels much better in this regard. After seeing a private psychiatrist and stating that she feels much better mentally her medication is being gradually reduced. GP keeps going back to depression causing tiredness grrrrrrrr. GP was very anti private anything. My daughter asked for a private referral to an endocrinologist - again GP very anti re this but says she will refer after the results of a cortisol blood test are known. This test was only agreed after my daughter asking for it. Any advice appreciated.

5 Replies

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  • First of all your GP sounds like he need to be fired for not listening to your daughters symptoms. What was his comment (if any) about the posted TSH being above range?! Can you see another GP in the same clinic?

    Note: Thyroid UK site has a link to private "Thyroid friendly" GPs. Contact them directly for the list. And FYI many Endos know little about thyroid as they are often Diabetes focused.

    Has she had nutrients tested? Is so what are the results (with ranges) for ferritin, folate, b12 and Vit D.

    The low antibodies posted indicate no Hashimotos.

    PS: Im not versed on adrenal issues, but do take Rhodiola and Ashwangandha along with selenium as part of my supplements for adrenal support.

  • Waking - 3.80 nmol/L. 6.00 - 21.00

    12.00 - 3.74 nmol/L 1.50 - 7.60

    16.00 - 3.23 nmol/L 0.00 - 5.49

    before bed - nmol/L 0.00 - 1.99

    If you could give me the result for the fourth sample I might be able to give you a little bit of help with the adrenal results, although I probably can't go very far with the analysis.

  • Thyroglobulin antibody 11.950 IU/mL 0.00 - 115.00

    Thyroid peroxidase antibodies 13.47 IU/mL 0.00 - 34.00

    Both the above results are negative, suggesting that your daughter doesn't have autoimmune hypothyroidism (also called Hashimoto's Thyroiditis otherwise known to patients as Hashi's). The thing about antibodies though, is that they fluctuate in numbers. A negative result can't be considered to be conclusive, but a positive result will be, even if a later test comes back negative again. Some people apparently have several tests before they catch the numbers when they are positive.

    Free Thyroxine - 15.08 pmol/L 12.00 - 22.00

    Total Thyroxine (T4) 89.9 nmol/L 59.00 - 154.00

    Free T3 4.09 pmol/L 3.10 - 6.80

    In the meantime, your daughter's TSH is too high. In a country with a compassionate and well-educated medical profession she would be treated for hypothyroidism with a TSH that high, but sadly treatment is rarely given in the UK with levels like this. Her Free thyroxine (Free T4) is in the lower half of the range, only about 30% of the way through the range. Her Free T3 is in the lower half of the range too - only about 27% of the way through the reference range i.e. only just above the bottom quarter of the range. Both of these are too low for most people to have a hope of feeling well.

    Reverse T3 23 ng/dL 10.00 - 24.00

    Reverse T3 ratio 11.58 15.01 - 75.00

    Although her reverse T3 is in range, it is very high in range, and it would be better if it was lower. The fact that her Free T4 is quite low in range and so is her Free T3 makes me wonder if your daughter has some other issue besides a thyroid problem. Reverse T3 could be high if the body was producing too much Free T4, which is clearly not the case here. The other common reason for producing high levels of reverse T3 is if the person is ill with some non-thyroidal illness.

    What I am not sure of is if the body will produce high levels of reverse T3 if the adrenal glands are producing too little cortisol.

    Does your daughter have gut problems? Low stomach acid? Indigestion or heartburn? Nausea? Constipation? Diarrhoea? Cramps in the gut? These problems are all common in people who are hypothyroid.

  • I should have added above that your daughter could probably get a diagnosis at some point, but it could be a long wait until her TSH goes above 10. Some doctors might treat if TSH goes above the reference range, rather than waiting for it to go above 10, but only if antibodies are also above range.

    The alternative is to treat herself, sadly, like so many of us have done. The easiest thing to start on is probably the Thai brands of NDT. If you want to know where to get them from then write a post asking for sources to be sent to you via private message.

  • Vitamin B12 - 809 pmol/L (140.00 - 724.00)

    Folate (serum) - 8.71 ug/L (2.91 - 50.00)

    25 OH vitamin D - 197 nmol/L (60.00 - 200.00)

    Ferritin - 98.61 ug/L (13 - 150)

    Iron - 31.96 umol/L (6.60 - 26.00)

    T.I.B.C - 60.6 umol/L (41.00 - 77.00)

    Transferrin saturation - 53.21 (20.00 - 55.00)

    I got the results of the above tests from an earlier post of yours.

    The B12 level is good. If your daughter is supplementing she could lower her dose, or take the same amount but for fewer days of the week. If she hasn't been supplementing B12 in any form then this would be something worth knowing.

    Folate - this is rather low (in my untrained opinion). Personally I prefer to get my level up to mid-range or the upper half of the range.

    Vitamin D - this is plenty high enough. In fact it may be a little bit too high - the optimal level given by the vitamin D council is around 100 - 150 nmol/L . Stop supplementation for three - 4 months and then re-test the vitamin D. A lower dose of vitamin D supplementation may be needed after the level has dropped back into the optimal range - either a lower dose daily, or a higher dose on fewer days of the week. Unfortunately this tends to be trial and error. Personally, I have found taking 2000 iU per day keeps my level roughly where I want it, but it is something people have to work out for themselves. Lots of people stop supplementing in the summer, and start again when the clocks change in October.

    Vitamin D supplementation increases the amount of calcium absorbed from the diet. You want that calcium to go into bones and teeth, not end up lining the arteries. To achieve that it is necessary to supplement magnesium and vitamin K2. Read some of SeasideSusie's replies to get info on magnesium and K2.

    healthunlocked.com/user/sea...

    naturalnews.com/046401_magn...

    Ferritin - if your daughter is supplementing iron then she has gone high enough and needs to stop for a while. It isn't a good idea to have serum iron over the range, and the saturation is also higher than desirable. For info on optimal levels for iron-related results, see this link :

    rt3-adrenals.org/Iron_test_...

    Your daughter could re-test her ferritin, iron, TIBC and saturation in three months, and see what level she is at. It is very much trial and error with iron, finding what supplementation is necessary to maintain optimal levels. Once your daughter's iron results have dropped a bit, if she eats meat she may be able to stop supplementing iron altogether and instead eat a portion of liver or black pudding once a week.

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