I'm planning on doing an Ultimate Performance blood test with Medichecks to look at a whole range of things. Particularly I'm interested in the thyroid values as it will be a 6 week follow up to my pervious one and I want to see if anything has changed. I'm undiagnosed and unmedicated but I had a very helpful reply from greygoose on my pervious results. I should mention I was severely iron deficient 3 months ago but ferritin is now coming up.
This Medichecks test also includes cortisol. I am aware of all the tips for getting an accurate result for thyroid values but I was wondering if there is anything specific to do/not do, to get a decent cortisol reading. Or, is this not a useful test to have at all and will tell me nothing therefore I'm wasting my money.
Many thanks for any advice on this ☺️
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Bertiepuss
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Iron-related question - What have you done to get your ferritin up, and over what time period, and what was the change in iron & ferritin blood tests ?
(Also will follow this thread here to see the answer on Cortisol!)
I've been taking ferrous fumarate with vitamin C (acerola cherry powder to help absorption and reduce constipation). Went from ferritin of 8 ug/L to 49 in approx 3 months. The serum iron in not so relevant as that changes every hour of every day depending on how much iron you've ingested from supplements and food at the time of testing.
Do the blood test at 9am. If there is anything awry about your cortisol level that requires you to follow up with your NHS GP, your GP may come out with "oh, cortisol has to be done at 9am as it varies through the day" and may attempt to fob off the concerns of yourself and the GP at MediChecks. I have literally just got back from having my bloods done again at the GP surgery as my MediChecks one was done about an hour later!!! TBH, my GP surgery seems to have a thing about patients being pro-active and/or private blood testing - I usually avoid telling my NHS GP about private blood test results, but on this occasion the urgent need for follow-up overrode that (MediChecks tried phoning me about the results - that's never happened before, they emailed to follow-up, and 111 said I needed urgent assessment), so 2 hours of back and forth yesterday until I got my NHS GP practice to agree to investigate what appears to be an adrenal problem, which on the day of my MediChecks test a few days ago was possibly not far off a trip to A&E. Hence, doing the blood test at the GP practice this morning, and GP appointment already booked for follow-up. Just need to find a decent endocrinologist not too far away now (I posted yesterday to ask for recommendations, responses by DM only).
Is the cortisol test useful? If you could have an adrenal problem - definitely. I do the Ultimate Performance test every year or so normally, although the one I had a few days ago was the first one since before COVID. I've found it very useful, as it's highlighted a few things over the years.
Thank for the tips JumpLiving, good to know about testing at 9am. Looking at the thyroid is my main aim but as I have an iron deficiency too (which I'm treating) I wanted this blood test to look at the whole body, including cortisol. So many overlapping symptoms, it's difficult to unpick what is what.
To be honest, the morning is my feeling best (least worst) time and I fade as the day goes on. Not sure how conclusive a 9am cortisol test will be but hopefully once results are back the lovely people on here might point me in the right direction if something is off. Good luck with your appointment, I hope you get to the bottom of what is going on.
This is the more useful cortisol test as it looks at free levels and 4 times throughout the day giving you a much better understanding... regeneruslabs.com/products/...
Blood serum cortisol at 9am gives you the total cortisol in your blood
Thanks for the link Eeyore100. Yes, I recognise the saliva test, I did one a few years ago. So the blood serum one sounds like it's not particularly useful unless it's either spots really low or really high levels. Oh well, trying to get everything in one test (to save money) doesn't look like it gives the best information.
I use the Ultimate Performance Test every couple of years, when it's on offer as it is good value for money. I've had a few low cortisol blood tests and a SST but they really aren't interested unless your adrenals are failing 😕
I assume it's the same with serum DHEA and saliva though I've never really investigated, my saliva levels is always below range and serum mid range
They might react if you are under range... Short Synacthen Test gives you a shot and measures your reaction to see if your adrenals are capable of responding
Yes, my poor adrenals have had a very hard time over the years, that's for sure. I do take Vit C to increase absorption of my iron supplement and also use salt to taste and don't restrict it's use. Still got low blood pressure often under 90/60 and a high heart rate, not sure why though, has been this way for a long time, maybe adrenal related, maybe iron. So hard trying to work out what drives what problem and therefore what to do to help, a common story for those on this forum ☹️
Just read your Bio... you sound very much like you are on the same path I started out on 5 years ago and only really made any headway when I found this forum.
Medics never mention how important it is to get your vits and mins in a good place rather than just into the bottom of their range... many of us make great progress with Three Arrows Heme Iron much easier on your stomach and much better uptake (awful website 10% discount with FRANKLIN) threearrowsnutra.com/en-uk/...
If you haven't added HRT to your regime then I would really recommend researching this, I wish someone had suggested this to me when in Peri... balance-menopause.com/subje...
It's another strain on your adrenals as they have to pick up sex hormone production when your ovaries stop
Thanks Eeyeore, just read your bio too, similar path indeed! I have been struggling for many years and the older I get the worse it gets. I'm reluctant to take Heme iron as I'm vegan but with ferrous fumarate my ferritin is rising at a reasonable pace so will continue with that for now.
My Vit D is good though, but I supplement, get out in the sun and test twice a year. Agree with docs not acknowledging anything as a problem unless out of range. I've now realised I've probably been iron deficient all my life after requesting all historic blood tests from childhood.
Yes, started HRT 6 months ago (read the Balance website and it made sense to me) but I believe I'm still not on an optimal dose so will continue with trying to find out what's right for me. I also have PCOS which I believe was under reasonable control...and then perimenopause started! Now trying to investigate possible thyroid issues but my results are not clear cut either.
I now use Iron bisglycinate ferrochel but haven't any latest results to see if that combined with a couple of heme a week are doing the trick... hopefully getting your iron up will help correct some issues 🤗
l'll tag Regenallotment as she has been experimenting too
Yes, bought some a month ago but been scared to try. As the fumarate hasn't caused me issues I feel like just sticking with what I know for the time being. I've gone from 8ug/L to 49 in about 2.5 months but know I need to be closer to 100. Plus upping HRT and also trying to deal with B12 I don't want to do too many different things and not know what's helping/hindering.
Do you feel you are on the right path now after 5 years and your health has improved? What's been most helpful for you? Thank you for all your help, it's much appreciated 😊
Great result with FF, its a torturously slow route for many, it suggests you are better at absorbing and converting than most so hopefully a few other tweaks will see big improvements 🤗
Since joining the forum and following the advice here I have gone from total wreck ready for the nursing home to a functioning being, brain and memory thankfully fighting back and I've been steadily increasing my exercise and building some muscle and stamina... I'm on an improving trajectory for the first time in a decade 😅
For me it was the desperately needed T3 that turned things around, tbh I broke all the rules and just added all of the supplements and T3 in the first month!
Oh and adding some testosterone and hydrocortisone
I did the Ultimate Performance Test from Medichecks 18months ago when I thought I must have early onset dementia and this is the first I knew about the existence of fT3!!
Went to the library and found Dr Barry Durrant Peatfield's book and then started hunting the internet and thankfully came across this forum 🙏 which started the fight back.
Insisted I be referred to Endo, did some gene testing which confirmed a wonk
I self source all the Vits and Mins (tbh NHS ones are the cheapest nastiest and they only provide if you are deficient) but I get all of the hormones from my NHS GP and NHS Endo oversees the T3, with the HRT you need to know what you want and tell them! 🙃
Steroid is self sourced, trying to get everything from the GP is like dragging a dead weight around 😕 thankfully avoided Private costs as it seems they aren't much better... plenty of information out there and on here
Interesting, thanks for sharing. I think I might have to read every post you've written to steal your knowledge as you're a lot further along than me and clearly much more educated as well!
Yes, with the HRT that's what I did, asked for what I wanted and there was no problem with it being prescribed although not yet gone down the testosterone route. Now have to continue learning about the rest. I just feel like it's one massive experiment that I'm not getting right.
I’ve been quite active 🤣and some threads do wander…. There is so much to learn, but you are your own expert, so much more chance of you getting it right than anyone else 🤗
Everyone here is right behind you so ask away, we have a huge lived knowledge library
fT3 - 3.7 (3.1-6.8) 16.2% through the range - exactly the same as you!
TSH - 1.75 (0.27-4.2) 37.7% through the range
These were from 1 month ago (Medichecks) but I had similar levels 3 years ago. Undiagnosed and unmedicated. Fasted at 9.30am. GP did TSH 3 months ago with a similar level - said all fine no need to look further.
I posted these results on this forum a month ago and I received a very detailed reply from greygoose (won't tag as I will be repeating) saying that fT4 and fT3 were pretty low but that the reasonably normal TSH was not reflecting this and should actually be higher, possibly pointing toward central hypo but further testing needed over the coming months to see if results remain the same. Interestingly your fT3 was also 3.7 but I think your your fT4 and TSH were a lot higher than mine before you started medicating
I was already on T4 with a top of the range fT4 and low fT3 which showed terrible conversion... you sound very like another newish member who recently had a scan which backed up her low results so hopefully will get her some treatment... I'll be back when I have found the thread 🤗
Thanks Eeyore100, you're so helpful🤗 Yes, my results do look quite similar to this members, just that her fT3 at 3.7 was actually below the reference range used on the test whereas mine is still above.
I see her ultrasound revealed nodules and Slowdragon made a comment about possible central hypo as her TSH was normal. I will investigate ultrasounds...
I see, your top of the range T4 was already medicating but it wasn't being converted hence low T3 and therefore needing to add that.
Thanks again for all your help, I'm so grateful to have others helping me to navigate this journey without a map!
You are welcome... we all swim around looking for answers and often others hold the key 🤗it's a bit like a mass treasure hunt and we all have a little bit of the map
Me again! Interesting that you said adding T3 was your turning point. Just wondering how low your T3 was to be able to get your GP to agree an Endo referral? Trying to work out what the trigger point is that persuades them.
Also, when you saw the Endo, were they totally onboard about giving you T3 or did you have a fight there (assuming you were not actually out of range)?
My fT3 was 3.7 on the private test (3.1 - 6.8) so 16.2% when my fT4 was top of the range so no room to increase
*When I got to see the Endo (one chosen from the TUK List as T3 previously prescribed) I had already started taking T3 and after filling in a before and after questionnaire she took me on.... though reduced my dose of T4 and T3 which put me back to bed for a month and a bit of a toe to toe when I told her I'd increased back to my functional dose... TSH is 0.05 but I accept that as it didn't raise on the reduced dose anyway! She leaves me alone after I asked for proof of all the usual threats of heart issues and osteoporosis.... Quality of life over quantity seems to get the point across
I’ve had a few months off three arrows and my ferritin has halved. I’m back on it every day for 2 weeks and then will have it two/three times a week.
HRT jury is out, awaiting genetics approval regarding cancer risk. Ovestin in the meantime has been a godsend and some acquired urtogestan at half dose is smoothing things out for me.
sorting my ferritin had the most miraculous effect on my energy levels and thyroid hormone conversion.
Hi Regenallotment, good to hear you found raising ferritin had such a good effect. My T4 and T3 are low in the range (undiagnosed and unmedicated), I did wonder if I sorted the ferritin if then the thyroid would improve. Time will tell when I next test ferritin and thyroid panel to see what's changed. How high did you have to get ferritin in order to feel better?
At 140 I was on fire, racing around trimming 6 ft beech hedges with no aches and pains, I did however then have palpitations and despite the very hot weather in July was getting hotter than normal with only light exercise. Next test showed over range. I think 100-120 will be where I need to be 🌱
It's a fine balance, too much no good, too little no good. It does seem that around 100 to be optimal, it's where I'm aiming. The idea of racing around with no aches and pains sounds most appealing...
I was looking at that test too via my GP.... The other one is the 1mg overnight dexamethasone suppression test (DST), which is timed and requires a morning blood test.
My stress levels are sky high, so not a surprise really. I'd rather it was much lower and my cortisol with it - this causes other kinds of very nasty problems 😭
I tried some of this and it totally monged me out! I don't know if it has got stronger, I passed it on to my BIL who uses it to cope with osteoarthritis
Bertiepuss In response to your original question I had the 9am Cortisol done by Medicheck. I was panicking as it was a finger prick test that wasn't going very well at all and my Cortisol result was sky high. I have assumed the two were linked and therefore the test wasn't very informative for me.
Yes, that's the trouble with finger prick tests, my last one made a right mess of my finger, the blood then stopped and I had to prick a second one. My heart rate was so high! I think it's worth paying to get a venous sample, as long as they don't stress you.
This Medichecks test also includes cortisol. I am aware of all the tips for getting an accurate result for thyroid values but I was wondering if there is anything specific to do/not do, to get a decent cortisol reading.
An early morning (8am - 9am) blood test for cortisol is the one that a GP would do if they suspected a cortisol problem - either Addison's (very, very low cortisol) or Cushing's (very, very high cortisol). So doctors think it has a purpose.
The blood test is supposed to capture the highest cortisol output of the day just like the first saliva cortisol test of the day - but they aren't measuring the same thing. And in some circumstances e.g. patient works shifts or has chronic sleeping problems, the blood test might not be very informative or very accurate.
If a doctor is lazy or stupid they will tell the patient that any time of day will do for testing cortisol and the patient ends up with a random cortisol result. The reference ranges for random cortisol tests are incredibly wide. And as we know, doctors think that anywhere within the reference range for anything is absolutely hunky-dory.
The difference between saliva cortisol and blood cortisol is described in this reply (by me) to another member :
Thank you humanbean, this is really helpful and I've read the links. The Nice document say HRT can elevate levels of cortisol due to cortisol-binding globulin, making interpreting serum cortisol difficult and requiring Endo input. I take HRT so that may affect my results making them unreliable. Not sure if HRT would affect a saliva test too?
From what I've read from your post to the other member it sounds like it is worth doing the serum cortisol test (in case something obvious turns up) but also a saliva test is necessary as there can be some variances due to the differences in measuring bound and unbound cortisol. Food for thought and another line of investigation for me. Thank you for pointing me in the right direction.
I have yet to fathom exactly how my chronic low ferritin (now on the up from supplementing) and low in range FT4 (30% through range) and FT3 (16.22% through range) play into all of this. If one upsets the other and then how this upsets the adrenals, or maybe it's the other way round?
I had similar thyroid results 3 years ago and I'm undiagnosed and unmedicated.
Another thing I'm trying to work is I have slightly raised IgM immunoglobulins. GP said not high enough to be of concern so ignore and no need to repeat. On reading further it seems this can indicate some sort of autoimmune reaction. Another line of enquiry that's confusing me.
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9am Cortisol blood test 
early morning blood test
Saliva cortisol test 
Salvia test for cortisol
