Low Cortisol

[caroash]

Hi I've tried to read some other posts on here about low Cortisol which are very informative. My Cortisol blood test came back at 100 do am being referred to endo.I suffer with fatigue,weakness and joint pain and some other symptoms I had a low Cortisol of 90 about 8 years ago,was referred to endo ,I had a synactben test,but because if was normal they decided I didn't have Addison's,So no follow up. I'm just concerned the same thing will happen and .Is seems if they think you don't have Addison's you are discharged.

[caroash]

Hi thanks for replying,I'm sorry you are suffering with this too,it sounds very complex to treat,but treat it they' should I just thought maybe protocol wouid be different 8years on. GPs aren't allowed to prescribe steroids as I asked him , knowing same thing may happen again.Not sure if my levels change.im guessing they Just go down as day goes on judging by my energy levels.

[SlowDragon Administrator]

Low cortisol can be due to being incorrectly treated for hypothyroidism

NHS only recognise Addison’s...not adrenal fatigue

Looking at previous posts you had very low B12

Are you now getting B12 injections and supplementing good quality daily vitamin B complex every day?

When were vitamin D, folate and ferritin last tested?

What vitamin supplements are you currently taking

Vitamin D is extremely important.

Are you on NDT?

How much

What were last thyroid results?

Do you have Hashimoto’s?

Daily vitamin C can help support adrenals

So can Adrenal cocktail

stopthethyroidmadness.com/a...

[caroash in reply to SlowDragon]

Hi thanks for your reply no I'm not on b12 injections as go thought wasn't low enough,but on oral b12 lozenges ,But D levels were 68 a couple of months ago doubled from 34 in Jan. I take a good multi,but C powder, fish oils and b12. I'm on thyroid S one a day,thyroid results were recently ft4 9 ref range 7-17 and TSH 1?75. Not diagnosed with hashimotos,did have that antibody test a few years ago. .

[SlowDragon Administrator in reply to caroash]

So on NDT it’s ALWAYS absolutely essential to test Ft3, Ft4 and TSH

Would suspect you are under medicated and very low Ft3

Always test as early as possible in morning before eating or drinking anything other than water and last 1/2 dose of NDT 8-12 hours before blood test

When supplementing B12 it’s recommended to also supplement a good quality daily vitamin B complex to keep all B vitamins in balance

Vitamin B complex with folate in not folic acid may be most beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Have you had BOTH TPO and TG antibodies tested?

Multivitamins are at best waste of money...but if contains iodine may actually be hindering

Come back with new post once you get full thyroid and vitamin results

[caroash in reply to SlowDragon]

Thanks so much for all this information,I need some morethyroid tests ,I will ask endo when I see them. I will get the b vitamins too.x

[SlowDragon Administrator in reply to caroash]

NHS rarely tests Ft3

Essential to test BOTH TPO and TG thyroid antibodies. NHS refuses to test TG antibodies as you have negative TPO antibodies

[Barrister]

Make sure that, if you have another SST (and you should with a cortisol of 100) that they also do an ACTH test because this will help to show if you have Secondary Adrenal Insufficiency as opposed to Primary Adrenal Insufficiency (Addison’s). These tests should be done first thing in the morning.

[caroash in reply to Barrister]

Thankyou I will ask for this x

[SlowDragon Administrator]

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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)

when on NDT make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Come back with new post once you get results

[humanbean]

Go to this link :

imperialendo.com/for-doctor...

and then click on the link to the PDF file.

imperialendo.co.uk/Bible201...

Look at pages 68 - 70 for information on how to prepare for and do a Short Synacthen Test, what to expect and how the test should be interpreted. I agree with the reply above saying that you must make sure before the start of the test that the ACTH is going to be tested too, ideally by phoning up the day before.

You need to make sure the test is done at the right time, and that you are not stressed before or during the test. Before and during the test, talk as little as you can get away with, don't gossip with anyone, avoid road rage, or an argument with your partner or kids. Delay breakfast until after the test, and only drink water before the test.

There are several types of Adrenal Insufficiency. Many Endos only do the tests required to diagnose Addison's, but to diagnose the other types you need an ACTH test.

en.wikipedia.org/wiki/Adren...

You might find these websites of interest :

addisonsdisease.org.uk/

pituitary.org.uk/

Good luck.

[caroash in reply to humanbean]

Hi thanks so much for this,I will read these links and information,x

[posthinking01]

HI there - there is a very good site specifically for Adrenal Issues - called ADSHG - The Adrenal Gland Self Help Group - same as this site very informative but more for adrenal gland issues - there is also an American One which is also good - called Inspire. There are people on there that have the same issues that might be able to give you information. Hope this helps.

[caroash in reply to posthinking01]

Hi thankyou so much I will go to these sites ,x