Hello, I just got my latest lab results. These tests were taken in the morning around 8 am. I have adrenal insufficiency (Addison’s disease ) and under acrive thyroid, Hypothyroidism (Hashimoto’s). I currently take 25 mg of hydrocortisone daily and 75 mg of NP thyroid. I know that I that I have low cortisol due to these labs and my diagnosis but my T4 has never been this low ever. My T4 has lowered a lot and I don’t understand why. Any thoughts or recommendations are greatly appreciated.
T4 free .77, Range (.82-1.77)
T3 free 2.6, Range (2-4.4)
TSH 2.9, Range (.45-4.5)
DHEA sulfate 4.0, Range (41.2-243.7)
Cortisol .4, Range (6.2-19.4)
ACTH 4.0, Range (7.2-63.3)
Prolactin 1.6, Range (4.8-23.3)
FerritIn 33, Range (15-150)
Lymphs absolute 4.4 , Range (.7-3.1)
Hemoglobin 12.1, Range 11.1-15.9)
Hematocrit 37.1, Range ( 34.0-46.6)
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Runner95
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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).
Is this how you did the test?
Your results suggest you are under treated and ready for dose increase in Levothyroxine
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to regularly retest vitamin D, folate, ferritin and B12
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
Ferritin is still low
When were vitamin D, folate and B12 last tested?
As you have Hashimoto's are you on strictly gluten free diet?
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
Hi there - I have the same - I am Hashi's and Addison's - the reply you received here was fantastic - as thyroid and adrenal symptoms cross over but it might also help to join the Addison's Disease Self Help Group who can help with some of the direct Adrenal Gland symptoms brought about by Addison's - some of them have thyroid issues too. But you will need the two forums. The information obtained on these forums is second to none particularly this one !!!
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Help with latest lab results please - TSH too low?
Help with Thyroid labs please
Help with thyroid results please
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