Low cortisol, low T3 results-pls advise, terrified I’ll have to stop work as just exhausted

[Midlake]

hi..

I’m on levo 100mg for at least a year now, been diagnosed hypothyroid for 2 years I think. . Had these tests done privately dec 2023. Previous test a year before saw lower TSH - seemed to have climbed up, and higher T3 than before.

I haven’t shown to GP yet- partly cos just depressed and exhausted, don’t believe they will listen to me, and just about cope with work then collapse! On HRT patches too. It’s got to point where I don’t know if can carry on working but have to as support myself.

Given up gluten, take glutatione, B vits, etc just started taking adrenal support supplements

What do you think these results should tell me to do next?

thank you so much

[TiggerMe Ambassador]

Very similar to my results and I took adrenal cortex, then for 8 months I took 5mg hydrocortisone alongside DHEA 10mg micronized (and all the HRT) and I'm feeling pretty perky these days, just dropped the HC and back on cortex.

Have you checked your sex hormone levels? Do you use testosterone?

It can be bloomin grim but we'll help all we can... what are your latest thyroid levels looking like?

[Midlake in reply to TiggerMe]

Thanks for your message so good to hear from someone experiencing similar. Tried explaining it to work colleagues, apart from usual moaning about how knackered I am, and just look at me blankly- I look fine unfortunately!!

Attached my thyroid results.

Did you see your GP for HC and DHEA?

I got these testosterone sachets which are a nightmare to dose - I think I’m supposed to divide a silver sachet of gel into 8 days worth. Gave up so just slap on a squirt… I know I’ve lost the plot!

I guess I must see my GP to sort this out!

Best wishes

Thyroid results

[TiggerMe Ambassador in reply to Midlake]

Hard to read can you do a bigger one? It looks like your fT3 is 2.9 which is why you feel so 💩 this is the active bit

Self sourced DHEA and HC as DHEA is prohibited over here unless you go private

Yep, I looked irritatingly 'well' which doesn't help when your body feels so heavy to drag around.... I go with a petit pois but if I over shoot I go marrow fat every other day 🙃

[GlowCoach Administrator in reply to Midlake]

Your TSH there is over 3 and FT4 only at 30% of range. No wonder you are tired.

In many ways to get a dose increase its about fnding the right doctor, being a little bit educated about the subject (reading here helps), maybe showing them medical papers but above all else be persistent.

If one GP turns you down then try the next one.

You could also point them to NICE guidelines where they recommend dosing by weight and show them the discrepancy in your dose and where the calculation points to.

weight in kilos x1.6 = estimated final dose - not accurate but a good guide.

nice.org.uk/guidance/ng145

1.3.6 Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

[Midlake in reply to GlowCoach]

Thank you - appreciate your advice, I feel less that I’ve just “given up”and it’s a real physical issue. I’ve been seeing a nutritional therapist who has been great and also given me a private doc details if no joy from GP - that’s regarding T3.

The info n support on here is great.

[GlowCoach Administrator in reply to Midlake]

A point about blood tests. It matters how and when you take them. TSH varies throught the day and best time for highest TSH is at 9am or earlier.

Stop any B complex or biotin containing supplements 4-7 days before the test. Biotin can interfere with certain types of blood test as it is used in the processing of them.

Fast that morning, only drinking water. Take Levo AFTER the blood test.

This gives highest TSH, stable levels of T4 and consistent results.

[TiggerMe Ambassador in reply to Midlake]

Do these read right...

TSH 3.3 mIU/L (0.27 - 4.2) 77.1%

Free T4 (fT4) 15 pmol/L (12 - 22) 30.0%

Free T3 (fT3) 2.9 pmol/L (3.1 - 6.8) -5.4%

T4:T3 Ratio 5.172 

So first thing you really need a dose increase, but your conversion is terrible so I'd also request a referral to Endo as it's looking likely you would benefit from some T3.

If you have enough stock I would start the increase now as it takes a good month before you start to benefit

Ask TUK admin for the Endo list and hopefully you can find a decent NHS one in your area as you are able to name who you'd like to see

[Midlake in reply to TiggerMe]

Thanks so much for your advice..so helpful to get me on track to tackle doctors etc.

I’ll weigh myself at work tomorrow (I work in a hospital but generally avoid at all costs that misery machine but really beyond all that now!) I can then work out approx levo dose.

The lethargy is the worst as it sucks any possibility of joyful, active, social life that once upon a time had at least a semblance of. Still on positive side I have rewatched all Sopranos and Mad Men and do a phd on them

Best wishes

[FallingInReverse]

Trying to work through this is exhausting, but as you note, there’s no choice we have.

It takes me three times longer to do anything and so much isn’t done. I’m masquerading as the person I used to be, and hoping my brain fog clears up before I’m found out, to be honest. It’s terrifying, I feel trapped in my head in this disease, and every minute need to recommit to pushing pushing pushing.

It’s a little hard to read your thyroid panel results, but looks like you have tons of room for a Levo increase. Are you anywhere near the 1.6 mcg/body weight kilo yet?

How is your approach going with the thyroid hormone replacement? Can you ask for an increase?

[Midlake in reply to FallingInReverse]

Thanks so much for your reply. I’m definitely going to go through my test info from here and at least attempt GP but also look along private lines ..

I can up my levo (and weigh myself at work… I’m in NHS workplace..never step on scales unless necessary).

The exhaustion is a vicious cycle- too tired to even consider eating properly as that means chopping and then all that cooking malarkey!

Anyway best wishes to you