My GP tested my morning cortisol levels (blood test). The result came back as 305, marked abnormal by the lab, but my GP has commented 'No action required'. No normal range is given in the lab results, but a quick google suggests this is on the low side?
I've been suffering with a range of symptoms (stomach trouble, exhaustion, twitching, weightloss, joint pain, brain fog...).
Does anyone know whether a result of 305 would be considered normal?
I have also done a 24-hour urine cortisol test but results not back yet.
Many Thanks
BI
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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
Ask GP to test thyroid antibodies and vitamin levels
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 .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Add any thyroid and vitamin results you have already
Or come back with new post once you get results
Four point saliva cortisol and Dhea testing can be more informative on testing.....as cortisol should have strong diurnal variation
Gluten intolerance extremely common issue with autoimmune hypothyroidism (Hashimoto’s)
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
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
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
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Depending on the time the test was done, then it might be considered to be on the low side but not by much & could be your normal. Cortisol varies through the day being at it's highest first thing in the morning & then dropping until there's only a small amount overnight. Ideally it should be 450-550 nmol/Ls first thing. Sadly many GP's don't have enough understanding of pituitary/adrenal issues so don't know what the levels should be. The 24 hour urine can take a few weeks to come back depending on where they send the test to. I'd add a chart but don't know how to!
Thank you both, that gives me a lot to think about!
The cortisol test was done at 9am. I woke about an hour and a half beforehand.
I’m taking oral HRT. Tested negative for PA but am having 3-monthly B12 injections because levels stayed low despite oral supplements/decent diet.
Too many weird and wonderful symptoms to list without being very boring, TSH has been tested and is good/low. In fact I’ve had loads of tests, a handful of results abnormal/borderline but getting nowhere!
I now have my 24 hour urine cortisol result and it is 40 nmol/d - no comment and no normal range given. I can't find lab ranges for my area (Gloucestershire, UK) online...
I've heard back from my GP today. My morning cortisol was low but 24 hour cortisol normal. They've referred me for a short synacthen test and to endocrinology, so that feels like progress! I've got no idea what's wrong. Deep down I don't feel it's Addison's as I've been feeling gradually worse for a good few years, but not been seriously ill at any point. I wonder whether any other autoimmune diseases can affect cortisol levels?
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