Endo asked me to stop all medication for four weeks then blood tests including cortisol, these are the results. Any comments gratefully accepted.
Serum TSH level....12.7 mu/L .... (0.27 - 4.20 mu/L)
Serum Free T4 level..... 8.1 pmol/L.....(12.00 - 22.00pmol/L)
cortisol (Gen 2) .... 569 nmol/L
Perhaps there’s a better endocrinologist in your area? One that treats their patients to make them better?
Stig5882
What was your endo's reason for using you as a guinea pig and make you suffer just so that s/he could see the inevitable in your test results.
What on earth did your endo expect to happen? A miraculous return to normal of a thyroid that went wonky a few years ago?
Sadistic so and so.
So you are now hypothyroid, as expected, and need to be put back on treatment immediately.
If you really want to see an endo, bin this one and find a decent one.
Hi Seaside Susie I'm assuming Endo wanted to rule out Addisons as last tests showed I was not converting T4. It was my first appointment (only took 3 years) and he was east european and did not speak very good english so I couldn't get much information. :/
Thank you for your reply. x
last tests showed I was not converting T4.
So why no FT3 this time? We all know that FT3 tests are so often dismissed, but if you have what is regarded as a proved case of inadequate conversion, surely it is absolutely essential?
(Obviously not - in the minds of the endocrinologist, lab or whoever made the decision.)
If you had Addisons, you'd have showed LOW cortisol and probably low/normal TSH with low free t4 and free T3 when first diagnosed. Easily looked up in notes. And you'd still have low cortisol even on levo - no need to stop it apart from doctor being an idiot sadist. And it would have very little to do with T4 to T3 conversion anyway.
If your cortisol was taken around 9am than it is range therefor a normal result.
Yes Endo requested blood draw before 9am.
Thank you for your reply.
We should check cortisol from saliva not blood anyway...
Not when they are looking at Addisons or Cushing's, very few Endo's in the UK do saliva tests.
UK doctors will not do saliva tests. They do not believe them to be better than blood tests. If we do our own, it's most unlikely that a GP or endocrinologist will even look at the results let alone treat off them. I say this from experience.
Thanks for that info FancyPants54
Most people on this forum request a cortisol test that includes measurements from morning noon and night because cortisol has natural variations over 24 hours. Was your endocrinologist ruling out Addisons disease? You don't give a lab range for cortisol so it's impossible to see if it's in the normal range or not.
As you can see, 4 weeks without levothyroxine has left you very hypothyroid. Your FT4 is below the bottom of the lab range and TSH is high.
What has your Endo instructed you to do because if cortisol is in the normal range and Addisons disease has been ruled out, I would have thought you need to start levothyroxine again quickly before you become very ill.
Could you contact your Endo immediately and ask what to do now? Failing that, go and see your GP and ask if they can contact the Endo and prescribe whatever is necessary.
I am still waiting on another appointment to see endo, I have a telephone appointment with my doctor in a few days but I have started taking the prescribed Levo 100mcgs daily straight after the blood draw as I was feeling very tired. Yes it was my first appointment with endo and he wanted to rule out Addisons. Thank you for your reply.
If you have Addisons disease then the leaflet for levothyroxine says you should not take until treated for adrenal disease so please ring GP and get a more urgent telephone appointment. However, it sounds like you were already on levothyroxine so why was Endo checking for Addisons disease? Did you have symptoms of adrenal deficiency?
Lab has stated Cortisol level is 'normal' no action required.
Ok, good that cortisol results are normal, at least you can be sure that you can continue to take levothyroxine. Just as well you started taking it again. I would find a different Endo as the others have already said. I edited the post above as you were replying.
In previous blood tests it showed I wasn't converting T4 so I'm assuming he was ruling out high cortisol?
I'm not sure how high cortisol prevents conversion of FT4 to T3 but I'm not a medic. What was your blood test result that showed poor conversion? If ruling out high cortisol then why did you need to stop taking levothyroxine. Addisons disease is adrenal insufficiency, I believe. Did you have symptoms of Adrenal deficiency? If not, then it sounds like your Endo is confused and I would not be happy with the treatment you've recieved if it were me.
Find another doctor, that one want to make you seriously ill. And make a complaint against him. You are not a guinea pig in someone's experiment. Those bloods show primary hypothyroidism - very over range TSH and under range free T4. You need an immediate increase in levo - not to stop it - you could go into a coma or suffer heart damage. Refuse to stop meds and ask for a referral to an endo.
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