Adrenal saliva results

[Magsyb]

Have been falling asleep in the afternoon, or having to fight it because of work. I’d also been intermittent fasting, had lost weight but now it’s stalled. I did a medichecks adrenal saliva test. My results are: waking 11.6 (normal), noon less than 1.5 (abnormal), 4pm 2.68 (normal), evening less than 1.5 (normal). As you can see my level is dropping significantly in the afternoon. I’ve stopped doing IF as I know that’s not good for adrenal fatigue. I’m having a breakfast of fats and protein. Does anyone have any suggestions?

[greygoose]

I would suggest that you give us the ranges, rather than just saying 'normal' and 'abnormal' because that doesn't tell us much.

Cortisol is supposed to be highest first thing in the morning, to get you out of bed and ready for the day; and then drop throughout the day until it's at its lowest at night, so that you can sleep. So, given those results as you've written them, it seems rather unlikely that cortisol is responsible for your afternoon fatigue.

[Magsyb in reply to greygoose]

Waking 11.6 (range 6-21), noon less than 1.5 (range 1.5-7.6), 4pm 2.68 (range 0-5.5), before bed less than 1.5 (range 0-2).

[greygoose in reply to Magsyb]

Well, it's a bit on the low-side all day, isn't it. I think your adrenals need a bit of TLC.

[Magsyb in reply to greygoose]

Thanks, that’s what I thought too.

[greygoose in reply to Magsyb]

You're welcome.

[SlowDragon Administrator]

What are your most recent Thyroid and vitamin test results too

[Magsyb in reply to SlowDragon]

Vitamin D 63.8 (range 50-175). I’ve been supplementing with the vit D protocol since this being done.

TSH 0.568 (0.27-4.2), T4 17.8 (12-22), T3 4.34 (3.1-6.8). I’ve had a dose increase as a result of that, am due a test to see what it is now.

B12 112 (37.5-188).

[SlowDragon Administrator in reply to Magsyb]

So currently

FT4 58% through range

FT3 only 25% through range

Helpful calculator for working out % through range

chorobytarczycy.eu/kalkulator

So you were not on high enough and not a good converter either

Important to test folate and ferritin too

Vitamin D needs improving to at least 80nmol and around 100nmol may be better

[SlowDragon Administrator]

As you have Hashimoto's are you on strictly gluten free diet?

Or ever tried it?

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

Low vitamin levels affect Thyroid hormone

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

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

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

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

chriskresser.com/the-gluten...

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

thyroidpharmacist.com/artic...

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

restartmed.com/hashimotos-g...

Gluten free diet may help improve conversion of FT4 to FT3

[Magsyb in reply to SlowDragon]

Thank you for such an in-depth reply. I haven’t gone strictly gluten free. I did go gluten free for a time and didn’t find any difference but I am lactose intolerant. My antibodies have come down so I know I’m reducing inflammation. You’ve given me a lot to digest! Thanks for your help.

[SlowDragon Administrator in reply to Magsyb]

So as you are lactose intolerant you are highly likely to either need high dose Levothyroxine or the addition of small dose of T3

Lactose intolerance is also very common with Hashimoto's

Are you using Teva brand of Levothyroxine?

ncbi.nlm.nih.gov/pubmed/240...

Lactose intolerance was diagnosed in 75.9 % of the patients with HT

read.qxmd.com/read/24796930...

These findings show that lactose intolerance significantly increased the need for oral T4 in hypothyroid patients.

Email Dionne at Thyroid Uk for list of recommended thyroid specialist endocrinologists who will prescribe T3

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

[Magsyb in reply to SlowDragon]

After those last results I persuaded my doctor to increase my dose, I’m on 150mcg, I can’t tolerate Teva so don’t have that brand. That’s very interesting about the lactose intolerance. I’ve learned a lot in the time I’ve been hypo but find, as I think I’m understanding it all there is so much more to learn. And I’m a person who likes to read, learn, understand.

[SlowDragon Administrator in reply to Magsyb]

Teva is the only lactose free tablet in Uk

Liquid Levothyroxine is lactose free, but expensive so medics don't like to offer it