Hasimotos and cortisol

[Plumpudding]

I have hasimotos and low cortisol. My life is a struggle every day. I'm currently perimenopausal which is putting stress on low adrenals. I need help on what to take for this maybe Ace or does anyone know an alternative doctor who can prescribe cortisol if needed. I can travel but live in Oxford. Many Thanks x

[Peder]

Are you not on hydrocortisone??

[Plumpudding in reply to Peder]

No I'm not.

[Peder in reply to Plumpudding]

I was diagnosed with hypopituitarism, a couple of years ago...which basically affected my adrenal glands which meant i was hypoadrenal. You should be under an endo...and i dont want to frighten you but have you looked at adrenal crisis where your cortisol level drops through the floor...esp you cortisol level can be affected by stress.... if you havent been given any advice... i suggest it in the strongest of terms....

[Peder in reply to Peder]

Not any more as the condition i had was as a result of an severe infection which knocked my pituitary gland all over the place. The pituitary gland is a super gland and is responsible for a lot of different hormones. The infection caused it to send the wrong signals to my adrenal glands and i almost stopped producing cortisol. I was at the time a front line police officer in Traffic, driving at speeds sometimes in excess of 160mph. this affects your adrenaline levels and so does stress especially in relation to fight and flight incidents, so i had all my work driving permits removed and i now drive a desk. Now the infection has gone, over a year ago,my pituitary gland returned to normal along with my adrenal and cortisol levels. as i was taking hydrocortisone, if i suffered a period of D&V, i was off to hospital as you cannot take the meds orally and your cortisol level needs to be monitored to avoid adrenal crisis. I had to carry around an injection kit etc...so if your levels are below normal, i would suggest doing some research. i had to even inform the ambulance service of my detials so that they had my details on file as it is life threatening, medi alert bracelet etc....I really think you need to be reffered to an endo, and at least have a SST done, What is a SST blood test for?

Serum-separating tube. Serum-separating tubes, also known as serum separator tubes or SSTs, are used in medical clinical chemistry tests requiring blood serum. If you have ever heard of addisons disease......

[greygoose]

How low is your cortisol? HydroCortisone is not something to take unless absolutely necessary.

[Plumpudding in reply to greygoose]

I'm waiting for my saliva results due anytime now

[greygoose in reply to Plumpudding]

OK

[SlowDragon Administrator]

How much Levothyroxine are you currently taking?

How long on current dose

Before seeing any thyroid specialist you need FULL Thyroid and vitamin testing

Have you got results you can add?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Email Dionne at Thyroid Uk for list of recommended thyroid specialists

thyroiduk.org.uk/tuk/About_...

[Plumpudding in reply to SlowDragon]

I take 100 one day and 75 the next

[SlowDragon Administrator in reply to Plumpudding]

Do you have recent results you can add?

Had vitamin D, folate, ferritin and B12 tested?

Do you always get same brand of levothyroxine at each prescription

Have you had coeliac blood test?

If this was negative are you now on strictly gluten free diet

[Plumpudding in reply to SlowDragon]

My ferritin was 8 my Vit d was 38 and TSH was good at 1.9

[SlowDragon Administrator in reply to Plumpudding]

What's the range on Ferritin?

Your Ferritin looks EXTREMELY low.

What is GP doing about this?

You need full iron panel. If iron is also low then you likely need an iron infusion, or certainly iron supplements

Thyroid hormones must have good ferritin levels

Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption

FERRITIN

healthunlocked.com/thyroidu...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

Post about iron supplements

healthunlocked.com/thyroidu...

Vitamin D is far to low

GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve vitamin D by self supplementing to at least 80nmol and around 100nmol may be better .







Once you Improve level, very likely you will need on going maintenance dose to keep it there.




Retesting twice yearly via vitamindtest.org.uk




Vitamin D mouth spray by Better You is good as avoids poor gut function.




It's trial and error what dose each person needs. Frequently with Hashimoto's we need higher dose than average

Local CCG guidelines

clinox.info/clinical-suppor...

ncbi.nlm.nih.gov/pubmed/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

endocrine-abstracts.org/ea/...

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

ncbi.nlm.nih.gov/pubmed/300...

ncbi.nlm.nih.gov/pmc/articl...

Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.

You will also need vitamin B12 and folate tested

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms

Just testing TSH is completely inadequate. Essential to test FT3 and FT4. With low vitamin levels TSH is often low, even if FT3 and FT4 remain low

Have you had FT3 and FT4 tested?

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet




(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

healthcentral.com/article/t...

[Plumpudding in reply to SlowDragon]

Wow thank you for this. I am gluten free. I really appreciate you taking time to explain this to me x

[SlowDragon Administrator in reply to Plumpudding]

Vitamin D is actually not really a vitamin, it's considered a pre-steroid hormone. Getting level optimal can help adrenals

You need to see GP ASAP about ferritin and getting a full iron panel test for Anaemia

[diogenes Remembering]

Have a look at Henry Lindner's site on Google where he describes the relationship between hypothyroidism and hypocortisolism and describes how he deals with it for patients.

[Plumpudding in reply to diogenes]

You just can't buy cortisol in the UK

[diogenes Remembering in reply to Plumpudding]

I don't think Linder advocates taking cortisol.

[diogenes Remembering in reply to Plumpudding]

He doesn't use cortisol as a rule, but only in exceptional cases where other steroids don't work. DHEA addition is important.

[Plumpudding in reply to diogenes]

Thank you

[Bramble83 in reply to Plumpudding]

Even if you could buy cortisol in the UK, I would strongly recommend you didn’t even consider it; it’s a whole different game to thyroid hormones and can be life threatening if used incorrectly. Please don’t start taking it, unless properly diagnosed by a specialist endocrinologist.

Have you had a 9am blood cortisol test?

Saliva testing is not an accurate way of checking cortisol levels, as it only reports free cortisol and what you actually need to know is the amount in your blood.

[Naomi8 in reply to diogenes]

Thanks for posting his website details again