Could someone please help with my recent tests. My saliva cortisol test shows high cortisol throughout the day and low DHEA. I have had adrenal problems for several years now and results have varied from low throughout the day to this present high one. They did normalise for a brief period back in 2013 then after that the evening ones were always high. DHEA levels have always been low.
In addition a recent Medichecks test has revealed high ferritin 202 (13 - 150) and low folate 9.23 (8.83 - 60.8). Other results appear normal
CRP HS 1.43 (0 - 5)
B12 150 (37.5 - 187.5)
Vit D 66.8 (50 - 175)
Previous tests in 2016 and 2018 showed my B12 levels were high at 834 and 776 and my folate levels were normal at over 45. Ferritin was normal in 2016 but had risen to 202 in 2018. I don't take any of these as supplements. What could cause my folate levels to drop so much? I eat healthily with plenty of fruit, veg, seeds and nuts. I also stopped taking the high dose Vit C I was taking for my adrenals as I thought I may be absorbing too much iron from my food but my level has stayed the same.
My thyroid results are:
TSH 0.013 (0.27 - 4.2)
T4 0.5 (12 - 22)
T3 5.62 (3.1 - 6.8)
These results have been pretty consistent over the last 8 years. I am on T3 only, due to conversion problems, taking 35mcg per day. I am 69 years old and was diagnosed in 2010 and have never really felt 100% well in all that time, always struggling with fatigue and insomnia. In the past I have seen Dr Peatfield several times who diagnosed adrenal problems as well as the conversion problem.
Last year after experiencing dizzy spells, breathlessness and increased bouts of atrial fibrillation I was sent to see my heart specialist again and also went privately to see an endocrinologist to determine whether it was my heart or my thyroid. I had a 24 hour heart monitor fitted and he was happy with the results and just told me to take beta blockers and blood thinners as he usually does. I only take beta blockers as and when I have a bout of A/F as they push my blood pressure down too much and make me very dizzy when I take them every day. The endocrinologist initially told me to drop my T3 down to 30mcg (I was taking 37.5mcg at the time) but this made my breathlessness and A/F worse so he put it up to 35mcg. He asked my GP to run a whole load of tests which all came back normal and he has asked my GP to refer me to a rheumatologist and a neurologist.
My GP rang me just as we were going into lockdown and has agreed to this but as nothing will happen very soon (I have to ring him in the autumn to remind him to refer me) I hope someone on this forum can help me in the meantime. My main problems at the moment are chronic insomnia and fatique, headaches that wake me early in the morning and last all day, aching joints and hot flushes. The A/F has settled down a bit, I only get a bout approx every couple of weeks and the dizziness and breathlessness is much better.
Sorry for the long post.
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sandyd
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Need to compare your results to the optimal results.
Your results :
1) 9.93 (2.68 - 9.3)
2) 3.81 (0.75 - 2.93)
3) 2.23 (0.36 - 1.88)
4) 0.94 (0 - 0.94)
Optimal results (from link above and using the ranges you were given) :
Morning at the top of the range = 9.3
Noon approximately 75% of the range = 2.385
Evening close to 50% of the range = 1.12
Nighttime at the bottom of the range = 0 ***
*** I don't believe the reference range for the fourth sample. I simply don't believe that a healthy person would ever have a zero cortisol level. I always think it might be healthy for a corpse. But in the absence of a more sensible reference range I'll stick with the one you've been given.
Compare your results to the optimal results :
1) Yours = 9.93 --- Optimal = 9.3 --- You produce 107% of optimal
2) Yours = 3.81 --- Optimal = 2.385 --- You produce 160% of optimal
3) Yours = 2.23 --- Optimal = 1.12 --- You produce 199% of optimal
4) Yours = 0.94 --- Optimal = 0 --- Not possible to divide by zero!
Totals : Yours = 16.91 --- Optimal = 12.805 --- You produce 132% of optimal
Given that you have had varying adrenal results over the years, sometimes being low, sometimes "normal", and now over the range it would be a good idea to be cautious in what you take for your adrenals, and you should consider testing again in 3 - 6 months, depending on how well you feel.
I had high cortisol (higher than yours) and I have found it very hard to reduce mine. But since you have had much lower levels you might need to be very careful not to overdo any treatment because you really don't want to end up with very low cortisol results.
How I've reduced my own cortisol is with Holy Basil (an adaptogen). Adaptogens have different effects on different people. Some people find that ashwaghanda can lower their cortisol, others say it raises it. Ditto with Holy Basil.
Some people say that adaptogens will lower cortisol when it needs lowering, and will raise cortisol when it needs raising. Personally, I don't believe in magic, and I think this idea is nonsense. I've never heard of anyone who actually said this is what happened for them.
I would suggest trying an adaptogen - there are several to choose from - see the above link. But I would say you should try only one at a time, rather than mixtures of adaptogens.
As I said above, I use Holy Basil - specifically this product :
Whatever you try to reduce cortisol, take a dose about an hour before you produced sample 3 (which was 199% of optimal). If there are no ill effects after a couple of weeks then try taking an additional dose an hour before sample 2 which was 160% of optimal.
Regarding your DHEA, the fact that it is below range suggests that your cortisol is going to get worse unless you find a way to stop the rot. It tends to decrease dramatically as we age anyway - but I doubt that it should ever end up below range in someone healthy. DHEA can be prescribed by doctors, I believe, and it used to be possible to import from other countries as a supplement. But in the UK it is now classified as an anabolic steroid and is a controlled drug, so it isn't really possible for the average person to get hold of it legally unless they are very lucky and can get a private doctor to prescribe.
Regarding the care and feeding of the adrenal glands you could check out some of the links in the following posts - but be aware that some of them were written for people with low cortisol, not high. Always do your own research to check that any suggested course of action is intended to do what you need.
CRP - this is a measure of inflammation and/or infection, and yours is low enough in range to suggest that you don't have a major problem.
However, a known reason for high ferritin is inflammation.
I've never known whether CRP stays high when inflammation occurs, or whether it rises then drops. So I'm rather confused by your ferritin and CRP and I wonder if they are contradictory or whether something else is going on that I can't identify. A major cause of inflammation under our own control is a high sugar diet. Areas of inflammation in the body could be gut, lungs, joints (most commonly) but I'm sure there are other sites that it can occur.
Your vitamin B12 is fine. If you are supplementing you might want to reduce your dose.
Your vitamin D is not bad but it might be better to be a tad higher. Optimal is considered to be either 125 nmol/L or 100 - 150 nmol/L depending on source. If you choose to supplement you would need about 3000 iU per day of vitamin D3. It is important not to overdo the supplementing because it can be toxic at very high levels. To do a single vitamin D level check, see this link :
Your folate is too low. I can't offer any ideas why yours may have dropped so much. Mine does the same from time to time and I have to supplement to raise it quite often. Optimal levels for folate are upper half of the reference range which in your case is roughly 35 - 60.
T3 5.62 (3.1 - 6.8)68% of the way through the range
Your T4 being below range is what you would expect in someone on T3 only.
Your T3 is not bad, but since you have no T4 to convert you might need a higher level of T3 than many people. Some results on T3 only suggest that people may need to go over the range by a smidgen. But ideally you would raise by, say, quarter of a tablet and see what happens.
Regarding your issue with occasional atrial fibrillation you might find this link of interest :
I have the same issue with beta blockers that you do - a single dose has an effect lasting longer than 24 hours and ends up reducing my heart rate and BP so much if I take them every day that I can't cope with them. I only take them when I need them, which my doctor is aware of. I haven't told my doctor that I cut the pills in half too. I've found that avoiding sugar helps a lot with my heart rhythm. (I haven't been diagnosed with A/Fib.)
Thank you for your comprehensive reply, it is much appreciated. Over the years I have tried numerous things to regulate my cortisol. In 2013, nn the advice of Dr Peatfield, I used Nutri Adrenal Extra to raise my cortisol. I used to find too much made me jittery and I stopped using it when my adrenals recovered a bit. He also prescribed DHEA and I took that for a while. I do wish he was still practicing as I seem to have lost my way somewhat. He always said my adrenals were my weakest link and if the adrenal support was too much then my thyroid uptake would be beyond my needs and cause symptoms. I have tried ashwaghanda and rhodiola in the past when my cortisol was normal during the day and high at night. It helped a bit at the time. This was from advice in a book called The Adrenal Reset Diet which I have dug out again recently and it advises Melissa (lemon balm) and a Chinese herb called Scutalleria for the stage I am at at the moment. So I'm giving that a go.
I have just received a pregnenolone supplement I ordered as I read on Dr Myhill's website that she recommends it for high cortisol, low DHEA. I have taken this in the past but cannot now remember how effective it was. Brain not as sharp as it once was. I will try raising my T3 a little. I have felt slightly under medicated since the endo told me to reduce it. I have to be careful though as too much brings on A/F.
Regarding the puzzling high ferritin, my CRP has always been low in previous blood tests so no inflammation. The first time it came back high I'd recently had a bad cold so put it down to that. I eat a fairly low sugar diet, just the occasional chocolate bar lapse but I do have digestive problems and very bad joint problems so maybe that is the cause? The blood tests ordered by my endo included a full blood count which came back as normal. It doesnt mention ferritin , would you have expected it to have flagged something up? I have ordered a folate supplement to try and get my levels back up again. I take a high strength cod liver oil for my vit D . I did leave off taking it for a week before my blood test though.
The link to the Afib video was useful. Interesting about the gut absorption issues. I do supplement with magnesium now and have done for about nine months now since reading about the heart benefits. I also stopped taking my calcium supplement at the same time and that also seems to have had an effect on the number of bouts of A/F I get.
Thanks for all the other links, I will look at them all. Hopefully I will get some answers when things get back to normal.
Haemochromatosis may be a possible (undiagnosed) thing going on here. I feel it warrants investigation. It's a liver disorder that can also affect folate levels (due to poor liver storage)... which can often be low in sufferers. The vitamin A in your cod liver oil will possibly enable iron uptake and now you've dropped Calcium (which I agree with) you have stopped taking something that inhibits iron absorption. Best to look at the Iron Disorders Institute for help. Iron blockers include turmeric for meals containing iron. It's far more common a complaint in Hashimoto's / autoimmune patients than the general population. A full iron panel is necessary for diagnosis. I don't have this complaint myself, but after taking iron tablets for while and eating liver (has vitamin A in it) and increasing vitamin C my levels became quite high AND I got the worst insomnia for a while... which may be a coincidence, but I suspect it could be another symptom of high iron.
hemochromatosishelp.com/hem...
N.B. Hot flushes and joint pain (hands, knees and feet) and digestive issues due to a dodgy liver are symptoms of haemochromatosis as well.
Thank you for your reply. I had wondered about haemochromatosis . My daughter bought me one of those DNA testing kits for Xmas and I tested positive for one of the variants in HFE gene for this condition. It did say however that I wouldn't necessarily develop it.
I do take turmeric for my joints. I didn't know it inhibited iron absorption though. I will continue to take it. My insomnia has always been bad since I was diagnosed hypothyroid. Prior to that I used to sleep like a log. I've had insomnia now for about ten years and only recently noticed high ferritin levels. Ironically before the menopause I used to be iron deficient due to heavy periods and fibroids.
I will have a look at the website link and have a word with my GP.
I have tried ashwaghanda and rhodiola in the past when my cortisol was normal during the day and high at night. It helped a bit at the time. This was from advice in a book called The Adrenal Reset Diet which I have dug out again recently and it advises Melissa (lemon balm) and a Chinese herb called Scutalleria for the stage I am at at the moment. So I'm giving that a go.
If those things you're trying don't help then the link about adaptogens I posted has lots more for you to try, if they seem appropriate for your circumstances.
Regarding the puzzling high ferritin, my CRP has always been low in previous blood tests so no inflammation. The first time it came back high I'd recently had a bad cold so put it down to that. I eat a fairly low sugar diet, just the occasional chocolate bar lapse but I do have digestive problems and very bad joint problems so maybe that is the cause?
Gut problems are rampant among people with hypothyroidism, probably because we end up with low stomach acid. Some people have success with raising their stomach acid with e.g. ACV - Apple Cider Vinegar diluted in water, lemon juice diluted in water, betaine hydrochloride with pepsin, digestive bitters. You should search for info on these suggestions on the forum - they get mentioned a lot.
Joint problems could be a cause of inflammation, but apart from optimising nutrients I don't know much about how to treat them.
The blood tests ordered by my endo included a full blood count which came back as normal. It doesnt mention ferritin , would you have expected it to have flagged something up?
A full blood count wouldn't normally mention ferritin - it's a separate test. You might find these threads of some interest. There is a possibility that you have low serum iron while also having high ferritin. This is what you would see in a condition called Anaemia of Chronic Disease (or Chronic Inflammation).
healthunlocked.com/thyroidu...
irondisorders.org/anemia-of...
See page 8 : irondisorders.org/Websites/...
irondisorders.org/Websites/...
I have ordered a folate supplement to try and get my levels back up again. I take a high strength cod liver oil for my vit D . I did leave off taking it for a week before my blood test though.
I haven't heard of anyone successfully getting a vitamin D level to optimal with cod liver oil, and I would be worried about taking in too much vitamin A with it. I would suggest that you take a dedicated vitamin D3 supplement and reduce your cod liver oil intake if you can. If you got your vitamin D3 up to optimal you may be able to keep it there with just the cod liver oil. It's worth a try.
Thanks for the further links/information. Much appreciated. I do have low stomach acid and use digestive enzymes. I do find they help with heavy, oily or spicy meals. I used to use apple cider vinegar but I have erosion of my tooth enamel so only use it now in salad dressings.
I bought some vit D with K2 spray today. Ive always been told my levels were adequate but I suppose that doesn't mean they are optimal. Ive always taken my cod liver oil for my joints but I've also discovered it helps with a horrible itchy prickly heat rash I get on my hands and arms if the sun is too strong. If I stop taking it I notice I get the rash when I go abroad. I'll try and get my levels up as you suggest and then try and maintain them with cod liver oil. My folate that I ordered online came today so hopefully get this level up too.
I've just reported this post. I wrote it. There have been several instances in recent days where links have either never become proper, clickable links or have ceased to be links some time after the post has actually been posted (I don't know which).
I know this happened to DippyDame and now it's happened to me more than once. In one case I realised that the links had failed fairly quickly and could remember what they were and fix them. But this time I can't remember which links I posted.
I'm just mentioning this so other people can check their own links have worked when they post or soon after.
I hope this works - I've been told by one of the admins that this problem of links disappearing is a known one and it happens when people edit their posts after they initially created them. As someone who regularly creates typos or even misses out entire words I edit my posts a lot!
This was from advice in a book called The Adrenal Reset Diet which I have dug out again recently and it advises Melissa (lemon balm) and a Chinese herb called Scutalleria for the stage I am at at the moment. So I'm giving that a go.
I would suggest that you do a fair bit of research before using lemon balm.
Thyroid disease: Don't use lemon balm. There is a concern that lemon balm may change thyroid function, reduce thyroid hormone levels, and interfere with thyroid hormone-replacement therapy.
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24 hour Adrenal test (saliva) - High cortisol
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High cortisol - help, please! 
High Cortisol blood test
