Hello, just trying to get a clear blood result and wondering if adrenal supplements too affect the blood results. I was getting very tired particularly after eating at lunchtime and having to lie down for a few hours as I felt exhausted. My practitioner put me on adrenal supplements and I think they are making a difference - I've had a huge amount of stress over the years so I know I was very depleted. I do low carb so it's not the carbs making me exhausted. I also do gluten-free and mostly dairy-free. Does anyone know about adrenal exhaustion and hypothyroidism? I'll post my last results, the endo decreased my dose to 125mcg, I was on alternate 125/150 after having been on 150mcg for years.
T4 26.7 - range 10.5 to 24.5
T3 4.3 - range 3.1 to 6.8
TSH 0.01 - range 0.27 to 4.2
ferritin serum 89 - range 30 - 400
iron binding 58 - range 50 to 85
Hb 117 - range 120 - 150
By the way the endo is one of the ones on the list, I saw him privately initially and he agreed to see me through my GP's referral afterwards. However he still seems a bit preoccupied with the T4, my T3 isn't high at all. I think because I get so exhausted after eating (lunch particularly), and do only have limited energy as I suddenly drop, I want to try and sort this out. It feels like my battery suddenly fails, I can't keep going all day. I don't work but am not sitting around apart from when I'm lying on my bed in the afternoon after eating!
Can anyone see where I should be going with this? Maybe I need to see someone else?
Written by
Pinkpetite
To view profiles and participate in discussions please or .
Adrenal glandulars won’t directly affect TFT’s, but I would stop adaptogens that influence the HPA axis.
Adrenal glands secrete cortisol which amongst other things is involved with blood glucose regulation, and the pancreas secretes insulin & glucagon involved in blood sugar metabolism. Both can become compromised in hypothyroidism.
If you are so tired after eating it sounds like inadequate insulin or insulin resistance. Even on a low carb diet we still need an insulin response to process starchy vegetables, fruit sugars, proteins that break down into amino acids, etc. (although protein is low on the glycemic index, it can measure high on the insulin index). We also require enough carbs to raise blood sugar enough for thyroid hormones to work well.
Yes, FT4 was too high but agree FT3 needs raising if you are symptomatic. Ferritin is much too low and low iron binding indicates serum iron is low also, and most likely the reason for (or contributing towards) your under-range Hb. Low iron /Hb would account for tiredness too. Have you had a CBC? Have you been diagnosed anaemic? Are you supplementing iron?
I haven’t checked your previous posts. Have you had Vit B12, folate & Vit D tested? Adrenal supports are great but we must get the basics optimised as well, as these nutrients & iron will help with more conversion of T4 - T3.
I did get more blood results but didn't put them all on. Here they are:
white cell count 6.4 - range 4 to 10
platelet 286 - range 150 - 410
iron serum 17 - range 9 to 30
transferrin serum 2,328 - range 2,000 to 3,381
iron binding 58 - range 50 to 85
% iron saturation 29%
ferritin serum 89 - range 30 to 400
HbA1C - 39 - range 20 to 41 - He was a bit concerned about this, he said it is unexpected for me - I think as I'm quite petite and very slim - but you may be able to say more.
I think he said I could take iron if I wanted for a short while but I can't remember and am not sure if I did take any or not, the test was back in October and I'm due another one next week - can I take iron a week before the test - do you know? Otherwise I could start it afterwards.
I did get my B12 up quite high, 803 - range 100 to 800, with a few patches for my April blood test, and my folate was ok - 14/3ug/l - range >2.7. My vit D is quite high as I supplement high doses. Maybe things can change in 6 months and they're low again?
I eat a lot of red meat but my iron levels are always low, he did want me to see a gastro consultant as he thinks I may have malabsorption issues but I haven't got very far with them as they were wanting me to eat wheat again and do a biopsy (the coeliac blood tests have always been negative). I feel awful physically if I eat wheat so I couldn't do it. Then they wanted to test for SIBO but I couldn't drink the sugary drink without nausea and burping.
Are you saying I may need to eat more carbs? I'm sugar-free (hence why I couldn't stomach the sugary drink) but I could put more carbs in my diet.
Maybe I will post next week's blood results and see where I am and go from there, and supplement iron afterwards.
If you are sugar-free and have an HbA1C result of 39 (20 to 41), this reinforces what I suggested above regarding having blood sugar/insulin issues.
Muscle or liver cells, etc, have an insulin-controlling gating mechanism but haemoglobin molecules can be glycated (joined with glucose) that freely enter & leave RBC’s, meaning the level of glucose inside matches the same as what is in the blood. Because RBC’s are continually renewing this allows a wide window of measurement of blood glucose (sugar) levels over the previous 2–3 months.
Low thyroid hormone can slow the cells uptake of glucose & decrease glucose absorption in the gut. It can also slow insulin response to elevated blood sugar & insulin clearance from the blood. Adrenal glands are suppose to secrete cortisol when blood sugars drop that signals to the liver to convert more glycogen into glucose, but many of us with low cortisol levels struggle with this.
When mixed up with a compromised pancreas, hence the blood glucose issues: hypoglycemia (too little sugar in the blood) and/or insulin resistance (too much sugar in the blood as unable to enter cells), and it is possible to have both. The severity of this will dictate how much it is affecting your bodies use of thyroid hormone. Have you had cortisol levels tested, either serum blood or saliva?
Therefore, with poorly-managed hypothyroidism you don’t have to eat a hugely sugary/carby diet to show traits of pre-diabetes. You should have received dietary advice re this high HbA1C result, particularly as your slim petit build indicates you not to be a high risk diabetes candidate. Has a retest been suggested in another 2-3 months?
After being diagnosed with Hashi I was horrified to find my HbA1C was high. Under a nutritionist I ‘reset’ blood sugar levels with a diet of slow acting carbs, fats and plenty of protein which takes longer to digest so preventing sugar spikes. I ate several small meals a day with protein at each, never allowed myself to get hungry. I supplemented Alpha Lipoic Acid (ALA) to help better utilise glucose, and Milk Thistle which also aids liver clearance slowed by low thyroid hormone, and Glucofit that lowers blood sugar levels by increasing insulin sensitivity. It only took a few months and blood glucose levels have remained good ever since.
Your iron's T/S is 29%. Anything under 25% is considered deficient and considering serum iron is only 38% through range and ferritin is 16%, it quantifies what I said above which is your iron is extremely low. Hb carries oxygen around the body & contains iron. Low levels usually signify anaemia when coupled with iron deficiency. Don’t supplement iron before your test. Then ask your GP to prescribe iron because he should then arrange follow-up blood tests to monitor levels as taking iron too high is toxic.
Your Vit B12/folate are good if you have maintained this level. Have you continued supplementing?
How high is your Vit D ?
Many of us have suffered malabsorption issues and intolerance of gluten. I would stay g/f & wouldn’t advise any invasive gastric investigations until thyroid & adrenal issues are sorted because gut issues may well improve as other symptoms reverse, and in the absence of conditions such as PA, absorption of everything usually improves. I have found Betaine + pepsin to be particularly useful in replacing missing gastric acid essential for absorption/digestion. Also digestive enzymes.
I can’t believe your consultant allowed an elevated HbA1C to pass by. I know you said he was on the ThyroidUK list but he doesn’t appear to be a specialist of thyroid or diabetes!
Thank you for such a considered reply. I can't take it all in as I get a bit confused with things but I will look up my last vit D test and not supplement iron until after my test next week. I get that I really need to sort my iron out before anything else. I do take betaine and pepsin now during meals, prescribed by a kinesiologist who didn't find me to be lacking in iron but she tested for the priorities to be treated. I don't think this endo from Dionne's list is the right one for me. He did re-test my HbA1c in 6 mths and it was exactly the same. I'm very aware I can't tolerate much sugar and don't feel right after eating sugar, I also don't feel right after eating. I'm aware I may need to eat more fat although I do try but I may need to look at my macros. I did have a blood cortisol test, I requested it through the endo as the GP wasn't interested, and he said it was fine. However I'm aware it needs to be tested at different points in the day to get a real reading. The adrenal supplement I was on is PURE adrenal cortex 200mg but I'm just about to start PURE encapsulations whole adrenal 300mg and adrenal cortex 160mg - I was going to take 2 of these daily after breakfast. What is PA by the way? And no I haven't continued supplementing B12 or folate - I could try and ask these to be added to my test next week as the blood is being taken at the GP surgery. Are you in the UK Radd? Wondering who your nutritionist was, I think I need to get proper help as things are still not quite right. I eat a lot of protein and a fair amount of fat with low carb vegetables but maybe I need to look at slow release carbs instead of low carbs. I get joint pain and find it better if I don't have the usual carb culprits. I mainly do low carb for my mood and so I don't get sugar cravings - I never ate much sugar, a square now and then never a whole bar but used to really crave this after lunch and dinner particularly as my energy would crash. Anything else you think could be added to this blood test while they're at it? Thank you so much for your help Radd.
Yes, I did go on a bit!! 🤣. I'll write each topic in a headed paragraph.
Iron - is too low so after next iron test discuss results with GP who will hopefully prescribe & monitor future levels.
Insulin issues - The nutritionist is in UK but her website has disappeared & my emails go unanswered so am guessing isn’t practicing anymore. Look into a diet that regulates blood glucose levels and/or maybe speak to your GP surgery’s diabetic nurse (or ask to be referred to one), and if you wish to supplement insulin/blood sugar supports my suggestions are above.
PA - is ‘pernicious anemia’, that I was only referring to as an example and am in no way suggesting you have it.
Nutrients - Vit B12 & folate often require continuous supplementation to maintain adequate levels as does Vit D sometimes. Having Vit D tested would be useful to assess levels because you have been self-supplementing.
FT3 levels were low but previous FT4 was over-range which can negatively impact FT3 conversion. Therefore, slightly reducing FT4 should encourage better conversion and together with the changes you are making above, it may be enough to raise adequate FT3 levels. Therefore, I wouldn’t start medicating T3 until :
- you have raised iron & ensured other nutrients are optimal.
- you have retested FT3 levels to assess if they remained low.
Adrenal Supplements - are great if you can tolerate them, as will also be (indirectly) helping your thyroid meds in working more effectively. When introducing any new glandulars it is better to start low & slow, especially with the whole adrenal that contains adrenaline. This avoids risking adrenaline rushes that people with low adrenal reserve can often experience.
Ok great thanks! I now know I need to continue with B12 and folate supplements as I stopped for some reason, I will ask the GP to add these to the blood test alongside Vit D if possible.I'm on 125 mcg daily now for over 2 mths so we'll see what this test next week says, good to hear that this dose may suit me better once I get my iron sorted out - and supplement with B12 and folate. I always take high Vit D daily.
I started the new adrenal this morning and have had no spike but will watch out for this. I am totally exhausted after my late breakfast, bacon and a keto roll and avocado, and was comatosed yesterday after xmas dinner - I just had lots of veggies with chicken, sausages and stuffing. I couldn't keep my eyes open an hour after dinner and was worried I'd had too many carbs (with the veggies as I had suede and brussels) but I'm seeing that I may need to up my carbs in order to help everything function better especially the T4 to T3 conversion and my adrenals. When I tried keto just over a year ago I was on the floor, flat, feeling like death - I did up my salt but I felt dreadful so I'm aware I have something going on in this area.
I will see a nutritionist locally, I was meant to last year but just kept getting overwhelmed with it all.
Are there any good adrenal groups that would benefit me? And I'm wondering about getting a salivary cortisol test done, probably privately.
You're welcome. The enormity of the tasks can appear overwhelming when we feel unwell.
A saliva cortisol test can be enormously beneficial regarding supplementing for the adrenals, but as you already are and have enough to deal with at present I personally wouldn't do one at this moment in time unless endo/nutritionist asks for it.
If you are getting Iron tested next week, I wouldn't start supplementing until after the blood draw. You are going to want to know the effect taking xx has on your results over xx weeks in case you are going to require an on-going maintenance dose.
Did they test CRP (non-specific inflammation marker)? I ask because your ferritin isn't what would be considered low (I'm quite envious 😊) Ferritin isn't a good marker for Iron if there is inflammation somewhere. ie If CRP is raised, it would explain why your ferritin isn't indicating deficiency, when your Hb of 117 is saying you are anaemic.
As I wrote I can't really remember but I think he said I could supplement it. I think I may have for a little while but stopped due to seeing a practitioner who said it wasn't doing anything. I'll see what this blood test next week says. Thanks.
I had coffee before my blood test, no food, and it was early morning with last dose of thyroxine 24hrs before. I just put the folate and B12 results on my reply to Radd and I know my vitamin D is high as I'm supplementing high doses, 4,000ius daily - the consultant told me to reduce this to 2,000ius daily. I'm not sure this consultant is too helpful as he wasn't bothered about my T3 result.
I will try and find the result but I think it was about 89 but I could be wrong. No, I'm not taking a B complex at the moment. Should I be? After the blood test?
My practitioner put me on adrenal supplements and I think they are making a difference - I've had a huge amount of stress over the years so I know I was very depleted.
I'm pleased that your supplements are helping you feel better, but just wanted to say that you can't usually make assumptions about your cortisol based on the level of stress you've been under.
I was under huge amounts of stress throughout many years of my life, mostly from untreated severe and chronic pain. And my cortisol wasn't depleted by that stress. Instead my cortisol was way over the range when I had it tested with a saliva cortisol test.
If you know nothing about your cortisol levels you shouldn't make assumptions on the basis of your life events and your symptoms. There is a lot of crossover between high and low cortisol symptoms.
I made the mistake in my early years of treating myself of assuming that I had low cortisol based on my symptoms. Before I started treating this supposed low cortisol I did a saliva test and posted it off to the lab, then went on holiday for two weeks. I took adrenal supplements while I was on holiday and they made me almost homicidal! I was really angry, and I got almost no sleep, I felt weak and tearful, and felt generally appalling. When I got home the results of my saliva cortisol test were waiting for me and showed that my results were way over the range, so I stopped the adrenal supplements immediately. It was an important lesson for me personally - never make assumptions about cortisol based on symptoms. Always test.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Blood Results and Thyroid results 
My Latest Blood Test Results - Adrenal Insufficiency Query
Blood test results and supplementing advice please
Blood test results for possible adrenal problems and chronic insomnia 
