Help with results please

[Deecam]

Hi everyone I have my results from Medichecks and I can see where my results for vitamins etc are low but do not really know how to interpret the thyroid, I wonder if someone can help. I apologise as this is a long post!

TSH = 2.4 (normal range 0.27 - 4.20)

Free thyroxine = 16.900 (12.00 - 22.00)

Free T3 = 3.79 (3.10 - 6.80)

Reverse T3 =18 (10.00 - 24.00)

Reverse T3 ratio = 13.71 (15.01 - 75.00)

Thyroglobulin antibodies = < 10 (0.00 -115.00)

Thyroid peroxidase antibodies = < 9.0 (0.00 - 34.00)

Active B12 = 72.600 (25.10 - 165.00)

Folate serum = 1.43 (2.91 - 50.00)

25 OH Vit D = 42.8 (50.00 - 200)

CRP inflammation marker = 6.46 (0.00 - 5.00)

Ferritin = 81.3 (13.00 - 150.00)

Cortisol saliva:

Waking = < 1.5 (6.00 - 21.00)

12 noon = 3.250 (1.50 - 7.60)

4pm = 2.110 (0.00 - 5.49)

Before bed = < 1.5 (0.00 - 1.99)

Genova test result Jan 2018 DHEA = 0.03 (0.25-2.22)

I was diagnosed as hypothyroid in 1997, I have no idea if I am hashi's? I was taking 125 mcg of Levo and saw Dr Peatfield who thought I had thyroidtoxicosis so reduced to 50 whilst giving adrenals time to recover. At 50 I had a red almost "glowing" butterfly shape thyroid visible (no discomfort) so increased to 75 and this has gone.

I am taking many supplements to try and improve my adrenal function (unfortunately intolerant to beef and pork so cannot tolerate Adrenavive.

I am taking so many supplements, however, (wheat, yeast, dairy, candida safe etc) that I am being physically sick. Migraines became so bad that two weeks ago on a visit to my GP (for migraine) he called an ambulance and sent me for emergency ct scan, Ecg and lumber puncture (all clear and yes they found a brain -yay!) Now taking Topomax which not thrilled about but better than debilitating migraine.

Sorry this post is so long but I'm obviously not doing something right - can anyone shed any light for me. I would be so grateful.

Many thanks

[fibrolinda]

Are you taking Levo? If so what dose?

[Deecam in reply to fibrolinda]

Hi Linda thanks for your reply I was taking 125 of Levo but was advised had Thyroidtoxicosis so reduced to 50 until adrenals recovered a bit. 50 was not enough so increased myself to 75 which got rid of the red "glowing" butterfly shape thyroid area on neck. Struggling to improve adrenals. DHEA in previous test by Genova = <0.03 (normal range 0.25-2.22). So have been taking 25mg of 7keto DHEA for a month now.

[fibrolinda in reply to Deecam]

I'm afraid Ido not know enough about DHEA to comment. What were your results when you were advised you had thyroidtoxicosis? Regardless of how overmedicated you were You were reduced by too much in one go, should only be by 25 at a time. Your poor body got a heck of a shock with a 75 reduction 😮

Now you are undermedicated.

What is being done about your dire folate and vit d? B12 would maybe be better up a bit and your ferritin isn't bad.

[Deecam in reply to fibrolinda]

Hi Linda we didn't actually have the thyroid results at the time of consultation and diagnosis of thyroidtoxicosis. I was advised to stop Levo completely for 5 days, order the Genova tests immediately - the results were T3 = 1.40 (0.61-3.38) andT4 = 4.38 (1.03 - 8.24)

T3:T4 ratio = 0.32. Order Adrenavive and start then recommence Levo at 50mcg. Although prescribed 125mcg by GP I had for some time been taking 200mcg in order to "keep going". I had been honest and my clinician knew of this so the reduction was even greater - going from 200 to nothing then 50. Yeh I did feel quite poorly, I know why now!

[fibrolinda in reply to Deecam]

Whoever this 'clinician' is he/she is dangerous 😣 good grief words fail me and I have to go out but hopefully someone more knowledgeable will be along to advise. humanbean knows sooooo much more than I

[Deecam in reply to fibrolinda]

Thanks Linda (I'm beginning to wonder!!) have a good day.

[Deecam in reply to fibrolinda]

Hi fibrolinda just an update. I am having NHS blood test tomorrow am for cortisol etc and my GP is showing my private tests to an endo colleague (although GP doesn't think they look too bad!). Fingers crossed the endo disagrees. Following bloods I will start supplementing for folate, vit D and B12 (although have been supplementing vit D and B 12 already - time to increase I think). Have a good day.

[fibrolinda in reply to Deecam]

Not to bad is not good enough unless you feel well. They need to be optimum eg, TSH below 1 and ft3 and ft4 in top third or even quarter of range unless on t3 or NDT as t3 tends to cause lower ft4 as it's mainly thought to be a storage hormone so as t3 is being taken direct storage isn't really required. Gosh hope that makes sense my brain is fogged... And fried with the heat... Not complaining, not complaining I'd rather sweat than shiver lol.

Are they testing thyroid or just cortisol? If thyroid don't take Levo for 24 hours before and fast in morning, water only till after test🙂

Are you taking k2 mk7 with the vitamin d? It helps direct calcium to bones etc rather than elsewhere. SeasideSusie is the most knowledgeable person I have ever come across on vitamins and minerals (and heck of a lot other stuff) Worth looking up her posts to others.

Very best of luck tomorrow... They're looking into Addison's as humanbean advised?

[Deecam in reply to fibrolinda]

Hi Fibrolinda thanks for your reply. The bloods were for thyroid, CRP, cortisol and something I forget - brain fog!. I took your advice and no Levo for 24 hours and fasted I'm morning only water. They said the test results would be available at GP in two days but I had a call from a GP at my surgery asking me some questions. Apparently my cortisol was 45 (normal range 150-600) and he wanted me to start tx straight away. He phoned the lab to make sure hydrocortisone would not impact future endo tests (yes I'm getting an urgent referral to an endo -please let them be any good). Then he phoned me at 5.40 told me to go straight round and get to a night chemist to start the Medes immediately - not to even wait till tomorrow. Urgent referral for investigation into possible Addison's. Wow what a turnaround! Thank you and Humanbean and everyone on this site for such wonderful encouragement. I will let you know how I get on. Bless you x

[fibrolinda in reply to Deecam]

Yes please do keep us informed and hope you start improving soon. ((hugs))

Linda x

[humanbean]

You urgently need to ask for testing to find out if you have Addison's Disease. You are producing so little cortisol that a stressful event could cause you to go into adrenal crisis, which is a life threatening emergency. Your doctor will insist on giving you a blood test for cortisol before referring you. Make sure the blood test is done at about the same time as your first saliva sample was produced, or as close to it as possible.

nhs.uk/conditions/addisons-...

patient.info/health/tiredne...

patient.info/doctor/adrenal...

en.wikipedia.org/wiki/Addis...

en.wikipedia.org/wiki/Addis...

en.wikipedia.org/wiki/Adren...

[humanbean in reply to humanbean]

Just noticed that you have been taking DHEA. If/when you get tested I think you should mention you have been taking DHEA. I don't know what effect it will have on your results (I'm not a doctor). For all I know it could mask the true level of your cortisol.

[Deecam in reply to humanbean]

Hi human bean and fibrolinda just to keep you updated I have been to my GP and shown him my private test results. He has ordered NHS blood tests (tomorrow) and says he will be showing my tests to an endo friend to get their response - although he said he personally thought they "didn't look too bad"! So fingers crossed x

[humanbean in reply to Deecam]

OMG, I do hope the results are definitive, one way or another. Ideally, cortisol should be at the top of the range first thing in the morning, not a long way under it!

Take a look at Example 1 on this page :

rt3-adrenals.org/cortisol_t...

Hope it all goes well for you, good luck.

[Deecam in reply to humanbean]

Hi humanbean thank you for your reply and info. It is possible you may have saved my life. I booked the cortisol blood test for the same time as my morning saliva test. My result was 45 (normal range 150-600). The lab phoned a GP at my practice the next day (today), who phoned me, asked me some questions and said he needed to check something with the lab and get back to me but he wanted me to start treatment immediately. He phoned back asking me to go to the surgery immediately, he had checked with the lab if he could start me on hydrocortisone or whether this may effect endo tests. He said I must start immediately as he did not want to wait to wait until tomorrow. He is making an urgent referral to an endo for investigation into possible Adisons. I hope I get a knowledgable endo - fingers crossed. So thank you so much humanbean, without your urging to get tested urgently I may have waited another couple of weeks. Bless you x

[humanbean in reply to Deecam]

You're welcome!

I'm so glad that you are getting the treatment you need and are being taken very seriously! Be aware that you may need to carry a steroids card (or a Medic Alert bracelet or necklace) for the rest of your life - ask about this if it doesn't get mentioned. If you have an accident or an emergency then medical staff need to know that you are on steroids - and steroids must never be stopped suddenly :

cks.nice.org.uk/addisons-di... (On this link click on the subjects in the left hand column for lots more info.)

shropshireccg.nhs.uk/media/...

Now that you are getting your cortisol replaced you should (hopefully) start feeling much better. I can't remember if you are on thyroid treatment, but I wouldn't be surprised if being on steroids has an effect on your thyroid hormone levels anyway, and any other drugs or treatment you take routinely, so you may need to alter dosages of various things or just re-test to see what is happening. Something to be aware of, anyway!

Some more links :

addisons.org.uk/articles.ht...

msdmanuals.com/en-gb/home/h...

msdmanuals.com/en-gb/profes...

Good luck!

[Deecam in reply to humanbean]

Hi humanbean - ha ha I've just this minute ordered a medic alert pendant then read your post! My other GP called me in today to give me a prescription for folic acid and told me about the card/alert for the hydrocortisone and to never ever run out.

Many many thanks for all your support and for the further information. Further blood tests are planned for 3 weeks time and seeing endo at some point. I will keep you posted.

Keep well x

[Deecam in reply to humanbean]

Thank you so much human bean and I'm so grateful for all the links you have included. So much work to help me - thank you x