Cortisol levels

[Pinkisland]

Hi all, can anyone tell me if there is a link between Hashimoto’s and low cortisol levels. My cortisol level on a 9 am blood test is 271. What does this suggest?

[SlowDragon Administrator]

Yes

What are your most recent thyroid and vitamin results

How much levothyroxine are you currently taking

What vitamin supplements

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

 

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

As you have Hashimoto’s are you on strictly gluten free or dairy free diet

[humanbean]

There is a connection between cortisol levels and thyroid disease generally, not just Hashi's.

amymyersmd.com/article/adre...

hypothyroidmom.com/cortisol...

paulrobinsonthyroid.com/t3-...

thyroidnation.com/effects-c...

thyroidnation.com/stress-ex...

hypothyroidmom.com/a-balanc...

link.springer.com/article/1...

Cortisol isn't always low with thyroid problems. Some of us end up with high cortisol levels. Neither low levels of cortisol nor high levels are desirable.

[Pinkisland in reply to humanbean]

Thank you. I am going for a short syncthen test to check why my level is borderline low. I know it can be caused by Addison disease. Do you perhaps know what cortisol levels would sugggest Addisons?

[humanbean in reply to Pinkisland]

Do you perhaps know what cortisol levels would sugggest Addisons?

I know of one member who was diagnosed with Addison's after having a saliva cortisol test which produced extremely low results :

healthunlocked.com/thyroidu...

healthunlocked.com/user/Deecam

I'm not sure at what point levels would reliably indicate Addison's with a saliva cortisol test - I doubt anyone knows. Saliva cortisol tests aren't used by endocrinologists as a diagnostic tool - they rely on other tests to diagnose, but very low results from a saliva cortisol test might suggest to the patient that it would be a good idea to ask a GP to be referred to a hospital for further testing. The first thing the GP is likely to do is a 9am blood test for cortisol to see if there is an issue with that before agreeing to do a referral.

The GP of the member who was diagnosed with Addison's thought that her saliva cortisol results "weren't that bad" which still shocks me!

If you want to have information on the tests that endocrinology departments do for patients you need to save this link for future reference :

imperialendo.co.uk/Bible201...

There is a description of the Short Synacthen Test on pages 68 - 70 on the above link. It gives info on preparation, how the test is carried out and how the results should be interpreted. Please note the comments about reference ranges on page 2 of the document.

.

There is another member who had extremely low cortisol from a blood cortisol test. In her case the Short Synacthen Test came back "normal". It turned out that her blood cortisol was low as a result of low T3, although it took quite a while to get to that point and to find out that it did wonderful things for her blood cortisol level. With the addition of T3 her cortisol rose up to be at a healthy level :

healthunlocked.com/user/mcp...

Take a look at what McPammy posted about 4 or 5 years ago about her thyroid and adrenals, on that link above. In one post she reported a 9am blood cortisol which was way under range, although it did fluctuate a lot :

cortisol 68 range 155-607

It improved with T3 to be in the hundreds, and she says she got her life back.

[Barrister]

A 9am blood cortisol level below 80 is now an automatic diagnosis of Adrenal Insufficiency. Along with positive adrenal antibodies this would indicate Addisons Disease (Primary Adrenal Insufficiency - PAI). An ACTH test (often done at the same time as the SST, if high also indicates PAI, if low then along with the SST could rule out PAI and therefore a possibility of Secondary Adrenal Insufficiency (SAI).

I had a saliva cortisol which came back extremely low. I then had an adrenal crisis so a SST was done - baseline was 15 and rose to 30 so immediately diagnosed with AI.

[Pinkisland in reply to Barrister]

Thank you for the explanation. I am finding it all very complicated.

[Barrister in reply to Pinkisland]

There is a very helpful FB group if you want to have a look and ask questions - UK Addison’s Disease & AI Info & Support Group.

[Neenazee]

did you find out whats the result of your synacthen test?

[Pinkisland in reply to Neenazee]

No I’m still waiting