I had a four point saliva cortisol test and was actually expecting then to be low….(we took them prior to starting me on meds for Hashimotos…still haven’t started any meds yet….)
My cortisol levels were very high in the morning, high in the two afternoon tests and came right down in the evening to normal level.
What do you guys think?? I list my current relevant bloods…
Cortisol
7am - 27 (6-21)
Midday - 8.87 (1.5 - 7.6)
16.00 - 5.7 (0-5.5)
23.30 - <1.5 (0-2)
Ferritin 20 ( 13-150)
Folate 2.32 (>3.89)
TgA 544 (<115)
TPO 347 (<34)
TSH 2.37 (0.27-4.2)
FT3 4.9 (3.1-6.8)
FT4 15.4 (12-22)
Vit D 58 (says adequate)
I feel shocking. Almost housebound. Weak, extreme fatigue. Slow resting pulse, very fast upright pulse. Some palms, ectopics. Air hunger. Blah!
What do you think?
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I tend to experience air hunger and an increase in my tachycardia and insomnia whenever my ferratin levels drop below the midway point. According to that range, your results are only 5%
Are you vegan/vegetarian? If not, liver could help improve your levels. You may want to do further testing to figure out the cause of your low ferratin. Folate needs improvement as well. Thorne b basic is recommended on this forum and its terrific in helping raise your levels.
TPO is high, removing gluten from my diet helped reduce my antibodies. You could give it a try if yourse so inclined to see if it would beneficial.
As for vit d, adequate means you're in range but it's not necessarily optimal.
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
I did full iron panel but it haemolysed unfortunately.
My ferritin has been low for YEARS!!! This is the highest I’ve managed to get it by taking horrible supplements ferrous fumerate etc. Doctors always say it won’t be contributing to my symptoms as my Hb is normal….although I haven’t had that checked in a little while.
I do supplement with a 3000 vitD spray daily.
I had 3 vit B12 injections at GP last year as that was low.
Very bizarre and very very difficult to get any help.
My ferritin has been low for YEARS!!! This is the highest I’ve managed to get it by taking horrible supplements ferrous fumerate etc. Doctors always say it won’t be contributing to my symptoms as my Hb is normal….although I haven’t had that checked in a little while.
Thousands of thyroid patients would disagree with medics
Extremely important to get ferritin levels optimal
SeasideSusie and humanbean may pop along with suggestions on ways to improve levels
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but a further 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
As your coeliac result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
A recent study showed a close correlation between serum ferritin levels and thyroid activity (8). In this study, enrolling n=50 diagnosed hypothyroid patients and n= 50 healthy control individuals, serum ferritin levels were shown to be reduced in hypothyroid patients (21.08 ng/mL) as compared to controls (59.89 ng/mL). In parallel, elevated serum ferritin levels were observed in hyperthyroid patients affected by Grave’s disease (9).
Interestingly, thyroid hormones regulate ferritin expression by a feedback loop mechanism. In a study including patients affected by Hashimoto’s thyroiditis with low ferritin levels, the administration of L-T4 therapy (levothyroxine), restoring an euthyroid function, significantly increases ferritin levels (10). Inversely, the synthesis of thyroid hormones by the enzyme thyroperoxidase requires iron so the depletion of iron store (low ferritin levels) may accentuate the decrease of free T3 and T4 levels (thyroid hormones) although the autoimmune mechanisms (chronic inflammation in the case of Hashimoto’s thyroiditis) are the principal causes of the low production of thyroid hormones. As mentioned previously, ferritin levels could be altered by inflammation and for an accurate interpretation, free iron and CRP levels should also be evaluated.
I don't particularly rate Medichecks cortisol test because when you look at the two later timed samples they don't have a proper range. Ranges are based on healthy people and anyone with a level of zero would likely be unwell or in the morgue. Also the bedtime one doesn't give a result, the lower the better at bedtime but it just says <1.5 so is that 1.4 (which would be high) or close to zero? That result doesn't tell you anything.
However, as your results are high I would show these results to your GP and point out that the first three are over range and would he arrange further testing to check for Cushing's syndrome which is when you have too much cortisol. Do some research on it so that you can have a proper discussion with your GP. I'm not saying it is Cushing's, I am not medically trained, but I think it's worth looking into so it can be discounted.
As for having low ferritin for years, this should be addressed by your GP because it will be causing problems and thyroid meds wont work properly when ferritin is low.
Yes, I looked into Cushings…I was hoping the low evening cortisol would rule it out…but I’ve forwarded it on to the private gp I am consulting regarding my thyroid and will also report it to my gp.
I have tried to get my ferritin addressed multiple times…to no avail. Im Considering a private iron infusion but I’m worried about the side effects of that…they give such a massive dose…
You know when you feel so poorly already….you really don’t want to feel any worse…
Ugh! Lots of things that need to be addressed though, I think….
I think you’ll feel a whole lot better once you get your folate higher. A lot higher! Take methyl folate. And you need to fix your ferritin. These two things alone Will help you feel better (it’ll take 4-6 weeks). Then I’d start looking at your thyroid and cortisol but only once you’ve tested and see your folate and ferritin rise.
Thank you! I’ve just spoken with GP who has just prescribed me high dose folate. I hope it’s methyl folate and not folic acid….I’ve been working on my ferritin for MONTHS! It’s up to 20….but very slow progress.
If it’s folic acid, just buy your own methyl folate. I buy a decent one on Amazon. Many here will tell you it’s worth buying a decent multi b vitamin so once I’ve taken folate on its own for a month or two I switch to Thorn Basic B.
LOL I actually just bought the Thorne b on Amazon yesterday. I also bought pure folate 400 mcg but the gp said it’s a much smaller dose than the 5mg she will prescribe for 4 months. I’m wondering if I should still have my b12 injection next month or wait til folate is up a bit as I know b12 causes the body to utilise folate….which will probably lower it further.
OK high cortisol, could likely be related to stress and low zinc zinc lowers cortisol, high cortisol suppresses thyroid hormones and basically zinc balances them...
High Antibodies suggests you have gut issues and systemic bacterial overgrowth or you have a systemic viral or fungi infection, do you know of any? If so get that/them sorted then both the antibodies come down and possible Hashimoto’s will resolve itself if the infection is in the thyroid
Low ferretin, low folate could be a couple of things, one ties into cortisol there's a trifector of nutrients copper iron zinc, low zinc, low ferretin could be tied to high copper level. And they are frequently out of balance.
Low folate, another contributer is the Pill the pill depletes nutrients to prevent pregnancy these include folate/B9 and B2 obviously these nutrients are responsible for more than that... plus it depletes a few more nutrients too...
Low ferretin and low folate the other thing is their both dependent on B2 and vitamin C
Vitamin D3 level it says adequate but not optimal. Here's why you need optimal between 70-80 there enough for you to produce cathelicidins, cathelicidins go round the body gobbling up bacteria, viruses, and fungus. Think antibodies
100-130 at this level there's enough to protect you from several cancers giving you the full protection that vitamin D offers
Optimal vitamin d also protects from weak muscles, Carpal tunnel, bone pain, other symptoms of low vitamin D...
So high antibodies…I have had them very high for over a decade now. I had a previous campylobacter infection in 2008 which caused me huge problems ( gastroparesis and pots…although the gastroparesis slowly improved)
I’m not aware of any gut issues now….apart from upsets with taking ferrous fumerate etc!
I really have no idea about zinc and copper! How do I test those?
Folate….I’m not on any pill or hormones etc. I wonder if my b12 injections lowered it?
I’ve started also taking 1000 vit c (with my iron) but it also really upsets my stomach so I take it as I can.
Vit D I take a daily 3000 oral spray….doesn’t seem to be coming up much on that….wonder if I should raise that dose….
Here's a great presentation on vitamin D, it's also magnesium dependent too youtu.be/NuWC2d0mTbo
B vitamins never take on its own, uf not you need a B Complex too, nutrients are also dependent on adequate stomach acid for absorption plus B vitamins 6-9-12 requires B2 for absorption too
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