hpa/stress/adrenal issue or central hypthyroidismo? Is T4 right?

[lauriegraham]

hello. I have posted before. I have low cortisol, low dhea, also low ferritin and a few other things. Low t3, low t4, normal TSH ( many results in link below)

An NHS endo who i saw for lipids (they are sky-high too) has said we could try T4 for 6 months.

Should I jump at that chance or try and stimulate the thyroid via the HPA axis? ie is it adrenal insufficiency that needs treating, HPA axis or thyroid or can they work in reciprocal directions

I feel out of my depth so any thoughts gratefully received

other symptoms include feel freezing in cold, white raynauds fingers etc, low energy

thanks

healthunlocked.com/thyroidu...

[Hidden]

Has your adrenal insufficiency been confirmed by your Endo? I had a look at your last post & although your cortisol level was slightly low first thing the others were okay although your night time one was a little high, which sort of suggests that the test wasn't that accurate. Have you had an early morning serum cortisol done? Has your Endo seen these results? If you did have adrenal insufficiency it would need treating as it is a life threatening condition if not treated. If your morning cortisol is low then your Endo should do a short synacthen test to see if your adrenal glands respond to the drug they give. If the Endo is suggesting to trial T4 then I would go with that in the first instance.

[lauriegraham in reply to Hidden]

Thanks, very helpful, i did not know about the short synacthen test. If the cortisol test was not accurate should I get a dutch test? they seem expensive.

[Hidden in reply to lauriegraham]

I'd ask your GP to do an early morning cortisol test as that will be accurate.

[SlowDragon Administrator]

If adrenals are low because of low thyroid levels they should improve as levothyroxine dose is slowly increased

[lauriegraham in reply to SlowDragon]

Very helpful. So it is bidirectional? Can ferritin also improve with t4, increasing absorption?

[SlowDragon Administrator in reply to lauriegraham]

Often vitamins do improve as levothyroxine dose is increased

But it also helps to have optimal vitamin levels, by regularly testing and supplementing, so that levothyroxine dose is able to be increased high enough and fast enough

Being hypothyroid often results in low stomach acid, this leads to poor nutrient absorption and low vitamins as direct result

[lauriegraham in reply to SlowDragon]

Thanks as always @slowdragon and @paulines.

Out of interest i found this chris kresser article where he suggest that it is the adrenals that should be treated not the thyroid. any thoughts either or anyone before I jump at the endo's offer of T4?

or @jimh111 who answered an early post and suggested central hypo?

chriskresser.com/5-ways-tha...

eg he says 'Weak adrenals can cause hypothyroid symptoms without any problem in the thyroid gland itself. In such cases, treating the thyroid is both unnecessary and ineffective, and addressing the adrenals themselves is the key to improving thyroid function.'