Advice on thyroid and adrenals with Fibromyalgia invited please

[ainslie]

My Partner has Fibromyalgia age 65, otherwise healthy, on HRT ie estrogen, prog, testosterone,DHEA, melatonin but nothing yet for thyroid or adrenals.

Here are her labs and temps, labs done 8.45am fasting.

TSH 2.32 range 0.27-4.2

When done in June TSH was 3.69 ,same range and lab but she had SIBO at that time

FT4. 19 range 12-22

Free T3 : range 3.1-6.8

Thyroglobulin antibody less than 10, range 0-115

TPA 25.8 range 0-34

Blood cortisol 550 ,range 133-537

Saliva Genova cortisol and DHEA

Morning 8am, 14.87 range, 2.68-9.3

12 noon, 4.91 range 0.75-2.93

4pm, 3.59, range 0.36-1.88

10pm ,0.88, range less than 0.94

Ferritin 126, range 13-150

B12 256, range 25-165, was supplementing

Vit D 200 range 50-200

Folate serum , more than 20,

CRP 0.5, range 0-5

All other hormones normal with HRT

TEMPERATURES

day one

8am 36.3

11.15am 36.1

2pm 36.4

5pm 36.4

8pm 36.5

Day 2

8am 35.8

11am 36.3

2pm 36.1

5.pm 36.7

8.30 pm 36.1

Day 3

8am 35.9

11am 36.2

2pm 36.35

5pm 36.3

8pm 36.4

Day 4

8am 36.2

11am 36

2pm 36.3

5pm 36.5

Day 5

8am 36.1

11am 35.9

2pm 36.5

5pm 36.6

She is always cold and has all the classic low thyroid,adrenal , fibromyalgia symptoms, she is very slim and quite fit and her hair is thick, always tired and mental fog/ confusion.

Her TRT doc suggested a trial of 1/2 grain armour and said to come off it I’m becomes jittery!. I am sceptical of this plan as I have read all the thyroid books including the big John Lowe and Gina Honeyman ones, Iam on 4 grains myself hence thinks 1/2 grain will maybe do more harm than good.

Any advice welcome, initially I was planning to buy thyroid meds and do it ourselves and may end up doing that with the help of the relevant books and forums inc this one, ideally I would like to find a expert to help her, I tried contacting Gina Honeyman but she didn’t reply. So all views welcome please

Thankyou

[Hidden]

I may be able to help you with the cortisol result, cortisol should be at it's highest point first thing in the morning & the drop through the day, so am early morning cortisol should be between 350-550nmol/Ls so hers is on the high side & needs further investigation. The Oestrogen contraceptive pill, HRT & Biotin found in some supplements can give an elevated result. Have a look at Cushing's syndrome, it is possible for cortisol to be within normal limit first thing in the morning but stay at that level through the day & doesn't drop as it should. She does need further investigations for it, her GP can repeat the early morning cortisol test, she also needs a 24 hour urine test, also the Dexamethasone suppression test but that might need to be done by an Endocrinologist. Unfortunately many Endo's are not conversant with pituitary/adrenal issues so it needs to be one who is. I may be able to help there too depending on where you are in the UK. Look up Cushing's on the Pituitary Foundation website or if you are Facebook then search for Cushing's UK & we can help with more information.

[ainslie in reply to Hidden]

Thankyou Pauline, I will read up on Cushings, I was a bit puzzled why cortisol appears high, I was expecting it to be low as she is a anxious person and has some constant pain from Fibro so I expected her adrenals to be worn out, the labs seem to imply otherwise

[Hidden in reply to ainslie]

The adrenal glands don't really wear out but can not be so efficient at secreting cortisol, it's a stress hormone so if she is stressed then cortisol levels will go up rather than down. The body tries to compensate by producing more to help, cortisol is used in every cell of the body.

[Jazzw]

What was the FT3 result? I can only see the range.

[radd in reply to Jazzw]

Also, what time were cortisol bloods taken and is there a DHEA result?

[ainslie in reply to radd]

Cortisol bloods were at 8.45am and DHEA was 1.4 , range 0.26-11, at these results she was on 10mg DHEA so we have upt it to 15mgCheers

[ainslie in reply to Jazzw]

Oops sorry typo,FT3 is 4.4