I have thought for some time that my symptoms of hashi’s may be linked to adrenal fatigue/malfunction.
Here it suggests that taking thyroxine can make these worse which could also explain why for me an increase in thyroxine causes my TSH to drop drastically causing my GP to panic and reduce. I found this article very interesting and I can relate to what it says. I have requested a second opinion from another nhs Endocrinologist and hope to discuss the possibility of adrenal fatigue.
I have adrenaline rushes in the night and hot sweats.
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
All thyroid tests should ideally be done as early as possible in morning and fasting.
If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
Last GP tests 26/03/2018 (T4 TSH and Vitamin D) when I was on 50mcg Thyroxine
T4 level 20 pmol/L [10 - 20]
TSH level 0.66 miu/L [0.5 - 4.4]
Vitamin D 112 nmol/L [24 - 167] (have been supplementing since October 2017)
Previous GP tests:-
15/03/2018 when I was on 37.5 mcg Thyroxine (Lab would not do other thyroid tests)
TSH 1.1 miu/L [0.5 - 4.4]
04/01/2018 when I was on 25mcg Thyroxine (Lab would not do other thyroid tests)
TSH 3.4 miu/L [0.5 - 4.4]
Last full thyroid tests and Vitamin D with Endo was 1/2/2018 when I was on 25mcg Thyroxine
TSH 1.8 mu/l (0.5-4.4)
FT4 13.6 pmol/l (10-20)
FT3 4.8 pmol/l (3.5-6.5)
Vitamin D 70 nmol/l (24-167) (have been supplementing since October 2017)
Folate and ferritin have not been done since 26/10/2018 along with Vitamin D B12 and short sycanthen test which came back 'normal'
Folate 8.6 (3.0 - 17.0) (have been supplementing since then)
Ferritin 75 (12.0-300) -previously 117 on 25/09/2017 (have been supplementing since then)
Vitamin D 50nmol/l (24-167) - this rose to 70 on 1/02/2018 as stated above (have been supplementing since then)
I have since been reduced to 25mcg prior to my major operation on 03/04/2018 by GP because of low TSH, however I have now increasd myself up to 37.5 mcg over past 6 weeks and thinking of going up to 50mcg again, although my TSH drops very low on that.
My last TPO antibodies were done 03/10/2017 which were 1300 (0.0-60.0)
Please note results in 2010 when a private Doctor put me on 75 mcg Thyroxine:-
When did you have low TSH? 0.66 isn't low - it's well in range and where a very large number of healthy people naturally have their TSH. Very low is 0.0?? I think you need a new GP. You also need to know free T3 as I suspect you aren't converting well.
But that was 7 years ago, and many people need suppressed TSH in order to have high enough free T4 to make enough T3 - or you might have been having a Hashi's flare if you didn't feel well a that time.
Make sure all vitamins are optimal before increasing Levo back to 50mcg
Can't see a B12 test result? Can be lowered by anaesthetic of operation
A good vitamin B complex will help keep all B vitamins in balance, helping folate and B12 too. One with folate in, not folic acid Eg Igennus Super B complex
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
If you can wait 6-8 weeks on 37.5 mcg before getting full private testing. Then you will know exactly where FT3 is.
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
Many need TSH pretty low on Levothyroxine in order to get high enough FT4 and most importantly FT3.
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
(Many of us need TSH nearer 0.2 than 2.0 to feel well)
Just testing TSH, FT3 and FT4 would probably be enough then, though it's good to test thyroid antibodies once or twice a year to see if dropping, especially when on gluten and/or dairy free diet
Be warned, it's very rare to find a doctor that believes that adrenal fatigue exists. For them, you either have Addison's, or Cushing's or there's nothing wrong with your adrenals. It's all black or white, to them.
This happened to me with an Endo. Because his 'gold standard Synacthen test' was fine, he said there's nothing wrong with me. Dr Barry Durrant-Peatfield says that this test is not worth the paper it is written on.
Two weeks later, I collapsed as my adrenals were failing. An emergency appt with a functional Dr means I am still here. Addressing the adrenals and thyroid has been a difficult journey as its hard to raise the thyroid dose while adrenals are struggling but getting there now as I am on two grains NDT.
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