I’ve been on this journey for a while. Not sure about next steps.
Results
T4 10.4 (7.9-14.00)
TSH 5.62 (0.570-3.600)
My recent adrenal stress function test shows ALL low day time levels. I crash with fatigue without adrenal supplement and my cognitive function is really diminished, heat intolerance, palpitations and tingling and weakness to name a few symptoms .. tinnitus and so on. Am I hypothyroid and how do I manage with GP? Thanks
Could you post the results of your saliva cortisol test, including the reference ranges? If you post the graph you got given as well it is helpful for us to visualise how good/bad your results are too.
If you have Addisons Disease or some other reason for very low cortisol (hypocortisolism) then you will need treatment with steroids which must be implemented by an endocrinologist after various tests.
en.wikipedia.org/wiki/Adren...
Humanbean
Serum 25-HO vit D3 level 55.6 nmol/(L >50 Normal)
Serum vitamin B12 817 (ng/L > 203 Normal )
I don't have folate or ferritin currently or TPA or T3... I just know I don't feel well.
Many thanks - how do I post a graphic?
People can only post a picture in the opening post of a thread. Click on "More" at the bottom of that post, then "Edit".
Below the text of your post there is an option to "Add Photo". Click on that and upload your picture, then click post.
Make sure your picture doesn't contain details like your name, date of birth, address or NHS number.
Medichecks adrenal stress profile July 2020
Waking ; 11 (6-21)
12:00 1.74 (1.5-7.6)
16:00 <1.5 (0-5.5)
Bedtime: <1.5 (0-2)
Thanks
Unfortunately you've chosen a poor saliva cortisol test.
The reference ranges for both the third and fourth samples allow for zero in the range. I doubt anyone would feel healthy with zero cortisol at any time of day - cortisol isn't an optional extra in the body.
The other problem is that the third and fourth samples don't give you an actual result, they only tell you that what you have is below 1.5.
The other problem is that you don't have a result for DHEA, which can often be helpful because it can alert you to cortisol getting worse if it is very low or below range.
Optimal results are given here - see example 1 :
rt3-adrenals.org/cortisol_t...
The best tests for saliva cortisol are from Regenerus Labs or Genova Diagnostics. See this link :
thyroiduk.org/getting-a-dia...
Personally I would use Regenerus because they are more geared up to dealing with the public than Genova.
It is clear though that your cortisol levels are not good and do suggest that you have adrenal fatigue. Adrenal fatigue can be treated with the correct diet and the correct supplements. Unfortunately doctors don't "believe in" adrenal fatigue, they only believe in "adrenal sufficiency" so people in your situation are on their own.
For info on how to treat your own adrenal problems I gave lots of suggestions in these threads - some of them are old and it's possible that some links might no longer work :
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
thanks Humanbean. I didn't realise this when I ordered. So how does this look alongside recent thyroid results? Would you suggest an adrenal test with Regenerus and test for T3, TPO etc and folate & ferritin? My recent TSH & T4 are NHS GP tests and my TSH is currently over the range. My Vit D & B12 look okay? Just need a plan...and without this we can't make a judgement about the thyroid?
thanks Humanbean I can see the guidance for treatment is based on the Medichecks reference ranges. I can see now that mine need to be much higher. Will this be impacting my thyroid function... is that the theory?
There is an important connection between thyroid and adrenals. Poor adrenal function affects thyroid and vice-versa.
You might find these links of interest. They aren't in any particular order :
functionalmedicine.net/pdf/...
ibrainandbody.com/the-stres...
hormonerestoration.com/Cort...
therootcauseprotocol.com/fa...
mayocliniclabs.com/test-cat...
Suggest you repeat FULL THYROID testing INCLUDING vitamins
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 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 .
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
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...
Thyroid plus vitamins including folate (private blood draw required)
medichecks.com/products/thy...
Thriva Thyroid plus vitamins
Blue Horizon Thyroid Premium Gold includes vitamins
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
monitormyhealth.org.uk/thyr...
Medichecks - JUST vitamin testing including folate - DIY finger prick test
medichecks.com/products/nut...
Medichecks often have special offers, if order on Thursdays
You need referral to adrenal specialist endocrinologist BEFORE considering starting on any levothyroxine
Low adrenals need full testing to see if low due to Addison’s or low due to being hypothyroid
Thanks Slowdragon.. I was tested at 8.30am in the morning without food /water etc. Had TPO and TG 2018 result negative. I don't have Addison's as far as I'm aware. So I need T3 & TPO & TG plus folate & ferritin... struggling to function at work.
Ever had ultrasound scan of thyroid
20% of Hashimoto's patients never have raised antibodies
healthunlocked.com/thyroidu...
Paul Robson on atrophied thyroid - especially if no TPO antibodies
paulrobinsonthyroid.com/cou...
Slowdragon, no never had a scan.
Then that’s something to add to the list to get done
Are you in the UK?
I have list of private London options
In the UK yes.
I meant for ultrasound scan in London
Do you have the London list Slowdragon?
Serum 25-HO vit D3 level 55.6 nmol/(L >50 )
Serum vitamin B12 817 (ng/L > 203 )
Folate > 20.0 ug/L (> 4.0)
Ferritin 84 ug/L (11 - 307)
How are my vitamin results?
Many thanks
Vitamin D
GP will often only prescribe to bring levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
But improving to around 80nmol or 100nmol by self supplementing may be better
ncbi.nlm.nih.gov/pubmed/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, may need on going maintenance dose to keep it there.
Test twice yearly via vitamindtest.org.uk
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7
It’s trial and error what dose we need
Calculator for working out dose you may need
40ng/ml = 100nmol
grassrootshealth.net/projec...
Government recommends everyone supplement October to April
gov.uk/government/news/phe-...
Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
Vitamin D is actually not really a vitamin, but a pre-steroid hormone
Folate, B12 and ferritin look pretty good
What vitamin supplements are you currently taking?
Will pm you scan details
I have seen an endo for Cushings ...not impressed
Latest results - pondering next steps
Next steps
Next steps
Understanding test results and next steps please 
