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Thyroid UK
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High cortisol - help, please!

Hi there,

I had a saliva test done by Genova and it indicates high cortisol on all four occassions :( DHEA is 0.12 (0.05-0.32).

I was put on Ashwaganda, 2 x 500mg magnesium, phopsatidyl serine, b6, b12, iron, taking also vit D 4000 units (levels are good). Added holy basil to the mix yesterday. I feel really tired, massive brain fog that makes me unable to work, have issues sleeping and I wake up at 4 am or later (2 months now).

I see that stress exarbates everything. Been reduced/stopped 3 grains NDT in July and restarted after 1 month on 3 grains again. Nothing feels quite right :) the way I feel fluctuates throughout the day massively and it just hits me. Stress makes it 100% worse. Considering SSRIs at this point! Also melatonin or Ambien did not work.

Estrogen and progesterone are both low. Was prescribed hrt for them, but a bit hesitant if I should take them...anyone with any advice...? Thank you

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Did you just stop your thyroid meds and restart at the same level? I t would be hard for your body to tolerate that. Have you had your thyroid levels tested recently and can you post with ranges?

I'm a psychotherapist and I personally dont believe that antidepressants are very often helpful and can even make the situation worse.

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Thank you for responding so quickly!

Yes...I realised after the fact that this should never taken place (doctors made a lof of bad decisions based on my tsh...).

My tsh is <0.01 (on NDT)

Ft3 = 6.5 (range up tp 6.8)

Ft4 = 19.1 (range up to 22)

I have Hashimoto's.

Vit B12 = 440 (197-771)

Vit D = 85 (30-125) - on 4000 units of vit D for 2.5 weeks at that point

Ferritin = 34 (13-150) - on iron supp for 2.5 weeks at that point

The worst symptoms right now are levels of energy, just all flat and picking up towards the evening, then trouble sleeping and I am very pale with bad acne (had a great up until August more less)...

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Your T3 was a nice level and on NDT your TSH would be naturally suppressed. This can make doctors unnecessarily nervous lol. Your B12 could be higher - mine is often over range and I'm fine with that. Hopefully D will rise but did you know it should be taken with K2? Its all about directing the calcium released. Your ferritin is still miserable. Have you had cortisol checked? It could be the reason why you are more lively in the evening and have trouble sleeping. Cortisol should be highest in the morning and gradually decrease and it is affected by stress (its known as the stress hormone)

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so this is my labwork from the last few weeks, after restarting mid-August this year.

I did the Genova test and I am high throughout the day on all 4 markers (8 am, 12 pm, 5 pm and midnight).

My B12 should be higher now and same with vit D - I have been taking them all the time since labs end of October. Ferritin should be rising too.

I am also quite anxious, going to CBT, but to be honest, I cannot manage this tiredness and brain fog. I was under a lot of stress this year too with moving countries, breaking relationship, new job etc so and then doctors told me to go off NDT for a month, then was put on 3 grains again...I am afraid this could be the result of it? I don't think it is my thyroid at this point? thanks!

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Your thyroid levels looked quite good and never should have been messed about with. I'm glad that other low levels are being addressed. I'm also really sorry you've had such a hard time over the last year. Chronic anxiety takes all our energy and raises our cortisol. I have a lot of people who come to me after trying CBT - it isnt best for everyone. If your anxiety is not reducing ask to see a counsellor or psychotherapist.

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I see my psychotherapist regularly.

I am just wondering if taking 3 grains straightaway could have had such a bad effect on my cortisol/adrenals? I am sure anxiety did add to it as I didn't know what was happening to me at the time.

thank you!

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You haven't posted what your cortisol levels were although you said they were high. Have you gained weight rapidly especially around your middle? Do you know what your BP is? Do you have a round face which gets red? If so have you looked at Cushing's syndrome?

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Okay, here it goes:

Sample 1: 13.49 (range 2.68-9.3)

Sample 2: 3.59 (0.75 - 2.93)

Sample 3: 3.75 (0.36 - 1.86)

Sample 4: 0.94 <=0.094

Dhea = 0.12 (0.05 - 0.32)

My previous adrenal saliva test was normal mid-2015.

I don't know, but I think I have some fat around my waist, but I am generally losing weight.

My bp is generally 100/60. My pulse is 72 or lower.

My face has been always more less round so not sure. I am mostly pale, but have bad acne for couple of months now, very oily skin - came out of nowhere.

Looked up Cushings, but not al matches so not sure. Could be just big stress? My estrogen and progesterone are off too...

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Your levels are fairly high but as you're loosing weight rather than gaining than it seems to rule out Cushing's - I'm glad about that you might not have it as it's not a nice condition.

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I think it could be high stress and anxiety altogether, have no other explanation. It all started with steroids taken for 2 days and stopping. Then doctors took me off thyroid medication and put me back on it.

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