High cortisol

[Airmed]

Hi everyone. This may not be an appropriate post, if not please discard. However, I often see posts about cortisol. My husbands granddaughter who lives in New Zealand has been quite poorly growing up with anxiety and prescribed anti depressants on and off. She is now 22, extremely bright and was doing a double degree until health, mainly anxiety forced her to withdraw from the course. Thankfully she is feeling better in herself. Largely, I believe, due to fact she has found a GP who takes her healthcare seriously and is listening to her symptoms. She has put on a lot of weight in the last 18 months still on anti Ds and still doesn’t feel well and has stomach issues, constipation and diarrhoea . She recently had a raft of blood tests. TFTs were normal but her cortisol levels are 700 units, top of lab range being 500 in New Zealand. CRP levels are mildly above top of range too. All others test results in normal range. Cushings has been suggested and she is currently having a Dexamethasone test. If anyone has any experience of this and can help I would be enormously grateful. Thank you

[greygoose]

TFTs were normal

Who said they were 'normal'? If it was her doctor, then what he meant was that they were somewhere within the so-called 'normal' range. But that doesn't make them good for her.

Do you have the actual numbers? She does have a lot of hypo symptoms - anxiety is a hypo symptom.

'Normal' is an opinion, not a diagnosis.

[Airmed in reply to greygoose]

Thank you. TSH only 3. something. Result slap bang in middle of range.

[TiggerMe in reply to Airmed]

3 something is showing signs of struggling (any idea what time of day) well worth getting them to test fT4 (storage hormone) and fT3 (the active hormone) to really see what's going on 🤗

Euthyroid should be around 2... the range is too wide I'm afraid

Need to get the blood draw timings right too... so pre 9am fasted, water only

TSH has a circadian rhythm and drops after 9am

[greygoose in reply to Airmed]

3 something is technically hypo. A 'normal' (euthyroid) TSH is around 1. Over 2 shows that it is struggling. And when it reaches 3 you are hypo. Why doctors think that 'slap bang in the middle of the range' is a good thing, I'll never know.

Is TSH all they tested? It isn't even a thyroid hormone.

[SlowDragon Administrator]

TSH of 3 is higher than average

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

She needs FULL thyroid test including thyroid antibodies, Ft4 and Ft3 plus vitamin D, folate, ferritin and B12

Ensure testing early morning, ideally before 9am and only drink water between waking and test

Also coeliac blood test

[SlowDragon Administrator]

also some research suggests some antidepressants lower TSH

[humanbean]

You/your daughter should find this document useful :

imperialendo.co.uk/Bible202...

It describes how all the tests (not just Cushing's) normally carried out in a hospital endocrinology department should be performed. It includes preparation, timing, methods, and interpretation of results.

In the UK it is quite common for doctors to miss out parts of tests to save money, and as a result they can't diagnose some conditions because they don't have the evidence.

[humanbean in reply to humanbean]

I found that my anxiety vanished and my depression reduced when I optimised my iron and ferritin levels, my vitamin B12 and folate, and my vitamin D. This only worked for me when I started to take enough supplements for long enough to actually make a difference to my levels.

Doctors throughout my life, when they prescribed iron supplements for me, would only prescribe enough for about two or three months. When I took over the testing and treatment for myself and ditched the doctors, I found out that my iron absorption was so poor that it took nearly two years just to get my ferritin up to mid-range, while my serum iron stayed extremely low. I took a maintenance dose of iron for another five years after getting my ferritin to mid-range. And during all those years my anxiety eventually vanished and my depression dramatically reduced.

Some people have the same effect from optimising the other nutrients I mentioned.

[Sunflower64 in reply to humanbean]

Can I ask what you used to raise ferritin?

[humanbean in reply to Sunflower64]

I started taking maximum dose of ferrous fumarate 210mg - 1 tablet, 3 times a day, back in 2013. I kept up that dose for nearly two years, which is how long it took my ferritin (iron stores) to rise to mid-range. My serum iron stayed extremely low. Then I started taking a maintenance dose of the same iron supplement which varied over time - 1 tablet per day, 2 - 5 days per week. I did that for five years and then finally my serum iron started rising. Eventually my serum iron and ferritin levels became self-supporting and I stopped taking iron altogether.

If I had my time over again knowing what I know now I would have saved up for an iron infusion, then tried to maintain it with heme iron supplements.

Apparently some people find they can raise their iron and ferritin more easily with heme supplements than they can with iron salts like ferrous fumarate.

Another possibility is that iron absorption could be so slow that the only sensible way to raise iron/ferritin would be with an iron infusion. Even then, some people need multiple infusions because their levels drop so dramatically quickly. My personal opinion is that this is likely to be indicative of long term iron deficiency.

.

For info on non-heme iron supplements i.e. iron salts :

healthunlocked.com/thyroidu...

Note that the dosages of iron supplements prescribed by the NHS have dropped a lot since I wrote that reply to another member for reasons given in this link :

healthunlocked.com/thyroidu...

The new doses for iron salts can be found here :

bnf.nice.org.uk/drugs/ferro...

bnf.nice.org.uk/drugs/ferro...

bnf.nice.org.uk/drugs/ferro...

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For info on heme supplements :

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

threearrowsnutra.com/en-uk/...

.

There are quite a few private iron clinics in England, I'm not sure about Scotland, Wales and Northern Ireland.

This is just one of them, in London :

theironclinic.com/

It would be worth shopping around because private iron infusions are quite expensive I think, and you probably have to pay for a consultation as well.

.

If you have an obliging doctor you could ask for a referral to haematology to be considered for an infusion.

[Sunflower64 in reply to humanbean]

Thank you, that is really helpful!