Help with labs please? desperate, house bound primarily

[ratqueenxo]

Hello, could anyone please help me with interpreting labs?

I am on 25mg hydrocortisone for adrenals.

12 hours fasted, except for a tiny sip of diet coke (i wasn't thinking, i barely swallowed it though).

No meds, no biotin.

Please any advice?

TSH 3,38 mU/L Ref: 0,27 - 4,20

T4-total° 8,9 µg/dL Ref: 5,1 - 14,1

Free T4 15,6 pmol/L Ref: 11,0 - 24,0

T3 total° 2,09 nmol/L Ref: 1,23 - 3,08

Free T3 5,5 pmol/L Ref: 3,6 - 6,7 <

Reverse T3° 24,4 ng/dL Ref: 17,0 - 44,0

FTI° 8,7 index Ref: 4,8 - 12,7

Extremely cold all of the time, have adrenal and hypo symptoms, excessive fatigue,

eyebrows won't grow, puffy face, gain weight all of the time, etc

I have T3 at home and NDT after a previous functional dr prescribed me to try, but he didn't know how to treat adrenals at the time.

[GlowCoach Administrator]

Are you taking any thyroid hormone at the moment? It looks like you've tried a few different types.

Have you tested key vitamins lately - ferritin, folate, B12 & D3?

What supplements are you taking and what dose are they?

Your results point to you being hypo.

[ratqueenxo in reply to GlowCoach]

Hi, no i've never been on meds. Drs won't acknowledge me as hypo, i've even see 3 functional drs, only one acknowledged it but he couldn't treat adrenals. I will post my iron lab here sorry i forgot to include it, also my vitamin d was 19.3 and the reference range was beginning at 20 so I know I'm deficient in that. Thank you. Found my vitamin D: 25-OH-vitamin D 19,2 ng/mL Ref: 20,0 - 100,0

iron panel

[SlowDragon Administrator in reply to ratqueenxo]

how old are you

Ferritin varies with age

Female?

Pre or post menopause?

Iron results pointing to chronic illness

See table here

labtestsonline.org.uk/tests...

[ratqueenxo in reply to GlowCoach]

Also I have a b12 vitamin test from February: Vitamine B12: 914 reference: 197 - 771

I'm planning on doing an updated one next week, thank you for your help.

I tried straight T3, and NDT(erfa) for a brief time with very little results. This was before I was on hydrocortisone albeit. I've tried taking 5mcg of t3 recently and don't feel anything. Not sure if this is good or bad.

[GlowCoach Administrator in reply to ratqueenxo]

Your iron & ferritin look OK.

Vit B12 you really need an active B12 test. What you have looks like a serum B12 test which is fine but the active test is more accurate.

Folate needs testing, you can get that done next week.

We use different ranges in the UK but you likely need a minimum of 3,000iu vit D. Try and get one that also contains vit K to help it go to your bones.

A word about diet coke. Its highly processed and may not be helping your fatigue. Replacing it with water might be beneficial.

[ratqueenxo]

OK, great thank you very much. I don't drink it anymore, thank you. I've seen something about an MMA test which I will look into. Making an appt to have those tested next week, thank you

[SlowDragon Administrator]

Free T4 (fT4) 15.6 pmol/L (11 - 24) 35.4%

Free T3 (fT3) 5.5 pmol/L (3.6 - 6.7) 61.3%

Odd results

Having Ft3 higher than Ft4

no thyroid antibodies test results?

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

[ratqueenxo in reply to SlowDragon]

Sorry I forgot to include I do have hashimotos

[ratqueenxo in reply to ratqueenxo]

My antibodies were as follows: Anti-THYROPEROXIDASE AL 20 ref: KU/L < 34

Anti-THYROID THYROGLOBULINE AL: + 129 ref: KU/L < 115

[SlowDragon Administrator in reply to ratqueenxo]

Have you had ultrasound sound scan of thyroid

have you tried gluten free and/or dairy free diet

[ratqueenxo in reply to SlowDragon]

Yes I'm doing both of those thank you. Is it possible I am hypo tho? I display all hypothyroid symptoms - im hopefully seeing dr Momi in a few weeks.

[McPammy]

what is your cortisol 9am result or have you done a cortisol saliva test privately before starting any medication to help adrenals. My cortisol was low when I had low T3. After finally getting help privately I was prescribed T3 medication alongside my usual t4 medication (liquid). My cortisol jumped from a low 150 to 450 ( range 150-650) after increasing my T3 from a low of 8% to 85% I’m a very poor converter t4 to t3 and have Hashimotos

I was also prescribed hydrocortisone for low adrenals/cortisol before the t3 medication by a stupid NHS endocrinologist. It didn’t help me, in fact it made things worse. It just kept knocking me out not giving energy. Be sure you actually need hydrocortisone as taking adrenal medicine could damage your natural output even people on steroids can alter their natural output

[ratqueenxo in reply to McPammy]

Hi, my original Dr (who didn't believe I had hypothyroidism), used an old blood test which showed almost 0 morning cortisol, and very high DHEA., he informally diagnosed me with NCAH However when I've done recent(ish) blood tests without taking HC that morning it was in the mid range. I've never taken T3 before my t3 seems to have risen naturally which I'm confused at.

Is there any testing I can do now I'm on it? When I try tapering it down I do find myself getting very stressed/agitated. I do believe I needed it at the time as I also couldn't tolerate thyroid meds, and for a short time of taking it (a few weeks) i could tolerate them again.However it was short lived and now i'm wondering if it's doing more dmg than good? I also get very cold when i try to taper, crave salt excessively too. I do believe I need them but I don't have sufficient data to prove that.

Thank you

[McPammy in reply to ratqueenxo]

You really do need a synacthen test before you mess about with any hydrocortisone treatment. I’ve had 3 of these tests all turned out adrenals functioning correctly. You firstly could do a 9am cortisol test through your gp easily. Or pay privately and order a saliva cortisol test. If your Dr said in the past your cortisol was zero I’m sure you’d be dead and you would have been seriously ill prior with addisons disease. Be extremely careful with adrenals they are your major support system for so many things. Do not mess with them unless advised by a good endocrinologist. I certainly would not take any cortisone medication without serious medical help prior and during.

Do not take T3 medication unless your bloods indicate you really need it

If hypothyroidism then always start on t4 medication and after 2 months check if you’re converting to t3 ok

If your cortisol was mid range without taking hydrocortisone that I suspect you don’t need it

[ratqueenxo in reply to McPammy]

It wasn't 0 but it was very low, OK thank you, would a saliva test still be valid if I'm on hc though?

I will book an appt to do a morning cortisol test, thank you.

Yes I hate them I'm basically left of my own to figure it out while on HC...I make sure not to take it past 1pm as following 1pm it instruct the adrenals to stop producing cortisol. Thank you - he was far too liberal

[McPammy in reply to ratqueenxo]

I think anytime of the day taking hydrocortisone would instruct your own adrenals to stop making cortisol not just after 1pm.

It dangerous to mess with adrenals without proper supervision and testing by a endocrinologist

[ratqueenxo in reply to McPammy]

He is treating based off of a book called safe uses of cortisol. I've heard mixed things, for some people they can wean off of it following this method safely.

Either way I am seeing a new dr soon who specializes in hashimotos and adrenal dysfunction, but in the meantime I will do the blood test for his appt. Thank you very much

[McPammy in reply to ratqueenxo]

Just be careful extremely careful you don’t want to damage your adrenals if they are working ok. You really don’t want a life time on steroids as they have bad effects

[ratqueenxo in reply to McPammy]

I pretty much disowned the dr who prescribed me it after he said I probably have lupus...lol he's far too crazy with easily diagnosing

[McPammy in reply to ratqueenxo]

Be very careful

[ratqueenxo in reply to McPammy]

Yes thank you I'm seeing a new doctor soon.