Dizziness/lightheaded/ fatigue/excessive thirst

[LXM827]

I am currently under Endocrinology but don't seem to be getting very far.

My GP did the 9am cortisol test and it came back as 295nmol so referred me to Endo who said that was normal. he did repeat it but this was at 11:55am test which came back as 345nmol. Other bloods came back ok, I believe - certainly those for diabetes etc.

I am currently waiting for my follow up appointment but apparently the Endocrinologist isn't concerned at all now.

This has been going on for almost 9 months - started off with the odd dizzy spell but now I am drinking 4-5L water per day and am often feeling woozy/off-balance/lightheaded etc with sometimes a dizzy spell lasting a few seconds or minutes. I also notice that I am now extremely tired a lot of the time - but particularly worse in mid-late afternoon.

I also have dark/purple type rash/patches on the tops of my arms and legs. Nobody seems interested in this though - seem to think it's bruising or dry skin!

I have had a water deprivation test for Diabetes Insipidus last week and all was good apparently - had to abort at 2.30 as had no urine output and the hour before test was only 18ml.

Have attacked blood results from Jan 2019. Got others too from same blood sample - but can only upload 1 pic it seems.

Anybody have any idea or any suggestions please? It's been going on for so long and it's debilitating. Thanks!

[LXM827]

Other blood results:

Urine crest conc 2.6 mil

Urine sodium conc 32 mm

Urine potassium conc 46 mol

Urine urea 76 mmol

HbA1c-IFCC 36 mmol

Cortisol 320 mmol

FSH 10.8

IGF1 23.5

LH 7.8 IU/L

Prolactin 329 mU/L

TSH 4.11 mIU/L

Free thyroxine 18.7

ACTH 16.1 ng/L

Samples all taken at 11.30 and received in lab at 13.15

[SeasideSusie Remembering in reply to LXM827]

LXM827

TSH 4.11 mIU/L

Free thyroxine 18.7

Reference ranges are needed please, to interpret these, as they vary from lab to lab. They will be at the side of the result on the print out like those in the picture above.

TSH is probably near the top of the range. If you'd had the test done by 9am at the latest after an overnight fast, it may have been over range and that would actually technically be subclinical hypothyroidism unless it's high due to non-thyroidal illness (a second test is usually done a few weeks later when TSH is raised).

Your FT4 certainly isn't low.

But for a full picture you need all the tests mentioned by SlowDragon in reply to your previous post

healthunlocked.com/thyroidu...

Dizziness and balance problems in particular can be low B12 - has this been tested?

[LXM827 in reply to SeasideSusie]

Ah ok, sorry!

HbA1c-IFCC - 36nmol. Range 20-42

Cortisol 320nmol. Ref range 06:00-10:00hrs: 172-497nmol

IGF1 23.5nmol. Rang 10.1-35.5

Prolactin 329mU/L. Range 100-500

TSH 4.11mIU/L. Range 0.30-4.50

Free Thyroxine 18.7 pmol/L 10.0-22.0

ACTH 16.1 ng/L. Range for samples taken between 7.00-10.00: 7.2-63.3ng/L

No, I don't think B12 has been tested - by either the hospital or GP.

Previous bloods done by GP which triggered the referral to Endo - taken in Nov 2018

Serum TSH 4.0. range 0.27-4.2

Serum Cortisol @ 9:15 - 342 nMol (no range given)

ACTH 14ng/L @9:15. Range 7.2-63.3

Serum Cortisol (repeated at 9am) 295nmol/L (again no range given)

Serum osmolality 297 mosmol/kg. Range 275-295

Serum calcium 2.51nmol. Range 2.20-2.60

Serum albumin 56g/L. Range 35-50

Serum sodium 145mmol. Range 133-146

Serum potassium 4.4mmol. Range 3.5-5.3

Serum urea 1.9mmol/L. Range 2.5-7.8

[SeasideSusie Remembering in reply to LXM827]

TSH 4.11mIU/L. Range 0.30-4.50

Free Thyroxine 18.7 pmol/L 10.0-22.0

These are euthyroid (normal) so don't point to a thyroid problem, but your TSH is a lot higher than one would normally see in a healthy person, which would probably be no more than 2. However, as mentioned, non-thyroidal illness can cause raised TSH. Your previous one was 4 but still within range. I doubt anything will be done about your thyroid results.

Again, I'd refer you back to the tests SlowDragon suggested in your previous thread to give a full thyroid/vitamin picture

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

As mentioned, dizziness and balance problems can be due to low B12 so I think it's worth pointing this out to your doctor. However, the NHS only does Serum B12 test I believe, the more useful test is Active B12 which can be done at St Thomas' Hospital, London, or you can do it privately with one of our recommended labs.

If I were you I would do the full testing privately.

Medichecks Thyroid Check ULTRAVIT medichecks.com/thyroid-func... does all those tests and includes Active B12. You can use code THYROIDUK for a 10% discount on any test not on special offer.

[loisbrucie]

I have diabetes insipidus caused by vasculitis which can cause purple rashes. On the night that I have to abstain from my medication for DI I get a dizzy drunk feeling, I assume it’s due to loosing salts due to urinating so much. I can sometimes offset this by drinking coconut water. I have low B12 and self- inject once a month.

[LXM827 in reply to loisbrucie]

Thanks for your reply.

I had my water deprivation test last week for diabetes insipidus and it came back all good so seemingly confirming I don’t have it - which is great but then the mystery continues!

Going to look into the B12 options though

[pinkjess17]

Hi I used to be like you with excessive thirst and urination. I was diagnosed with POTS syndrome and am advised to take extra salt on meals. Your cortisol is low and urine sodium is low which points to low blood volume. This would make you dizzy and very tired. I was advised to take enough salt to get the urine sodium level to 170. If I were you I’d try increasing salt to taste to see if it helps some of your symptoms. You may also wish to take a cortisol saliva test with regenerous or medichecks to see what your levels are, as the NHS only treat complete adrenal failure (addisons).

[Swanagegirl]

Your cortisol is low should be 600 - 700 at 9am. Were you stressed when you did the test ? Ie had you rushed to get there or driven through crazy traffic ?

Any stress increases cortisol if you still produce it.

Don't bother with saliva cortisol tests - you can however get blood ones to do at home.

Definitely worth doing one at home 9am - But you must be super zen calm , chilled out before doing.

[LXM827]

Thanks fo your reply.

Always somewhat stressed when having bloods taken - because no one can ever find a vein and it always hurts massively!! Apart from that, was calm on both.

Had a 9am one done by my GP with a result of 295nmol which Endo has now said is fine but because I told him GP had said it was low, he repeated it (2 months later by this point)! at the hospital - a random test at 11.30 with a result of 320nmol. Again told normal.

[LXM827]

It’s just getting so debilitating now.

If I walk too far and/or too quickly I start to feel woozy/ lightheaded and out of breath very quickly and legs feel like jelly.

My GP has referred me to ENT now in case it’s my ears - particularly as my balance is off too