Endoscopy - due to conversion issues

[Lost_Girl]

Recently saw an endocrinologist who ran the following tests. He has referred me for an endoscopy before putting my symptoms down to anxiety or depression. I am at 98.2% through range on T4 (100mcg levothtroxene) and 35.1% through range of Free T3. I haven’t a clue what else has been tested for - so have attached all my results. Comments will be gratefully received. Thank you.

[SeasideSusie Remembering]

Lost_Girl

I am at 98.2% through range on T4 (100mcg levothtroxene) and 35.1% through range of Free T3

Therefore you are a poor converter of T4 to T3 as mentioned in previous posts and as Angel_of-the-north replied in your other post an endoscopy wont show this, it's already shown in your thyroid results. Are they doing the endoscopy for a different reason?

It's your low FT3 that's causing problems, don't accept a diagnosis of anxiety or depression, these can be symptoms of hypothyroidism and your low FT3 shows that you are not optimally medicated. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well. What you need is slightly less Levo and the addition of T3. Not easy to get on the NHS any more unless you have an enlightened endo.

Vit D: 94nmol/L is below the level recommended by the Vit D Council which they say should be 125nmol/L vitamindcouncil.org/for-hea...

You may wish to supplement to raise this level, if you supplement with D3 then you should also take it's important cofactors magnesiumand Vit K2-MK7 vitamindcouncil.org/about-v...

Everything else in your results list appears to be in range.

You need the following tested, as previously advised

B12

Folate

Ferritin

All vitamins and minerals need to be optimal for thyroid hormone to work properly. Good conversion can't take place otherwise.

You can help conversion by supplementing with selenium l-selenomethionine - no more than 200mcg daily, and some people prefer to test before supplementing. Zinc also helps conversion, again test.

[Lost_Girl]

Thank you - hugely appreciated

[Hidden]

What time was your blood test done? I see that your cortisol is 330? The range they give is the range of cortisol for the day as it changes throughout the day. Cortisol should be around 500 around 9am.

[Lost_Girl in reply to Hidden]

Hi PaulineS - wondering if I could ask you another question please?

I contacted consultant with comments that this cortisol test was done in the afternoon - he allowed me to retake ... my cortisol blood test was 325 at 8.20am (less than my previous one at 330 in the afternoon)... obviously it’s ‘in range’ but lower! I have not a clue if it means anything and would be grateful for any comments or reading material references. I have just read about adrenal fatigue... I can tick so many of those boxes! Thanks again.

[Lost_Girl]

Hi

It was done around 2pm ish I think. Does that makes a difference ? Thank you

[greygoose in reply to Lost_Girl]

Hidden probably isn't going to see that result because you didn't click on the 'reply' button under her comment. I've notified her for you.

But, yes, it makes a huge difference. Didn't they give you a range? That seems rather high for a 2 pm cortisol. It's normally done around 8 am, when cortisol is supposed to be high.

[Lost_Girl in reply to greygoose]

Hi

Thank you. Range given was 133 -537. Blood tests were done after I saw endocrinologist.

[greygoose in reply to Lost_Girl]

Stupid man. That's no time to do a cortisol test. Not sure the lab knew what they were doing, either, because that range does seem high for 2 pm. I don't know, but your level is just about mid-range, so your endo will think it's fine. They love results slap-bang in the middle, for some reason. You'd be better off doing a private 24 hour saliva cortisol test, if you can. So you can see the complete picture. Did he test DHEA?

[Lost_Girl in reply to greygoose]

Thank you. Sorry I don’t know what DHEA is. I have posted everything he tested

[greygoose in reply to Lost_Girl]

DHEA is an adrenal hormone. It's usual to test it when testing cortisol.

[Jazzw]

Just to add - an endocrinologist has no business diagnosing mental health issues so make it clear to your GP that you don’t want that written on your medical notes.

[Angel_of_the_North]

How on earth is an endoscopy supposed to show conversion issues when conversion takes place in cells not gut? Yes, it might show if you had absorption issues (low t4 and low t3). Are they perhaps testing for coeliac? Those results for free t3 don't look as bad - now just over half way through range. Looks like and "I've no idea so we'll test a lot of stuff and see what happens" reaction. Some sex hormones tested, but not all, No B12 or folate. TSH would have been higher if test done in the morning

[JanW]

I seriously think you need to question this with your doctor as I see no reason at all for you being told to have an endoscopy. For instance mine done a few weeks ago was due to problems eating, looks into the gut etc I have Sjogrens. It's not painful but then again also not pleasent . Please do take more advice.

[Lost_Girl in reply to JanW]

Thank you - I am in middle of composing a letter to him.