Hidden in reply to Gman124 years ago

Sadly any Endocrinologists are conversant in Adrenal/pituitary issues so don't understand the issues. You need to find one that does but ask your GP to do a morning blood cortisol to see what that is, it's not always important to have DHEA tested when looking at Cushing's or adrenal insufficiency. If you do decide to have further testing done then don't take any supplements until you know what is going on. I'm not sure that they can say a tumour has to show prolactin in the 100o's or even 100's!!! Yours is certainly outside of the normal range for a man. The Pituitary Foundation will help you to find an Endo who is knowledgeable in pituitary/adrenal issues. The fact that your prolactin is high points to a pituitary issue rather than just adrenals.

Gman12 in reply to Hidden4 years ago

Yeah she said word for word,

‘Us doctors don’t start getting excited about Prolactin levels until their in the 1000s - if all tests and everytime else is fine, you just have erm, high Prolactin’ and shrugged.

I’ve started taking a b complex so I’ll stop that along with the others. All I know is, since that stressful event a year ago I haven’t felt the same. Maybe it triggered this and put my body out a whack?

Or these symptoms were laying in wait and triggered the stress in the first place? Who knows. I always remember feeling mildly tired but then who doesn’t?

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Angel_of_the_North in reply to Gman124 years ago

They also think in black and white. So if your blood results are right at the top or right at the bottom of the normal range, as mine were, it is "normal, no action" in spite of symptoms. But if the result was one point higher or lower it would be Cushings or Addisons.

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SeasideSusieAdministrator in reply to Gman124 years ago

Gman12

So your DHEA was at a good level back then.

What time were your thyroid tests done?

The 17th November TSH is slightly higher than one would expect for a normal healthy person, although the 28th November one is just about at the limit, 2 or below is where one would expect it to be for someone without a thyroid problem.

When looking for a diagnosis TSH needs to be as high as possible, and this is as early as possible in the morning for blood draw as TSH is highest at midnight then lowers throughout the day and is lowest early afternoon. Eating can also lower TSH and coffee can affect it as well, so delaying breakfast and water only until after the blood draw all helps with TSH.

Do you have any previous thyroid results? Have you ever had FT4 right at the bottom of the range? Low FT4 with a normal, low or slightly elevated TSH can indicate central hypothyroidism which is where the problem lies with the pituitary or the hypothalamus, this is where the signal to the thyroid to make thyroid hormone doesn't get through well enough and the FT4 stays low.

Adrenal tests should be done on a "normal" day to reflect your normal levels.

Gman12 in reply to SeasideSusie4 years ago

I did my 2 recent TSH Tests first thing in the morning (around 7am) and fasted. So hopefully their more accurate.

My T4 on a previous test was 17 I think so it’s still within normal range. The lowest my TSH has been was a year ago at 1.99 - and that was taken around 9am after breakfast so not so accurate.

I think I’m getting somewhere since. investigating hormone issues. Put it this way - every test for every single thing I’ve ever had done has come back fine APART from Prolactin and cortisol tests. So that’s where I’m headed I think.

What the route cause was, I’ll never know but I’m guessing it has to be the stressful episode.

I’ll look to re do the adrenals maybe after Christmas

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Gman12 in reply to SeasideSusie4 years ago

I’ve been advised from other members to let you know about my vitamin test results (posted down the thread) as well as my supplement regime. Thanks for you help, it’s very much appreciated!

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Hillwoman in reply to Gman124 years ago

My reply to you last night should have appeared directly under yours and not down below...

I take it you're in the UK? The medical profession in this country is an outlier in terms of setting the upper limit for TSH at 10 before starting treatment for hypothyroidism. I can't remember off-hand which country has proposed an upper limit of 2.5, but you get the picture. Many people on this forum find that once they are symptomatic their TSH needs to kept at 1 or below. Bear in mind also that the TSH lab reference ranges are derived, at least nominally, from healthy people.

You mention your mother has hypothyroidism. The condition often runs in families. She must have felt very unwell with her TSH at 17! Is she being prescribed levothyroxine?

You could get your own private tests of thyroid function through Blue Horizon or Medichecks. If you do, make sure you choose one of the more comprehensive thyroid panels for your first one, testing TPO and TG antibodies, FT4, FT3 (most important), TSH, vitamins B12, folate and D, ferritin, and CRP. Come back to the forum with the results, but start a new post, and we'll do our best to help.

We still need to think about your raised cortisol, but from what you've told us so far, it may just reflect the fact you are under physiological stress from elsewhere in the body. Cushing's should be ruled out though, as it carries an increased risk of cardiovascular disease, among other problems.

If you haven't already done so, have a read of the Thyroid UK website, and come back to the forum if you need additional references for your research. You'll see a symptoms list on the website - I think I must have had every one of them in the days when my health was being mis-managed by the NHS.

Gman12 in reply to Hillwoman4 years ago

Yeah my mum struggled, she has been on Levo for years now and seems back to normal. Hypo and hyper runs in both sides of the family - all women though.

I’ve beat you to it - I’ve had those tests done aswell haha they are...

Both antibody tests are < 10 - (0.0 - 115 & 0.0 - 34)

T4 - 14.2 pmol/l - (12 - 22)

FT3 - 5.36 pmol/l - (3.10 - 6.80)

TSH - 2.08 mIU/l - (0.27 - 4.20)

Active B12 - 93.8 pmol/l - (37.50 - 188)

Serum folate - 4.71 - (3.89 - 26.80)

Vit D - 86 nmol/l - (50 - 150)

CRP - 0.27 mg/l - (0.0 - 5)

Ferritin - 131 ug/l - (30 - 400)

Iron - 25.3 umol/l - (5.80- 34.50)

T.I.BC - (59.43 umol/l - (42 - 72)

TS - 42.62 % - (20 - 50)

The saliva tests do kind of measure how I feel, my cortisol is above the high range first thing in the morning -might explain why i feel quite energetic and ready to go first thing in the morning.

Mid afternoon I start going downhill especially after I’ve eaten (healthy clean meal with water). My cortisol is also too high at 4pm - so why don’t I feel energetic then? I’m spaced out and Brian fogged out my mind at that point.

It seems that at bedtime also my cortisol crashes significantly <1.5 - Range 0.0 - 2.0 which would explain why at 10 - 11pm lm like a sedated zombie.

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Hillwoman in reply to Gman124 years ago

We do need cortisol in the morning to get us up and about (I make very little of it) but thereafter it declines gradually through the day. If you feel like crud again in the afternoon when your cortisol is higher than it should be, then your adrenals are trying to compensate for a deficit elsewhere. It indicates stress, whether physiological or mental. But if you have Cushing's, then you have a primary adrenal problem, and that needs specialist attention.

Are those thyroid function test results from the blood draw you had after eating? If so, it's important to repeat them.

Your folate and vit D could stand improvement, and also your B12, which some people have to keep high in range to feel well.

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Hillwoman in reply to Hillwoman4 years ago

I should add that your FT4 is near the bottom of the reference range, though your FT3 looks ok at the moment. That pattern is something we often see here in people who are not feeling unwell or are unusually fatigued. It's another indicator that the thyroid is beginning to struggle. Read posts and comments by Diogenes on the forum. He is Dr John Midgley, an active researcher into hypothyroidism.

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SilverAvocado in reply to Gman124 years ago

I'm glad you've added these vitamins. It was the question I had in mind all the way through the thread. You mentioned you supplement, but you really need to see the tests to target supplements you need.

B12, Folate, Ferritin and Vit D are said to be the 4 to look at first. You've got all of those and they all look a bit low. The rule of thumb is you usually want them at least halfway up the range, but for Vit D and B12 the ranges are set low, so it's better to be near the top.

You've had SeasideSusie comment in your thread, she's the most knowledgeable about vitamins. If I were you I'd cut and paste this vitamin information as a reply to her and ask for advice to supplement these.

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SeasideSusieAdministrator in reply to Gman124 years ago

Gman12

Active B12 - 93.8 pmol/l - (37.50 - 188)

This isn't bad. Below 70 is where it warrants investigation into B12 deficiency, so yours is OK. I don't know the optimal level for Active B12, just with serum B12.

Serum folate - 4.71 - (3.89 - 26.80)

This is very low, it should be at least half way through it's range, so 15.5+ with that range.

Vit D - 86 nmol/l - (50 - 150)

The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. To bring your level up to the recommended level the Vit D Council suggests supplementing with 2,500iu D3 daily. However, they also suggest supplementing with 5,000iu on the days we don't sunbathe, so as it's winter and we can't make Vit D naturally from the sun, you could take anything between those two doses but retest in 3 months time. Once you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

There are important cofactors needed when taking D3 as recommended by the Vit D Council -

vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

naturalnews.com/046401_magn...

Check out the other cofactors too (some of which can be obtained from food).

If you have Hashi's then for best absorption use an oral spray or sublingual drops.

If you don't have Hashi's then a good quality softgel with minimal ingredients is a cheaper option, look at Doctor's Best (only 2 ingredients - D3 and extra virgin olive oil).

CRP - 0.27 mg/l - (0.0 - 5)

Great result.

Ferritin - 131 ug/l - (30 - 400)

Ferritin is recommended to be half way through range. Your level isn't dire by any means but if you want to increase it then you can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

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Gman12 in reply to SeasideSusie4 years ago

Thanks again, I’ll re post this up here so you get it. It’s strange as my folate a year ago was 8.00 with a diet that wasn’t so great? And now a year later it’s 4.71 after eating extremely healthy.

My only guesses is that either stress or has triggered an absorption problem. Or, I’ve had an absorption issue all along and just never knew?

My diet a year ago included a lot of whole grains - bread/pasta/cereals - these are usually fortified with folic acid and not much green veg at all. I’ve cut all those carbs/starchy/grainy foods out mainly and decided to try and get my folate from Greens - and hey ho, my folate level has dropped. Does that mean I can only absorb synthetic folic acid as opposed to natural folate I wonder? Maybe that explains the drop in levels?

I’ll start experimenting with both supplements and see what benefits me most. As far as I know, my experience with methyl supps aren’t great - I felt wired and anxious on methyl b12 for example.

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SilverAvocado in reply to Gman124 years ago

I can't fault your vitamin regime, but I'm not at all an expert, SeasideSusie would be best to spot if there are any obvious gaps. Not being able to tolerate B12 sounds like it could be a clue. B12 deficiency and anaemia is a whole other rabbit hole to look into that might be useful. Some people end up injecting instead of the sublingual tablets. I'm not sure if you need to look into the ferritin, but Susie could advise.

I'd say there's definitely a lot you could try with reducing your activity and see if resting improves your symptoms. 'Stress' just means asking more of your body than it's able to give, so these can be very enjoyable but still be hurting you. Something to give a lot of thought to, because its always a painful process for everyone to give things up. There's a huge stigma about resting in our society, but it really is true that it's the best medicine. My advice would be to really give a hard look at that big list of activities you gave, and think about what you can cut out or convert to something lower energy, for example ditch the weight lifting and do gentle walking or yoga instead, or even better go home for a nap, or take on a few hours of work at a desk each week, or cut down the hours you work altogether.

Its worth redoing the test on a day that you're doing your normal amount of activity. Its always said to do it on a stressful day, not a day when you're resting. Unfortunately there isn't enough traffic about this to know if it makes much difference But it may be that what you're looking at is quite misleading. Looking back I noticed that you're doing some of the most intense exercise in the morning, and I think that's a bad idea because the test shows that your body is already quite stressed just from getting you out of bed.

Another little thing with adrenals is that they act to do the work of keeping you going when you haven't eaten recently. So definitely make sure you're eating as soon as possible when you wake up, and don't be doing things like exercising without food beforehand. When my adrenals were bad I would also eat if I woke up in the night, and one of the first early symptoms I had would be to wake up ravenous in the middle of the night after I'd been lifting weights. My personal experience has been that weightlifting is one of the most challenging exercises to stress the adrenals and slightly downgraded thyroid function. Now I've been a lot more ill I can look back and see I was having symptoms around weightlifting years before I noticed them anywhere else. At the time I just thought I needed to increase my cardiovascular fitness to handle it.

SilverAvocado in reply to SilverAvocado4 years ago

Oops, I also wanted to mention that having low vitamin levels isn't a comment on the quality of your diet. Its more to do with the digestive system not being on top form, so the nutrients you're eating are not ending up absorbed into your body and being used.

Poor quality stomach acid is just one example that goes hand in hand with thyroid problems.

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Gman12 in reply to SilverAvocado4 years ago

Thanks again! I’ll aim to get the cortisol re tested after Christmas in the new year. At least I’ve got an insight which gets me on the right track.

It’s strange as my folate a year ago was 8.00 with a diet that wasn’t so great? And now a year later it’s 4.71 after eating extremely healthy.

My only guesses is that either stress or has triggered an absorption problem. Or, I’ve had an absorption issue all along and just never knew?

My diet a year ago included a lot of whole grains - bread/pasta/cereals - these are usually fortified with folic acid and not much green veg at all. I’ve cut all those carbs/starchy/grainy foods out mainly and decided to try and get my folate from Greens - and hey ho, my folate level has dropped. Does that mean I can only absorb synthetic folic acid as opposed to natural folate I wonder? Maybe that explains the drop in levels?

I’ll start experimenting with both supplements and see what benefits me most. As far as I know, my experience with methyl supps aren’t great - I felt wired and anxious on methyl b12 for example.

I used to kill myself in the gym around 8 - 9 years ago now I’m very sensible with it. Maybe I’ll try switching the times I workout and see if they improves. It’s just that training ag 7:30am is more beneficial before work and also I feel stronger.

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SilverAvocado in reply to Gman124 years ago

I don't know enough about vitamins to comment on the folate. For all I know it could fluctuate quite a bit in general, although I've just looked up my own results and mine stays quite stable over time.

It's possible that grains did suit you better, a strange thing with thyroid problems is that some people do very well on a low carb diet, and other do very badly.

I was thinking about your thyroid panel results, and how you have a pretty low freeT4, but a good freeT3 ( with these it matters a lot where you are in the range. These are a normal distribution, so the average healthy person would have a readin right in the middle of the range, the lower it is the more likely it is the thyroid is playing up), and I remembered something. The thyroid makes a lot more T4 than T3. T4 is the storage form, and the body has to turn it into T3 to use it.

A thyroid researcher that uses the forum is researching how the body will work hard to keep the T3 level good, even when the thyroid starts to fail by increasing the effectiveness of the conversion throughout the body. This explains a pattern like yours, the freeT4 is low because the thyroid is struggling to make enough hormone, but the rest of the body is increasing conversion to T3, so the freeT3 remains good.

Although I've just noticed youve only typed 'T4', so maybe this isn't a freeT4 test, and I may be completely wrong.

But if I'm right it's a bad position to be in, because as you commented above, a doctor won't diagnose you until your numbers get much much worse

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Gman12 in reply to SilverAvocado4 years ago

Yeah it’s free t4 so your right. My free t4 has been ‘17’ A couple of months ago which is bang in the middle so it can do it. I suppose it’s normal for thyroid hormones to fluctuate daily and mine only do slightly. But yes, I have heard to best for TSH to be 1 - 1.5 (basically under 2.5 ideally). In fact if I lived in certain other countries I’d be regarded as ‘boarderline hypo’ as their cut off is 2.5 I believe. I think Germany is one of the countries that has a 2.5 cut off in fact.

Ah it’s all very complicated and every slight change makes a difference. As it stands my aim is to,

Raise my folate

raise my Vit D

raise my ferritin - ( even though my iron levels are quite towards the high end so I Don’t understand while Ferritin is low?)

Raise my b12

Rest and concentrate on repairing my adrenals better - this I have been doing for the past 10 months or so, maybe it’s just going to take longer to repair/re start them.

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SilverAvocado in reply to Gman124 years ago

Good luck! Unfortunately anything with hormones is slow going.

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