Hello! I have been having major issues with my thyroid getting optimal again after two miscarriages. The last one was nearly 6 months ago and I am still struggling.
I just recently had my cortisol tested and it looks like there are some issues there.
MORNING: 8.3 (3.7-9.5)
NOON: 1.7 (1.2-3.0)
EVENING: 0.6 (0.6-1.9)
NIGHT: 0.5 (0.4-1.0)
My functional MD is telling me it isn’t my thyroid but is probably stemming from adrenals. She is basically just recommending Adaptogens. Does anyone have any thoughts on this? I am so tired of feeling unwell and would ideally like to try to get pregnant again next year.
Thanks!
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shanriggs
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• Morning at the top of the range - yours is fine at 79% through range
• Noon approximately 75% of the range - yours is only 28% through range.
• Evening close to 50% of the range - yours is bottom of range at 0% so too low.
• Nighttime at the bottom of the range - yours is close to the bottom of the range at 17% so is fine.
So you have two samples that appear to be good (morning and night) and two which appear to be low (noon and evening).
"She is basically just recommending Adaptogens. Does anyone have any thoughts on this?"
Be aware that although adaptogens are meant to be "balancing" they do, in fact, lower cortisol and I can confirm this from my own experience.
I was seeing a practioner and my samples showed:
Morning - 93% through range
Noon - top of range at 100%
Evening - 86% through range
Night - 28% through range
So my morning and night were fine, noon and evening too high. My practioner put me on adaptogens. She didn't suggest retesting and due to many reasons I stopped consulting with her. I didn't think to retest and continued with the adaptogens for 2 years when I tested again and they had all falllen right down to very low levels, i.e. - 20%, 13%, 15% and 0%.
I then had the long and frustrating job of trying to get levels back up again and I'm still working on it over 18 months later.
So the message is be extremely careful with adaptogens, whatever adrenal supplements you use test regularly to monitor your levels.
With your results you don't want the adaptogens to lower your morning or night levels and you actually need something to raise your noon and evening levels and I don't think adaptogens will do that.
Thanks so much for your detailed and thought out response!
I’m pretty frustrated with the functional medicine route, honestly... I mean they are better than conventional doctors, but I have literally shelled out hundreds to possibly thousands of dollars for appointments and tests, etc. and feel like it has not gotten me anywhere further than I was.
I had a feeling the Adaptogens might not be the answer... so the question is, do you know how to appropriately raise cortisol levels?
Thanks in advance! It is nice to talk to someone about this, feeling frustrated and lonely in this situation.
It's difficult when you have mixed results like yours. Mine were all low so it was easy for me - adrenal cortex or adrenal glandulars (whichever suits) as they can raise cortisol. But I honestly don't know how you do it when you have low results in the middle of the day like yours but you don't want your morning and nighttime results to be changed.
I was taking mine at Breakfast and lunch (lunchtime supposedly being the latest time to take them) and it's slowly raising the levels across the board except for the morning one.
Maybe - and this is purely a maybe as it's just guesswork and not down to me being trained or having any knowledge whatsoever of treating mixed results - just maybe taking a glandular or cortex at lunchtime would be a start. I don't know. This is not advice it's just my own thoughts.
Other things that adrenals like are Vit C and B Complex.
Google "Adrenal Cocktail" as well.
Stress can be a factor - I believe my lack of raising morning cortisol might be due to poor sleep, and poor sleep is a form of stress.
What’s crazy is my sleep is horrendous lol so I am super duper surprised my morning cortisol after waking up is SO high...
The doctor suggested that maybe my cortisol starts spiking around 3 AM, which is causing it to be super high in morning and also causing me to wake up throughout sleep. I typically wake up 2-4 times per night, once around 12 AM, then around 2-3 AM, then around 5-6 AM and usually have to get out of bed by 6:30 AM for work. Try to get into bed by 10 PM every night.
I know we are obviously not doctors, but do you think my levels are low enough to warrant taking cortisol? I rather now and I have actually heard that makes things worse in the long run... then again I’m desperate to have more energy.
I know we are obviously not doctors, but do you think my levels are low enough to warrant taking cortisol?
Sorry, I have no knowledge of this and it's not something I would personally do, or suggest anyone else does, without guidance from an experienced practioner.
Do you have any thyroid knowledge/experience?
Only 45 years of my own hypothyroidism journey with it's ups and downs and how I have managed to claw my way back to reasonable thyroid health after joining this forum. My story is in my profile which you can read if you click on my avatar.
Just read your profile/bio SeasideSusie! Certainly sounds like you have been through it with some health issues. I applaud you for staying strong and being your own advocate! You are quite the resilient woman.
I thought I had a thyroid issue after chronic fatigue and was put on NP Thyroid (30 mg) last August 2018. My mom has Hashimoto, so in my head I thought that had to be the case for me. Immediately I felt amazing, cycles became regular, conceived two months later (had my first miscarriage at the end of 2018).
Now I look back at those thyroid results prior to starting medication and my levels were not only normal, but ALL in OPTIMAL ranges. I wish I had never started taking the medication and looked for the root cause. Now I can’t get my thyroid levels back to a sufficient level and feel stuck. If I sent you a note with my results, could I get your opinion on some things?
I didn't have any particular symptoms that I can isolate and link to low cortisol as it was during time I was tweaking my thyroid meds to find my optimal dose.
I'm sorry, I'm not an expert in this so can't answer your question with any accuracy. I can tell you that my thyroid meds are now optimal and have been for a while but my cortisol levels aren't, but my cortisol issue was caused by taking adaptogens for too long rather than natural causes.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also 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 before eating or drinking anything other than water . 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).
If/when also on T3, or NDT make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
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
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.
So it's important to get TPO and TG thyroid antibodies tested at least once .
Have you had yourself checked for sticky blood syndrome. That also can cause miscarraiges and this possibility is also often ignored by doctors or over composted this causing hemorrhage so be careful. After a still birth my daughter had an autopsy on the baby and was diagnosed with sticky blóod.she was m monitored and medicatef throughout her next two pregnancies and is now the mother of two.i think it is dt Thomas,s which is doing research into sticky blood.
Yes, I have been checked for several clotting disorders/sticky blood syndrome.
For both of my miscarriages, I had to have D&Cs and they both came back chromosome abnormal. It good just be bad luck twice in a row. Two fertility specialists are recommending we try again before heading the IVF route with genetic testing of embryos. I will be 28 soon so I guess they still think there’s time and I seem to be getting pregnant easily (both pregnancies conceived first time trying). It’s almost as if my body is not being selective enough about letting which embryos stick.
They have checked my ovarian reserve and have done a follicle count and everything seems to be in line for someone my age. I have taken the last 6 months to take supplements and do some things that hopefully can help with egg quality.
I am so happy to hear things worked out for your daughter! Hopefully I can get there one day.
Tackling sleep deprivation would be my priority. I suspect you have a cortisol spike in the night and that's why by lunch you feel so exhausted. Adaptogens can only work with what you have in the bank and they certainly cannot magic cortisol out of thin air. Your functional doctor is copping out by suggesting Adaptogens.
If you have low vitamin D I'd treat that as a priority as it works as a master hormone. This is so much easier to do if you take super absorbable Magnesium as it makes vitamin D more available. Read Dr Carolyn Dean on this subject.
Also, and this is something I have recently 'tweaked' is to take niacinamide at lunch - it helps with low energy at this time of day (especially around 2pm) and apparently helps with sleep later on. It's quite a cheap supplement to take as well, so you don't lose much by trying! It's one of Dr Myhill's (CFS expert) favourites. I have it at around one o'clock. I told my daughter about taking it then and it is helping her too.
N.B. I don't have a multi with B3 in it at breakfast as I take b12 and folate together and b5 and b2 together as well ( you may be better off getting these two through diet ) . I take p5p (b6) mid morning and evening with magnesium and zinc. The rest I get through diet biotin (eggs) and b1 (oatmeal). I also recommend co enzyme q10 in the morning. This is not a strong recommendation, but it works for me!
Thanks for the detailed response, I really appreciate your time!
Vit. D was low last year so I started increasing my dose and my level is now 78 (range 30-100). I feel like I’m in a good spot there!
Zinc was also at the high end of normal, so I was advised to reduce supplement a bit.
I did do a nutrient test last August that gave me what I am deficient/near deficient in but unfortunately did not include ranges. Here’s the list:
- Vit. B12
- Panthothenate
- Serine
- Oleic Acid
- Vit. A
- Vit. K2
- Calcium
- Zinc
- Chromium
- extremely poor antioxidant function
- MTHFR C677T heterozygous
Since those results, I began addressing the deficiencies and taking a good bit of supplements but also addressed my diet and cook/eat at home more.
I also take the correct version of B vitamins since I need the methylated versions due to the MTHFR gene.
I am working with a nutrionist to repair the gut, liver and things like that. She has me taking some supplements with meals to help with better nutrient absorption.
I also take CoQ10 daily as suggested by a fertility doctor for egg quality (600 mg).
It’s been a hard year but I feel like I have greatly reduced my stress levels and have handled things okay, although I do get bouts of anxiety and depression from time to time for sure. I am sensitive and can cry pretty easily. Also a perfectionist, which I am trying to let go.
I guess I just don’t get why I am not seeing more results with thyroid and adrenals if I am doing all this work and have been for months. I almost wonder if I even ever needed thyroid medication and was given it to shut me up. I’ll post results in separate post.
It probably was a serum test unless your functional doctor actually understands Magnesium deficiency issues. Serum Mg tests are useless - in fact they're dangerous as they give a false impression of what is going on elsewhere in the body - the 1% of Magnesium in the body that is in the serum is kept at a constant level by the purging of other areas (bone and muscle) of this vital mineral... If this didn't happen we'd all be dropping dead with heart attacks.
Magnesium together with b6 (as p5p) are vital for cognitive function and emotional stability. If you've got an MTHFR issue don't forget that you need p5p instead of standard b6. The only trouble with having b vitamins and vitamin d in larger doses is they use up Magnesium.
Also, (taken from The Magnesium Miracle) Magnesium oil applied to the skin can increase DHEA production, thus reducing anxiety and PMS symptoms.
As Seaside Susie has pointed out from her own experience (I've tried Ashwaganda and Rhodiola - and the honeymoon period soon wore off) it may be risky long term using adaptogens. Better to try taking some adrenal support, either through vitamins and minerals or the core glandular may work for you (I've not tried it) or pregnelalone which Dr Myhill says is upstream of many hormones. Look at Dr Myhill's website for advice on adrenals.... you probably need DHEA tested as well. There may be someone on here who has Addison's who can advise?? I know from my own experience that focussing on good thyroid conversion to t3 can take the strain off your adrenal glands.
Yeah, I’m definitely weary of the Adaptogens. I don’t want a short term fix, I want to fix them for the long term!
So I did have DHEA-S tested around the same time as adrenals. It was 169 (59-432). It was 191 in January post first pregnancy and has definitely decreased a bit.
I do also have normal total testosterone BUT super low free testosterone.
Hi there, I would be interested to learn what type of symptoms you have for your low cortisol levels please? I have this currently and am being further tested this coming week so any help would be appreciated.
I am just exhausted and wiped out all the time. I ache a lot of the time, too. I usually have normal blood pressure but it’s on the low end. I am super sensitive to bright lights and guess I have issues handling stress. Some times I feel like I am going to pass out and get tunnel vision.
Sorry for your struggles. I know for me, optimizing my FT3 (the active form of thyroid) I believe has helped my pituitary gland make ACTH, which stimulates the adrenals to release cortisol and aldosterone. My energy and blood pressure are returning to normal. Haven't rechecked my day's four cortisol levels yet, but I feel like they are normalizing.
Thanks for sharing your insight! I get confused as on what to work on first: adrenals or thyroid! But I wonder if helping one automatically helps the other?
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