Help with Low cortisol, adrenal fatigue and hypothyroid symptoms..

[Violet-clementine]

Hello..

Firstly, can I write that I’m finding everything confusing, upsetting and frustrating!

Secondly.. sorry for the long back story post.

I’m not very good at understanding blood tests, ranges.. I suffer from mental health issues (Generalised anxiety and AVPD) which mean my GP practice think I’m a pain and are really unhelpful, and I struggle with trust issues (haha, them thinking I’m a pain could be my paranoia!!!🤫)

So, I gained a lot of weight suddenly about 10 years ago now.. my hair started thinning and breaking, dry skin, tiredness, brain fog, crippling depression (it was before I was diagnosed with any mental health stuff)

The weight gain in particular really has affected my self confidence and has upset me massively. No matter what I do, healthy eating, calorie counting exercise 5 days a week.. nothing would help.

And I have hair extensions to try to make my hair semi normal.

I asked my GP to look at my thyroid function and they said the results came back normal.. which is great right! My weight gain etc.. must be because I’m getting older, maybe I should move more eat less and treated depression.

Over the years I have asked them to check a few times but they say that everything is always in range.

I have been doing Hiit and free weights 5 days a week and have been eating high protein low carb diet for probably 3 years and although I stopped gaining weight I didn’t really lose anything.

I started going to a health gym run by physiologists who use a machine to run tests on muscle mass, fat mass and several other things..

they worked out a resistance training programme and monitored my diet and re-tested me 3 months later. They were baffled that nothing had changed in that 3 months and said that something is definitely blocking my weight loss. It could be high cortisol due to stress.

So, my GP very reluctantly tested my cortisol level. And this surprisingly came back quite low! Twice!

They have now referred to endocrinology who want me to do a short synacthen test to rule out Addison’s (this is in August) but they said they’re pretty sure I don’t as I don’t have any other symptoms and one of the main symptoms is weight loss (which I obviously don’t have - I wasn’t insulted honest!)

They have also run lots of other tests that to check my pituitary gland and a few other things. They have written a letter to my GP and myself saying that everything has come back normal and if the short synacthen test doesn’t pick anything up they will discharge me and won’t need to see me again.

My opinion on all this is heading towards adrenal fatigue, and that I won’t get any support from the NHS and that my body and adrenals are just exhausted.

I’ve been really down and stopped going to the gym as it’s not really doing anything. But now unfortunately all my clothes are too tight and my self esteem is rock bottom.

But, when trying to decipher the results (as I got the impression they were just trying to get rid of me) I noticed that my T3 was slightly on the low side. Could this be something or am I clutching at straws! My Gp and endocrinologist say they are normal.

I’m very very fed up with it all.

Any advice on anything is very very welcome.

Thanks x

[greygoose]

Well, first thing you should do is post the results here, with the ranges, and let's have a look. When a doctor says 'normal', all he means is 'in-range', and that's not always good enough. It's where in the range the result falls that counts. So, let's have a look!

[Violet-clementine in reply to greygoose]

Thank you so much for your reply, I don't understand some of the test abbreviations and I am missing some of the ranges, but these are the results that my endocrinologist has sent my GP:

Cortisol 258 (>500)

HB 133

Na 139

K+ 4.1 (3.5-5)

Urea 3.5 (2.5-7)

Creatinine 60 (64-104)

Bilirubin 7 (<21)

ALT 24 (10-45)

ALP 45 (30-130)

Albuin 41 (32-50)

CorCa 2.36

WbA1c 35 (20-42)

fT4 14.3 (9-25)

TSH 1.33 (0.3-4.2)

fT3 3.1 (British thyroid foundation say 3.5-7.8 GP says its in their normal range)

FSH 5.6

LH 7.8

Oestriodiol 324 (200-730)

Vitamin D 69 b(50-70)

Prolactin 132 (80-400)

x

[greygoose in reply to Violet-clementine]

Yes, tests without ranges are useless. But your cortisol is very low, so good job he's doing further testing.

fT3 3.1 (British thyroid foundation say 3.5-7.8 GP says its in their normal range)

I'm afraid it doesn't work like that. You absolutely have to have the range used by the lab that did the blood analysis. There are not standard ranges. Don't know what the BTF was talking about, but you can't use just any range. In fact, that range is far wider than we usually see. It's usually 3.1 to 6.8, but they do vary from lab to lab.

[Violet-clementine in reply to greygoose]

They haven’t let me know any ranges and I won’t see them now. They haven’t explained anything but that it’s all normal.

FT3 range 2.6 - 5.7 is what my Gp go by.. I’m guessing they use the same labs as the local endocrinology department.

Yes, my cortisol is very low. They have said that some people have low cortisol and that’s just how it is. They are hoping to rule out Addison’s officially with the short synacthen test in August.

[humanbean in reply to Violet-clementine]

If you do a search for "pathology" at the website of your local hospital, (or the hospital that does the blood tests in your area) a few pathology labs do publish their reference ranges, so you might be able to find what you want to know that way.

But your GP and consultant can't refuse to give you information from your medical records. You are legally entitled to get copies. And that includes reference ranges.

[Violet-clementine in reply to humanbean]

Thanks!.. I’ll have a look x

[Violet-clementine in reply to humanbean]

I had a look on the website for pathology, but I couldn’t find anything.. and what was there I couldn’t really understand, so not sure if Ive just missed it.

[humanbean in reply to Violet-clementine]

It might not be available. Only some pathology departments publish reference ranges. It's always worth checking though.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4, TT4, FT3

plus very important to test both TPO and TG thyroid antibodies, also to test folate, ferritin and B12

Your FT3 result is useless without ranges

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

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. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Your vitamin D is on low side. Aiming to improve to around 100nmol. Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you try 1000iu for 2-3 months and retest. It's trial and error what dose each person needs. Once you Improve level, you may need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk

[Hidden]

What time was your cortisol blood test taken? If it was around 9am then it should be around 500nmol/L . Although the synacthen test may rule our Addison's it could be that you have secondary insufficiency which is treated the same way as Addisons but slightly different with the source of the issue. Make sure you get the results when you have it done. Unfortunately many endo's are not experienced with pituitary/adrenal issues so may well say that you results are fine when they may not be. The SST should show that your base level of cortisol doubles within the hour for it not to be a diagnosis of either Addisons or adrenal insufficiency.