Cortisol and HRT

[olga67]

I’ve just received the results 9AM Cortisol blood test.

389 (150-500). My Endo is happy with the results, no further investigations.

She admitted that I look very ill and shaky and in her opinion it is because my TSH is supressed.

I am also on HRT for my horrid sweats end hot flashes. I need 6 pumps of oestrogel to keep it under control plus 100 utrogestan daily without break.

I feel that my NDT stopped working. I feel like death. Could I have adrenal fatigue? Would the HRT influence my Cortisol?

Please advise

[greygoose]

Whatever is wrong with you, it has nothing to do with the TSH. Whether it's suppressed or over 100, the TSH itself does not cause symptoms. Is TSH all she tests?

You need full thyroid testing:

TSH

FT4

FT3

TPO and Tg antibodies if you don't know if you have Hashi's

vit D

vit B12

folate

ferritin

NDT cannot stop working. It's hormones, not drugs. But, could be that you're not taking enough of it despite your suppressed TSH - it's perfectly normal for TSH to be suppressed on NDT.

You could have adrenal fatigue but you would need a 24 hour saliva cortisol test to find out. The serum cortisol test is not very reliable, and in any case, I would say your result was on the low side.

In short, you do need a lot more testing to find out what's wrong.

[olga67 in reply to greygoose]

Thank you GG for your rapid response. I know that supressed TSH is not a problem, just explaining how my Endo is thinking :). Typical! I’ve posted my results on here several times and do believe that I am as optimal as I can be. Even if there is a room for improvement it would not explain my horrendous symptoms, even Endo agrees to that. I’ve already ordered saliva test.

I also think that my cortisol on the low side. May be Hidden can comment?

[greygoose in reply to olga67]

In your post three months ago, you said that you thought T4 was causing your problems. Have you tried T3 only since then?

[olga67 in reply to greygoose]

No, I have not. I’ve got hot flashes and night sweats and went to my GP, who prescribed me HRT and referred to the Endo (nr. 3). I decided to wait, didn’t want to complicate things.

I am glad that she is investigating and excluding things but for my thyroid she is pretty much useless.

[greygoose in reply to olga67]

Yes, most of them are. Well, T3 only is something to bear in mind. Worth a try.

[olga67 in reply to greygoose]

Thank you GG, I will

[SlowDragon Administrator]

Hopefully your cortisol test also increases DHEA

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

I realise you are not in UK so probably need a different supplier

[SlowDragon Administrator]

Just seen ....you did this one few months ago

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

As you have Hashimoto’s and PA are you supplementing a good quality daily vitamin B complex.

What about ferritin levels

Are you on strictly gluten free diet?

[olga67 in reply to SlowDragon]

Thank you SlowDragon. My ferritin from a week ago is 137 and I don’t supplement it. I am gluten free and SI Hydroxo twice a week pus methylated B complex. From what I’ve read on here NDT can’t work properly if adrenals are off, could it?

Could you comment on my last saliva test? It is been a while , could my results change drastically since then? I appreciate it .

[Hidden]

Both HRT & the oestrogen contraceptive pill may give an elevated cortisol result, so your could be lower than what it actually is. The only way to reliably test your cortisol levels is to come off the HRT for 6 weeks prior to any testing.

[olga67]

Is it false elevated result? My cortisol is high but not getting into the cells? Forgive me my ignorance, I don’t understand how it works.

[Hidden]

Your cortisol isn't high if it was done between 8-9am, although it may be higher than it actually is due to being on HRT. Cortisol varies throughout the day, it's at it's highest first thing in the morning & then drops throughout the day.