Would love some thoughts / comments on my MediChecks results please.
Bit of background- I was diagnosed with primary adrenal insufficiency (Addison’s) at the start of this year and am on hydrocortisone, which makes me feel a million times better in myself although still quite tired
There are a few things though that niggle me and don’t seem to have improved with HC, so I decided to get everything checked...
I am permently freezing cold (morning temp is about 36.0-36.3), my hair comes out in handfuls, we’ve been trying for a family for 12 months with no luck but all tests have come back ‘normal’. My resting heart rate is also between 38 bpm and 42 bpm permently.
I decided to get a full check with MediChecks just to see how everything looks and see if it gave me any clues as to the above.
These were my results:
TSH 2.2 mIU/L (0.27-4.2)
FT4 15.3 pmol/L (12-22)
FT3 3.5 pmol/L (3.1-6.8)
TGAB 10 IU/mL (0-115)
TPOAB 9 IU/mL (0-34)
Ferritin 48 ug/L (13-150)
CRP-HS inflammation 4.74 mg/l (0-5)
Vitamin D 68 nmol/L (50-200)
Folate 19.98 ug/L (2.91-50)
All comments really appreciated 😀
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Bramble83
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Morning Bramble83 I'm not knowlegable enough yet to help but just wanted to say that doing a Medichecks set of tests has helped me get through to another stage of NHS tests that I was going to be denied. Found them really helpful in gaining more control of ongoing symptoms that were being dismissed.
I can see things that probably need attention but will leave it to other brill people on this forum.
I'm interested in what others have to say as I'm being investigated for Addisons and it's all new to me.
Thank you Sally and really pleased to hear that it helped you.
How far along are you into your Addison’s investigations? What tests have you had so far? I think I was quite lucky and mine was diagnosed without any delay or difficulties but I get the impression that’s not the case for everyone x
Hya thought my reply hadn't been sent so you will get a slight repeat of my first one. sorry! Bit early for my brain.
I'm only at the start of investigations for this but its as a result of help from Thyroid UK forum re thyroid levels results and the possible reason it may be to do with Central Hypothyroidism. Years of deteriorating health but always told results were 'normal' or 'all in my head' , Chronic Fatigue, Fibromyalgia, ME etc. All my results were at the bottom of the ranges for years so considered to be ok but symptoms said otherwise.
I've learned a lot since then and stand my ground better now though that's hard at times. GP is supportive to me though.
Just lucky I had a bit of money come my way and could afford to do these private tests. Not everyone has that choice sadly. But for the same reason as you I wanted everything checking at the same time so I had a baseline to work from.
My cortisol is practically non existant (unmeasurable) in the morning. Peaks at 2pm when I'm most tired!! Then disappears again.
On 21st August hospital will do early morning cortisol blood test and Synacthen test. So it's a start.
Also having Cardio tests and waiting for results.
My hot water bottle is my best friend all year round apart from the very very hot days and my salt intake amuses my friends!!
Well it’s fab that you’re getting a synacthen test so soon- there’s no ambiguous results for those, so you should get an addisons diagnosis no problem at all if your baseline cortisol is undetectable.
I feel like a different person since being on daily hydrocortisone.
Well, first off, your ferritin is very low. And your vit D could be higher. Can't see a result for vit B12?
For your thyroid, the TSH says it's beginning to struggle a bit. And your FT4 is a bit low. But, your FT3 is very low, and that's where the problem probably lies.
However, doctors only go by the TSH, and they take one look at yours and think there's nothing wrong with you because it's mid-range, and they think that's wonderful! And they've been told that to get pregnant the TSH just has to be under 2.5, so everything must be tickety-boo! They just have no idea about the FT3.
So, you really need to keep an eye on this. See if your FT4 and/or FT3 go under-range. Your TSH should be higher with such a low FT3, and that might indicate a pituitary problem - Central Hypo. But, at the moment, it would be very difficult to find a doctor that knows enough about thyroid to investigate it.
Thank to Greygoose, it was actually your previous advice that gave me the encouragement to get everything else checked and a full set of tests.
I tried discussing the T3 result with my endocrinologist and you’re correct, he thought it was absolutely fine!
I’m seeing an infertility specialist on Tuesday who is also an endocrinologist so i’ll see if he’s a bit more interested!
Having done a bit of reading up I’m thinking the low ferritin is probably why my hair is falling out???
Is there any reason it would be so low? I presume a high dose of iron tablets would sort that out.
That Vit D result is actually whilst supplementing at 4000IU per day for the last 6 months. Do you think it’s still a bit too low?
B12 was 248pmol/L (25-185) but this is because i’d been taking a high strength supplement at the advice of my GP to see if it made a difference to my short cycles whilst trying to get pregnant. I have stopped taking this now as it’s made no difference after 3 months but clearly very much elevated my B12.
So I guess it’s a case of wait and see if the results get any worse before someone will take any notice of the thyroid ones.
How often would you recommend testing to see a difference from one set of numbers to the next?
I will get retested in 3 months and up my dose of vitamin D.
Is there anything I can do to increase my t3 without the help of a doctor or do you think I’m best to hope it drops below the range in 3 months and someone does something about it?
I don't think there is anything you can do to increase your T3, no. If your thyroid is incapable of making hormone, for any reason, the only thing you can do is take thyroid hormone replacement - T4 or T3.
It is, yes, but I wouldn't recommend you self-treat at this point.
How was your primary adrenal insufficiency diagnosed? Did you have an ACTH test? Are they certain the problem is with the adrenals themselves, and not with the pituitary?
Yes I had 3 synacthen tests done (as they were surprised I was doing so well considering the result) and failed all 3 and my baseline ACTH was raised, hence the primary not secondary diagnosis.
OK, because it's strange that you have the adrenal problem and the low TSH…
Still, try raising your nutrients and see if your TSH rises a bit, which will raise your FT3. If you rush into self-treating now, you'll muddy the waters and make it more difficult to find out what's wrong. But, if you could get a test for Human Growth Hormone, that might help with understanding of the problem. How are your sex hormones?
Sorry this is all quite new to me- why would the adrenal problem and low TSH be strange?
It’s intesrting that my TSH has shot up since I was put on hydrocortisone- before that it was 1.26. There are a couple of scientific articles I found saying it’s not uncommon and untreated adrenal problem can falsely lower TSH? Not sure if you’ve heard of that?
Aldosterone is very low 60 (80-640) too which was seen to support the primary AI diagnosis.
DHEA was borderline, so they’ve put me in a supplement for that. Testosterone was right on the border of the low end.
Progesterone seems to be very low and thought to be one of the reasons i’m struggling to get pregnant- the second half of my cycle is only about 7-9 days rather than the 14 it should be. They seem to think it’s becaise my body was putting all its effort into trying to make cortisol so there was a ‘pregnalone steal’ taking place resulting in low progesterone. I do ovulate each month without fail though.
My SHBG was high though, which no one seems to understand.
My inflammation marker is also right at the top of the range and was flagged for repeat testing my MediChecks but I think inflammation is quite common with low cortisol.
why would the adrenal problem and low TSH be strange?
Because, they can both be caused by the same thing, a pituitary problem, and yet they're saying the adrenal problem isn't caused by the pituitary.
We frequently see low cortisol with a high TSH - i.e. hypothyroidism. And, hypothyroidism causes a high TSH UNLESS there is a pituitary problem.
Thyroid Stimulating Hormone. The pituitary secretes it when it senses that the level of thyroid hormones in the blood is low. The lower the thyroid hormones, the higher the TSH. But your FT3 is sitting on the bottom of the range, which is not 'normal', no matter what doctors might say, and yet your TSH is bouncing along at mid-range. It should be higher than that.
I wouldn't exactly say that going from 1.26 to 2.2 is 'shooting' up. It's still not high enough to stimulate the thyroid to make thyroid hormone. It could be that your low TSH is caused by low cortisol. So, what are your cortisol levels now? Are they back in the right place?
Aldosterone is very low 60 (80-640) too which was seen to support the primary AI diagnosis.
I'm not too sure how that works. I though that if there was a pituitary problem, it would affect all the adrenal hormones, not just the cortisol.
I don't know about SHBG, but I thought that was usually high when sex hormones were low.
What would Human Growth Hormone Show me?
HGH is also a pituitary hormone. There are quite a few :
So, if that was also low, it would be another indication of a pituitary problem.
I think you're going to have to adopt a wait-and-see strategy, whilst retesting your thyroid hormones from time to time, to see how they're doing. You're obviously not going to get a diagnosis of hypothyroidism at the moment, and things might change, anyway, if it's all caused by low cortisol.
I don’t know about my cortisol levels at the moment- i’m on 20mg of HC a day and will see my endocrinologist again in a few months. They don’t really tend to monitor levels just go with how you feel. I still feel quite tired but nothing like before.
I will look into whether I can get a private test done for the human growth hormone, as would be interesting to know.
I’m not too sure about the aldosterone either but on all the diagnosis charts primary requires aldosterone replacement and will have low aldosterone values and high renin (which I have both) whereas secondary doesn’t and will have normal values apparently.
Thank you so much for all of your help- I will wait and see what the fertility specialist says on Tuesday as I think generally they want tighter controls on thyroid than endocrinologists and GPs.
I will also do as suggested and get retested in 3 months time.
I really appreciate the time you’ve taken to help me 😀
although you thyroid hormones are within the normal range i think it likely that they are too low for you and you might benefit from some thyroid hormone. You pulse and temp clearly indicative. You could also consider taking some ferritin, floate and vit D with K2 for a while to see if that helps your thyroid function. Thye are all a bit low and if you support these your thyroid function may well improve with out starting on thyroid hormones. It is a rather long and winding rd to getting well from these issues. It might alsos be worth getting your B12 tested and take some B12 after whatever the result. Better4 U do a nice Vit D and k2 supplement and a B12 spray. Your Vt d needs to be nearer 100 and ferritin could be a bit higher for good thyroid function. You can buy some ferrous sulphate from the chemist but do not take for more than a month without re testing.
My own TSh has rarley risen above 2 but I cannot function with out thyroid hormones. I have a freind who is in her 80s I advised her totry the vitamin and mineral approach first btu after a couple of weeks she bought some thyroid hormones. The change in her is remarkable, she has looked sort of haggerred and sressed for years she now looks twenty years younger, has lost loads of weight and is running around like a 30 year old. Her TSh was only 1.5 hence my reluctance at the time to such suggest the hormones straight off but she clearly needed them.
The longer I spend on this forum the less seriosuly I take the TSH test. It is for the most part codswallop.
Those results are actually after supplementing with Vit D at 4000IU per day for at least the last 3 months.
The ferritin is after supplanting with 65mg ferrous sulphate per day for the last 3 months.
I am also in a prenatal vitamin in the hope that at some point I finally fall pregnant, so that includes 400 of folate per day.
My B12 is actually super high as I have very short cycles and my GP suggested I try a B12 supplement. It made no difference so I actually stopped that a month or so ago. Result was 248 (25-125)
I am struggling with my weight and have been for quite a while- I run 3 times a week minimum (5-8km each time) and despite religiously sticking to a 1200 calorie per day diet can not lose any weight.
I am super happy to try taking something but unsure if I should wait a few months and see if the T3 and T4 levels drop and TSH rises to a point where a doctor will pay any attention.
I presume you didn’t have your doctors support for thyroid hormones with your levels and have self medicated?
Do you then just regularly get private tests done to check everything is okay?
People with thyroid issues do not absorb vitamins very well. You do however need about 10,000iu a day of Vit d to get levels up when low. You will reduce your thyroid function even furthur by not eating enough and with strenuous exercise, it will be very counter productive for your health and weight loss. Have a look at a site like, weight loss resources or myfitness pal and use thier app to calculate how many calories you need a day to maintain and for now stick to that.
You TSH might not ever raise to a point where your GP is able to treat you. I have a good relationship with my doctor who knows that I self treat, takes blood for me and is happy to discuss. he accepts that I need the thyroid hormones and has seen me become very ill without them but will not treat as like many doctors he feels unable to divert from conventional practice.
My own experince of having children when not properly treated or even at all treated for thyroid problems has been having two children with significant learning difficaultys, my own health deterioating badly and now my youngest is ill with CFS. If only I knew then. I would therefore recommend you taking at least a year to get really well before trying to get pregnant. You are not well. Your periods might also sort out on some thyroid hormones.
That’s really sad that it’s had an impact on your children 😔
Where do you buy your thyroid from and how did you decide what dose to take etc?
I would love to take a year before trying to get pregnant but I am 34 already. Also during my blood work one of my fertility hormones came back at the upper limit which suggests low ovarian reserve. Premature ovarian failure is also one of the side effects of Addison’s, so I need to be careful about waiting too long, as it seems time isn’t really in my side. Fortunately we have an appointment with the fertility specialist next week 😀
You might try a tablespoon of coconut or MCT (MTC?) oil in your coffee every day and check into "The Real Skinny on Fat", functional medicine (Dr. Mark Hyman) and Dr. Izabel Wentz - that will show why you aren't losing weight even from running and a low calorie diet. Your body may have lowered its temperature in response to being 'starved' and a lot of your body functions are slowed down (incl. hair/nails) in order to turn available energy to the most important ones.
I would normally recommend things that could help t4-t3 conversion as they've helped me (see first link). restartmed.com/increase-fre...
(I'm not a non-converter - just a bit of a reluctant one.) However, it seems you're also struggling to encourage your thyroid to make hormone in the first place. I agree with previous posters that you need someone to take your actual thyroid hormone levels seriously - not the TSH. This is possibly how the body deals / over compensates when your adrenals have been sluggish for so long. Now, that you are getting adrenal hormone the thyroid likewise needs to be kick-started back into action!
I suspect that you now have a general suppression of the hypothalamic-pituitary-adrenal axis. I also suspect (and would certainly want your doctor to test the possibility) that you may have some Secondary Adrenal Insufficiency in your pituitary (still classed by endos as Addison's Disease - which is confusing). Normal/ Low TSH levels for anyone with pituitary issues cannot be relied on as a diagnostic marker of healthy thyroid production. It certainly warrants more investigation of your pituitary in general as it's also linked to fertility problems - I found this link (I think it's a US one) but looks helpful.. good luck. I also added Dr Myhill's link as I find her stuff useful in general.
Thank you, those links are really interesting and will be really helpful. I will start trying some of the things to enhance T4 to T3 straight away.
Can I ask how you know you’re a ‘reluctant converter’?
I’m fairly certain I’m only primary AI as my ACTH is elevated and my aldosterone is very low, which from my understanding both preclude secondary but maybe it’s still a possibility.
The difficulty is knowing what to do next when no one is interested in the T3 reading because my TSH is fine!!
I've probably always had issues with low in range t3 possibly due to adrenal fatigue, but more likely low iron. Getting iron levels up has helped enormously. I supplement selenium, zinc and magnesium too and take one good quality b complex plus additional p-5-p (b6) when I am experiencing stress. It's important to note that taking iron is tricky and requires vit C. Also, some people (me included) do need lambs liver or slow cooked lamb to boost levels (good source of zinc as well which is vital for adrenals).
Bramble83 can I ask what symptoms you had that made you get tested for Addison’s?
Whilst I don’t think my adrenal insufficiency is that bad, I strongly suspect it’s pretty poor and is heavily involved in my symptoms.
I did a Jedi checks test for cortisol and it was all quite low but I was advised that I really need a better test and dhea too, so I’m waiting on a Regenerus test arriving.
Did your gp suspect Addison’s or did you have to convince them?
I’ve been really lucky and my diagnosis has been really simple and straight forward, although I get the impression that’s not the case for a lot of people.
The thing that made me go to the GP was that I started drifting in and out of consciousness and passing out and after a while I narrowed it down to what was causing it; alcohol, caffeine and exercise.
I went to the GP and they sent me for testing on my heart- echos, ECGs etc and all came back 100% fine but the loosing consciousness continued.
By pure fluke I worked out that drinking a glass of orange juice or a bottle of coke made me feel much better, so I suspected low blood sugar and bought a blood glucose monitor from amazon.
Through testing when I was starting to feel really shaky I worked out that my blood sugar was dropping below 2, which is quite dangerous and I was very symptomatic with it.
I went back to the GP, they tested me for diabetes which came back negative, so he referred me to an endocrinologist.
They admitted me to hospital for the day and did a glucose tolerance test which was 100% normal.
At that point he said the only other thing he could think of that could cause hypoglycaemia was adrenal issues, so he booked me in for a synacthen test.
I had 3 tests over the course of a month because I wasn’t particularly symptomatic except for the hypoglycaemia and failed all three.
I also had my baseline cortisol and ACTH checked and my baseline was very low and my ACTH high, which confirmed a primary insufficiency diagnosis.
They put me on daily hydrocortisone and I hadn’t realised how bad i’d felt until I started taking it. I realise now that I was completely and utterly shattered the whole time but i’m quite a ‘get on with it’ kind of person so just put it down to working hard and being busy. I knew I hadn’t felt like doing as much as I used to but again just got on with it, didn’t really want to spoil anyone else’s fun and put it down to doing to much and working too hard.
The only other symptom I had noticed which did make me wonder if something wasn’t quite right was I found it very difficult to concentrate.
What were your actual cortisol results from MediChecks?
DHEA may well be okay as it’s the opposite side of the cascade to cortisol so can be reasonably unaffected.
Aldersterone will give you a good indication as that will be low.
Just realised I’ve put “Jedi” checks! 😂 Ha ha, I’m no Star Wars rebel, “medi” checks clearly!
Also, I have major monthly problems now with endometriosis pain, something I’ve never had before, and there is no family history of, but I strongly suspect is due to the progesterone steal.
If only my gp would make the same links I have......
V interesting! I too find that I feel much better if I eat something, even if it’s just a sugary sweet. I definitely struggle when I need to eat, even if I don’t yet feel hungry. My glucose/diabetes/heart checks were all normal. I’ve never passed out tho. All my symptoms are on my profile.
Much like you, I’m a get on with it sort of person so after my initial crash last year I’ve just been battling on. I’m better than I was then but I’m far from right. The fatigue and other weird things are awful.
My cortisol results were:
morning 8.35 (6-21.00 nmol/l)
12 noon 1.59 (1.50-7.60 nmol/l)
1600 <1.5 (0-5.49nmol/l)
Bed <1.5 (0-1.99nmol/l)
I’ve been taking all my supplements to try to help my adrenals so it’ll be interesting to see why the new tests show.
Any ideas you have would be much appreciated though as I continue in my quest to be well again!
I’m not familiar with those units and am not sure how to convert them. I am used to seeing cortisol in the 100s as a measurement. Although clearly you’re at the low end of the scale.
Perhaps you could exaggerate your low bloody sugar? If you tell them you’ve started passing out they will have no choice other than to take some action. Saying you’re tired or don’t feel well doesn’t seem to get you very far but passing out is an entirely different matter.
As hypoglycaemia is a well known symptom of adrenal insufficiency it is a simple link to make.
My recommendation would be that you push very hard for a short synacthen test with your endocrinologist. It’s a super easy test... it’s literally two blood tests, one before and one after an injection and the results are very easy to interpret. Either you pass the test and your adrenals are okay or you fail it and something needs to be done.
I suspect that as I’m hypothyroid, following a period of extreme stress my adrenals had finally had enough resulting in firstly my crash, then this continuous battle to feel well. In recent months I’ve made the low blood sugar link so I will push that point (and maybe embellish a little!) with my gp. It’s not so far from the truth as sometimes when I’m on my period, I have nearly passed out. I’m guessing because of the extra strain this is putting on my system.
Here’s hoping I’m a stage nearer a conclusion , thank you 🤞🏻
I would definitely embellish a little as nothing scares a doctor more than someone passing out- it really does mean to them that they have to take action. As blood sugar is so transient they also have no way of knowing / proving that you might be embellishing slightly!!
If you happened to have been driving at the time you will scare the life out of them (I very nearly passed our whilst driving- pulled into a garage forecourt and was lucky enough that someone saw me in the car not looking too well and asked if I needed anything. yes! A LOT of sugar).
It frustrates me as a synacthen test is such an easy way to diagnose adrenal insufficiency but it seems like the last test in the world some people get offered.
Folate and ferritin need to be higher. You have very mild Hashimoto's (don't let a doctor tell you a non-zero reading for TPO or TG is OK). Have you made any dietary changes? I would suggest you evaluate your diet for unsafe foods, of which gluten and dairy are the first candidates. Your FT3 is too low, needs to be between middle and top of its range. Are you currently taking any thyroid hormone(s)? I would be suspicious that your CRP might decrease if you supplemented all B vitamins from a high-quality/non-synthetic source. Did your tests include a B12 reading? A trace mineral supplement that includes selenium and zinc might help you convert T4->T3 better.
No i’m not taking anything for thyroid, only hydrocortisone for primary adrenal insufficiency.
Yes the results did include a B12 but it was sky high (248 with a reference range 25-165) due to supplementing at a very high level as suggested by my GP as my cycles are very short and we’ve been trying for a family for fhe last year. I have stopped that supplement now.
I haven’t made any diet changes at all but could definitely try that.
I will look up selenium and zinc as suggested- thank you!
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