Thyroid UK
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Interested in some advice regarding thyroid and Cortisol readings

So I’m male, 62, retired due to depression 3 years ago, lacking in enthusiasm and energy, but not stuck in my bed. I just can’t get going in the morning. Feel more enthusiastic at night but can’t get going. Taking 60mg of fluoxitine (which is the max I’m told) and some vitamins got my diet going well, but totally lack enthusiasm. Still see the Shrink, but I don’t have a clear pathway ahead, it’s just for a blether. He doesn’t think I should take myself on as a project! Friends and very understanding family give advice but I can’t, can’t go with it and move forward. Maybe it’s just me. Oh I also pee a lot in small quantities. It’s just old age? of course!

Got thyroid checked by Dr and he said it was within parameters etc etc etc blah blah. So, got two tests from Medical Company last year. Eventually summoned up courage to show the paperwork to the Doc, guess what? Yup! Didn’t even read the Doctors comments provided.

Here’s the info with the Normal range indicated. Let me know what you think?? I’ve chosen to make no comment, yet!

Cortisol waking 40.06 R 14 to 21

Cortisol 12.00hrs 9.46 R 4 to 9

Cortisol 16.00hrs10.22R 2.5 to 7.0

Cortisol before bed 5.17R 0.8 to 4.5

CRP 1.10R <5

Ferritin154.7R 30 to 400

TSH 2.17R 0.27 to 4.20

T4 Total77.7R 64.5 to 142

FREE T413.92R 12 to 22

FREE T33.77R 3.1 to 6.8

REVERSE T323 R 10 to 24

Anti-Thyroidperodoxidase Abs 44R <34

Anti Thyroglobulin Abs342R <115

Vitamin D 46Insufficient

Vitamin B12314 consider reducing

17 Replies
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Was there no range given with the B12? Was it an active B12 or a normal test?

Your thyroid is struggling, to have a TSH of over 2. And your FT3 is very low. Your antibodies are high, so you have Hashi's - do you know about Hashi's?

Your cortisol is high, so your doctor should be referring you to an endo for further investigation.

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I agree with grey goose-you need a referral to the endo - your morning one is very high.

I doubt your GP has a good enough understanding of cortisol and the effects.

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I think you are right.

Thankyou

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Assuming you are in UK?

Your vitamin D is low, but probably not low enough for GP to prescribe

Supplementing with vitamin D mouth spray by Better You Is good as avoids poor gut function of Hashimoto's. Perhaps try 3000iu strength once daily or 1000iu strength twice daily

Aim to increase level to around 100nmol

Important to retest 2-3 months after start supplementing as vitamin D is toxic in excess. Some peoples levels improve rapidly, others may need higher dose

Likely to need maintenance dose of 1000-2000iu once you improve to around 100nmol

Testing twice yearly ideally. Get out in sunshine in summer too

Low vitamin D is linked to depression

Do you supplement any B vitamins or take a multivitamin? Wondering why your B12 is so high

If you don't supplement then suggest you get homocysteine levels tested. High B12 without supplements is odd

No folate result?

As greygoose says.....your high antibodies confirm you have Hashimoto's also called autoimmune thyroid disease.

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's gut and gluten connection is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

Going strictly gluten free may also improve your depression

verywell.com/is-gluten-why-...

ncbi.nlm.nih.gov/pmc/articl...

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Hi SlowDragon

At the moment i'm taking B complex of the shelf from Tesco and Vitamin D 12.5ug also just of the shelf

I've gone Gluten free in the last few months and it has helped my digestive system big time. I can tell now whenever I have had gluten, although not sure what the timescale for this is? Would it be next day or two days or what? I am not 'down' as I was a few months ago, but have little or no energy nor desire to achieve anything. I function, my Dr says you look well to me. As for the sun, dont like going outside too much, part of the anxiety i'm afraid. And I do understand about exercise, but it means going out.

Some good advice which I will take on board, thankyou.

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SlowDragon, meant to say, due to brain fog forgot to add Serum Folate level which was 17.29 in a range of 8.83 to 60.8 nmol/L. Not sure if that good bad or perfect.

Thanks

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Your cortisol levels are high & needs further investigation especially if you are quickly gaining weight around your tummy, have insomnia, muscle & joint pains, have a round flushed face, these are all signs of Cushing's disease where your body is producing too much cortisol. You need to ask your GP to do a 9am cortisol blood test & 24 hour urines & refer you to an Endocrinologist who understands Cushing's - not all of them do!

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Hi PaulineS, struggling to lose weight, constantly around 190 lbs even although my meals are all so good and no carbs with protein etc. Alcohol helps of course! I don't drink very much though. All my weight is in my tummy, sleep has been poor recently and then I cant wake up in the morning. Joints are getting worse. Always feeling the cold too.

Thinking about what you say, cos I have been thinking about this anyway, I think I might try to see a different Doc at the practice.

Thankyou

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If you are Facebook there is a Cushing's UK group facebook.com/groups/2207009...

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Hi greygoose, not sure if the B12 test was active or normal.

B12 was 314 pmol/L insufficient should read <250 and too much should read >725

Everything was done at a cost in my Dr's surgery with blood samples. The cortisol was done by me at home. Dr should be refering me, yes but he'd need to read the results first!!!!!!!!!!!!!!!!

Thanks

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Well, then, you'd better show him! :) You do need testing for Cushing's, as PaulineS says. But, no point in asking for a 9 am cortisol blood test, because you've just done a 24 hour saliva test, which is far more accurate! But, you need a specific test for Cushing's - can't remember what it's called.

So, your B12 is a bit on the low side. It should be at least over 500. It wasn't an active test, by the way. Not the right range.

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Which company did your test

"Vitamin B12314 consider reducing.

B12 was 314 pmol/L insufficient should read <250 and too much should read >725"

Can you type out exactly what is written on the results sheet because what you've written there appears to be contradictory.

I think Medichecks does Active B12 and Blue Horizon does serum B12. If yours is serum B12 then it's too low, if it's Active B12 it too high.

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Hi Seaside Susie

Blue Horizon was the company. Sorry I don't have the vocabulary yet to explain myself clearly yet.

Vitamin B12 reads 314 pmol/L

deficient <140 insufficient 140 -250 consider reducing dose >725 is exactly what is printed. Can I add a picture to these replies?

Thankyou

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No, it's fine no picture needed :)

So your serum B12 is 314 and that is low, it should be at least 500 as anything below means that deficiencies can begin to appear in the cerebrospinal fluid, according to Sally Pacholok in her book Could It Be B12. Top of range is best, even 900-1000, especially in older people as it can help prevent dementia, and if you have no symptoms of B12 deficiency you could supplement with sublingual B12

b12deficiency.info/signs-an...

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"Serum Folate level which was 17.29 in a range of 8.83 to 60.8 nmol/L."

Just noticed this. Folate is too low, it should be at least half way through the range so 34+ with that range.

You need a good B Complex, supermarket and high street brands don't cut it I'm afraid, they tend to contain cheap ingredients and often the least absorbable form. I use Thorne Basic B which increased my Folate from bottom to top of range in 2.5 months and I now take it a few times a week rather than every day to maintain my level.

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Thanks Saeside,I will get on to that one right away

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You clearly have Hashimotos and maybe Central Hypothyroid as TSH t4 and t3 will always be low in Central Hypothyroid

But as said your cortisol results must also be investigated for Cushings

Time GPs got a kick up the bum and learnt to read and understand blood test results

Esp thyroid ones

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