Greetings everyone! Happy Thank God It Is Friday (TGIF)!!!!!!!
Hope everyone is ok and laying in provisions for Christmas!
I got some interesting blood results which seem to indicate the relationship noted above is very important.
I am very, very tired, have all hypothyroid symptoms (confirmed Hash's), in massive stress, depressed, major brain fog, muscle decline and body shaking.
I finally got my useless encrinologist to do some adrenal blood work (not the 24 hr cortisol yet).
What do you think of the adrenal, thyroid link?
ACTH - 2.7 (1.6 - 13.9) - Seems very low normal range
Aldosterone - 191 (118-946) - Again very low normal range
Cortisol Random Mid Day - 173 (65-540) - Just at 1/4 of range in mid day!
TSH - 1.11 (0.35-5.00)
Free T4 - 14 (11-23) - Very low normal
Free T3 - 4.2 (6.4-5.9) - Under 50% of the range
I have been confirmed with candida overgrowth and mould in my body (my house), why I am stressed.
My adrenal and thyroid function seems low.
Is my Pit gland not working well leaving me exhausted. The messaging to the TSH seems ok though.
What do you think dear folks?
Hugs to all of you. Blessings and Good Health.
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ASkepticalConsumer
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All the blood tests were taken at the same time, mid day. Because of the huge shortage of blood labs here in Canada, sigh, there simply is few options to get your blood done. Only people with Cholesterol issues get the early morning time slots.
You can book an online appointment with Dynacare and choose the time slot that works for you. Also, I leant on this forum that a 24 hour urine cortisol test was more accurate
Early morning is considered best as shows pituitary/adrenals capacity to secrete highest amounts of hormone. Cortisol follows the same circadian pattern as ACTH, and both yours are too low even considering a midday blood draw.
Aldosterone is low too. Have electrolytes been checked for sodium/potassium levels? Do you have hypoglycaemia or blood sugar issues?
The link is HPA axis (hypothalumus- pituitary-adrenal) which links in with the HPT (hypothalamus-pituitary-thyroid). There is also the HPG axis (hypothalamus-pituitary-gonards) which link to HPA axis. Remember no hormone works in isolation, each influenced by many factors and fluctuations causing changes in other glands hormone levels resulting in local and systemic effects all over the body.
Are you medicating thyroid hormone replacement?
Have you had thyroid antibodies TPOAb & TGAb checked?
Thanks dear folks, hi Imaaan! Yep I know Dynacare, they ask seperate questions now if you want an early morning.
Radd, you are correct. I know much about the HPA axis via Dr. Lam.
It is obvious that my adrenals are tired, so many symptoms. I have my anti bodies tested regularly, all above normal but really bad.
It is the linkof the adrenals to the thyroid and sex hormones which is so vital for our health.
You posts have helped, I see the encrinologist in 20 minutes!
Hugs so much.
Cortisol Random Mid Day - 173 (65-540) - as others have said it's better to have cortisol measured around 8-9am to get a true representation of what is going on. The chart I've attached shows what normal cortisol levels should be. Yours is on the low side but not drastically so, the reference range covers the whole day, cortisol is at it's highest first thing in the morning & the drops during the day.
cortisol levels
Your ACTH is on the low side but again it's best done first thing in the morning, ACTH pulses through the day so it isn't always an accurate result. If the pituitary is affected then it may not be producing enough TSH so you need to measure T4 this should be in the mid teens. The attached chart shows how ACTH impacts our health.
She has had fT4 measured and it's 25% thro range with fT3 well below range so I think her TSH should increase to correct accordingly.
So a pituitary problem is possible? The question is what to do to correct. I suspect for the cortisol result alone, the advice may be to remove the stress (mold problem etc) being suffered but unsure if that would correct a pit'y problem.
I'm certainly no thyroid expert. But my 24h cortisol test a while ago (high around midday) indicated an issue and thyroid data suggest secondary/pituitary problem. I've elected to address the (known) underlying problem instead of masking it via medication.
If there is a pituitary issue then she may not be producing TSH as it's a pituitary hormone. It depends what the pituitary problem is, it could be an adenoma that is causing the issues, it needs investigating. of course it could be something easy like treating the mould but it needs checking out. With a pituitary issue it isn't always the case of masking the problem with medication but treating it & so improving health, ie Cabergoline to treat high prolactin; Hydrocortisone to treat the low ACTH, if not treated that can be a life threatening condition. Surgery may be necessary if it is a functioning or large benign tumour.
100% agree that the underlying cause must be determined before treatment is planned whether that be medication or alternative. Unfortunately, at least here in the UK, NHS rarely follow that principle!
Sadly in the UK there are few Endocrinologists who are conversant with pituitary/adrenal conditions, however there are some brilliant ones around working in Centres of Excellence, who will look into this & treat accordingly. Through my involvement with the Pituitary foundation, leading Endo's & the FB support group I help with I'm aware that there is a movement to increase the awareness of these conditions, the first hurdle is the GP! I've had a pituitary tumour which caused Cushing's Disease & I now have secondary adrenal insufficiency, meaning I am steroid dependent.
Hello this is my first post. I found your situation not so dissimilar to my own.
In 2015 I had a mass on the brain initially diagnosed as a Macro (big) Pituitary Adenoma . It later transpired to actually be a Meningioma. This was fully resected as the technical term medics use describing its removal. (10 hr operation ouch!) .
Where the tumour was , adjacent to the pituitary and the part of the brain that controls body temperature. You would have thought that when I went to my GP with systems such as feeling chilled on a summers day. Almost a sensation of chills going around your body a bit like when you yawn. This even happened in London on the day it reached 40 degrees! Yes goosebumps as well ; it feels bizarre at the time. I’ve had numerous Thyroid TSH tests all normal . I pressed the GP because of my medical history for T3 T4 tests to no avail. She did do a B12 which came back low and a folate low ish but in normal range.
I’ve just paid for a Medicheck blood test where
TSH was 3.44
Free T3 5.7 ( within the normal range. )
B12 was 55 low but within range and Folate was low at 5.5
Vitamin D low at 62
I tell my GP I feel weak and I’m exhausted after a 30 mile bicycle ride and immediately they think I’m fit and strong but actually I should be able to ride 30 miles without breaking sweat . I should be capable of riding 60 to 85 plus miles.
I’m taking B12 tablets now and I’ll probably get folate ones as well but my body is telling me something is not right. I’ve got a routine MRI soon checking the tumour isn’t growing back so hopefully anything sinister will be ruled out .
See my other post … I was treated at Southmead one of the centres of excellence you talk about . If you could give me a name for a Endocrinologist who has expertise in the area of how a tumour next to the pituitary and it’s removal could influence how I’m feeling presenting with symptoms suggestive of a Thyroid issue , I would like to know!
Many thanks indeed for your posts and analysis. We are frankly all better than the doctors out there for sure!
It is a week to Christmas, yes, we all need some down time, blessings on your family!
First, my encrinologist, said:
* Free T4 and Free T3, too low. She increased my synthroid to 50 mg per day and warned me to watch for over stimulation based on this amount
* My adrenal numbers were fine - yes fine. Not!!!!!!
So she is better than most encrinologists. Side story, Imaaan kindly told me about a Thyroid and Encrinology clinic in Oakville, Ontario Canada (Toronto area). I got my menopause dr to refer me - took only 3 weeks for an apt (should tell one something). I had a videoconference on Wed with the Dr. Bolt at this clinic - a Totally useless, arrogant, disinterested encrinologist . I provided the same blood work I noted above. He did not want to talk about anything other than the TSH, he said the free is not relevant. OMG, OMG. He did agree to 25 mg of Synthroid. The blood work requisition shows only a TSH test, nothing else.
Truly the most miserable doctor I have ever dealt with. Sorry for the side story, thought you would like to hear this.
OK, so my menopause doctor (I take bioidentical estrogen, progesterone and testosterone) advised yesterday my same blood work indicates low adrenal function - the low aldosterone is a particular issue.
She ordered 2 mg of naltrexone for me, low dose. I note that naltrexone is used to treat Hashi's etc and low cortisol - sounds just like me. I just took the first pill.
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What worries me is your posts regarding the pupituary gland and a potential tumor. I have wondered about that. I do not have any doctor willing to check that out. Sigh.
I think I have enough Synthroid now. I do wonder about conversion given my candida, mould and stress.
Imaaan kindly told me about a Thyroid and Encrinology clinic in Oakville, Ontario Canada (Toronto area).
^ You have me confused up with another member because I have never suggested an endocrinologist to you. Wish I could offer some insight but I'm really clueless when it comes to the pituitary gland. Hopefully someone else can help.
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