Help please!!! Hypo and cortisol blood results

[1965Katy]

Hi, I am new to this group and would love some of your wonderful help.

Background

Saw a good private endocrinologist because I was feeling cold etc. May 2016. (I am no longer covered for private health care and cannot afford to pay).

May 2016

Results before starting levothyroxine

F4 10.4

T3 3.03

TSH 1.61

He started me on 50ug daily and also 200mg ferrous sulphate

Aug 2016

On 50ug results

T4 12.4

T3 4.2

TSH 0.9

So he increased to 75ug daily

Nov 2016

On 75ug daily

T4 13.4

T3 4.2

TSH 0.7

So he increased to 100ug daily

Feb 2017

On 100ug daily

T4 16

T3 3.8

TSH 0.2

Happy so he left dose unchanged

July 2017

Continuing on 100ug daily

T4 16.2

T3 3.5

TSH 0.3

Happy so left dose unchanged and said to continue on this dose ongoing.

Said he didn't need to see me again as stable nicely euthyroid and I have been looked after by NHS GPs since then.

Jump forward, I stupidly gradually reduced my dose thinking I could wean myself of levothyroxine not understanding anything about hypothyroidism. I have osteoporosis and read something bad about levothyroxine and bones which I now now is mistaken. Beginning of 2020 I got breast cancer and I have been preoccupied with that.

For the last couple of years, I have only been taking 50ug for four days a week and 75ug for three days a week. I have been feeling increasingly tired and wiped out but I have been blaming it on other conditions. Now I am wondering if it is thyroid related.

March 2023

Complaining about fatigue my breast oncologist did lots of blood tests including thyroid.

T4 11.9

T3 4.9

TSH 1.42

(I took levothyroxine on morning of blood tests).

Vit D 123 (50 - 200)

April 2023

NHS GP only tested TSH and said I was fine.

TSH 1.49

I said I wanted to increase dosage explaining my previous mistake in reducing but now she doesn't want me to. I was assertive and said I was increasing to 75ug daily so she reluctantly agreed and said I needed to be tested in 6 - 8 weeks time. I obviously want to increase to 100ug because I felt great on that dosage.

Meanwhile had cortisol tested. All blood tests taken at 9am

April 2023

700 (range 170 - 490)

May 2023

801 (range 170 - 490)

July 2023

729 (range 170 - 490)

As you can see, I have high cortisol and have been referred to NHS endocrinologist. This long awaited appointment is happening on 10th August.

I want to be fully prepared and know what to ask etc. and would really appreciate any help you could give. Could my high cortisol be caused by my hypothyroidism being under treated? It was tested back in 2016 and it was fine. I have been reading your posts and am so impressed by your knowledge and also your kindness.

I have probably left things out but I am so tired and my brain is so foggy!

Many thanks

Katy

[SlowDragon Administrator]

please add ranges on Ft4 and Ft3 results

Different labs have different ranges

Always test thyroid early morning and last dose levothyroxine 24 hours before test

Which brand of levothyroxine do you take

Is your hypothyroidism autoimmune

Have you ever had thyroid antibodies tested

Your results would appear to all show under medicated and/or poor conversion of Ft4 to Ft3 ….but need ranges to be certain

ESSENTIAL to test folate, ferritin and B12

What vitamin supplements are you currently taking

High cortisol is typical when not on high enough dose levothyroxine

Adrenals try to compensate for lack of thyroid hormones

As levothyroxine dose is increased and vitamin levels optimal cortisol should reduce

[1965Katy in reply to SlowDragon]

Hi, Thanks for your reply and help. I have just updated with all info and created a new post. Hope this is the right thing to do.