Adrenal saliva test & DHEA

[Insomania]

So at my last GP appt to review all my results, 21 months of blood tests* since the multinodular goitre was discovered in May 2021, the GP said I do not have primary thyroid and I need to let it go, he believes my symptoms are carers burnout.

I raised secondary/central thyroid and we seemed to reach a compromise in doing one last test to check my adrenal function was tested because I'm so fatigued. NHS is a blood test (GP referred but not yet done), I said I would do an adrenal saliva test too.

Results are in and cortisol is low 3 out of 4 points as is DHEA.

What should I be pushing for next please?

Thank you so much, you've all got me this far!

* I have multitude of symptoms and feel really unwell which is why I have persisted but until the numbers fit into a box, I cannot be referred to endocrinology.

Symptoms include: debilitating insomnia, fatigue, brain fog, cognitive issues (finding words, memory), aching muscles, neck and back pain, cold, palpitations, nightime anxiety/panic, digestive issues, weight gain. Iron, vitD and vitB12 are low and being treated. Gastro issues like coeliac ruled out by blood test and checked/biopsy during endoscopies. Cholesterol normal.

I take HRT; low-dose Amitripyline for insomnia; Tranexamic Acid for menstrual blood loss; VitD3 softgels, B complex, triple Magnesium & VitK2MK-7 all recommended here.

[Pookie2]

I have adrenal insufficiency. I can’t answer to your test results due to I have done blood work. I understand your symptoms. I recommend IF your cortisol is low (their is different herbs and supplements that you take/don’t take if you have high cortisol.

🧐Please Check With Your Doctor due to your thyroid condition and your tests are different.

Low cortisol: I take Synthyroid and T3. I prefer the natural Armour Thyroid (allergy to fillers). I take DHEA 5 mg (if you can Pure Encapsulations or another clean supplement). Take also Methyl Folate 1,000 mcg. Both DHEA and Methyl Folate take with breakfast.

After lunch, I take a quality B complex, DIM (regulates hormones/over the counter), Vitamin D , Zinc, Magnesium.

Throughout the day with lots of water take Ester C.

Around an hour before bed I take another magnesium, Ashwaganda and progesterone.

Suggested: Get all your hormones checked. It helped in the evening for me to take an epsom salt bath about 2-3 times a week (helps joints, chills you out ). Try to elevate any physical or mental stress. Try to get outside in the sun. Some days as you improve, don’t overdo when you feel better (you might relapse). Eat a low inflammation diet, no gluten , try to control sugar, eat vegetables with vitamin C.

🤗Very important: read up on Circadian Rhythm. Your sleep is essential for healing! Try to go to sleep between 9-10 pm. Try to leave the phone alone at least one hour before bed. I turn my ringer off and leave it in the living room. My friends know that I don’t answer them till morning.

I hope that things improve. Take baby steps. I am still trying to realize how to change the little things in life to heal. Sometimes it is chilling at home or saying No. 🤗

[radd]

Insomania,

Your low level results are typical of many on the forum as adrenal reserve eventually becomes compromised after years of supporting inadequate thyroid hormone levels. 

If your 9am blood cortisol comes back low, you could ask for a hospital Stim test to eliminate Addisons. Many members have been offered this too and thankfully don’t have Addisons, although not having a diagnosis when one is feeling so ill can be upsetting/confusing too. 

Both my cortisol and DHEA rose after optimising my thyroid hormones. What were your previous thyroid numbers and did they include FT3? 

Some members have found glandulars very useful (I didn’t as they have always made my head go all swimy). They come in both thyroid and adrenal and can be quite powerful in effects (good and bad), so start low and slow. If you have read Dr P’s book you will know he was a huge fan. 

Be aware glandulars may alter your labs and possibly put your GP off prescribing.

Great contribution from Pookie but be aware DHEA is prescription only in the UK.

[Insomania in reply to radd]

This is how @slowdragon interpreted my results in a recent post:

“Thyroid results look “normal”….though Ft4 is at lower end of range 

FT4: 14.4 pmol/l (Range 10.5 - 21) Ft4 only 37.14% through range 

FT3: 5 pmol/l (Range 3.5 - 6.5) Ft3 higher at 50.00% through range 

TSH is not reflecting the fact Ft4 is struggling.”

TSH was 0.32 in December and 0.59 in January (nhs range 0.35-5.5)

I emailed the cortisol saliva results to the GP. The message I got back from receptionist was “Dr says it is important to note that the results are within range. GP has booked a cortisol blood test for 8.40am [in a a week] and will refer if it is low.”

Will ask for a stim test too.

I haven’t read Dr P’s book, who is Dr P?

[radd in reply to Insomania]

Insomania,

Regarding your thyroid results I agree nothing stands out. FT3 is often higher when FT4 is reducing in an effort to retain wellbeing but a raised TSH would be the driving force trying to encourage further T4. Low TSH and low thyroid hormone levels happen in central hypo when there’s an issue with the pituitary or hypothalamus, but your FT3 result is good.  

Given you are so symptomatic, you could have tissue hypothyroidism. This is when there is adequate thyroid hormone in the blood but it’s not being up taking and/or utilised in the cells. Essential cofactors for enzymic activity that allow the T3 hormone to become active are any micronutrients known to help the mitochondria, balanced blood glucose, balanced sex hormones and the right levels of thyroid hormone. 

Given you have a goitre diogenes suggested you ask to have your iodine levels tested. Did your GP agree to this? There is controversy about the best way of testing iodine levels but they can be useful if interpreted correctly. I had to do a urine iodine test for my endo several years ago. 

Dr Peatfield was affectionately known as Dr P. He was a great doctor who helped many of us who couldn’t get well on Levothyroxine alone. He wrote ‘Your Thyroid and How To Keep It Healthy’ which gives a great overview of thyroid physiology.

With your issues you might also benefit from reading Dr Myhill’s book new 'The Underactive Thyroid’ or checking out her website as she is more ME/Chronic fatigue. drmyhill.co.uk/

Looking back at your previous posts you were severely deficient in serum iron and ferritin. Haemoglobin levels were just about hanging in there but levels could have dropped by now unless you are supplementing iron. Iron is also needed in the whole cascade that helps T3 become active.