Starting hypo?

[AKatieD]

Dear All

These are my student daughters results. I posted them on the Pernicious Anaemia group as obviously that is her most immediate problem.

I looked at the thyroid results and thought they looked ok for somone not treated for now, but the PA group said to ask you what you think so here goes ...

Thanks

[greygoose]

She wouldn't get treated with those results because they are all nicely in-range and antibodies are negative.

BUT her TSH is on the high-side, suggesting the thyroid is struggling to make the required amount of hormone.

And her cortisol is very high - she should see a doctor about that.

What time of day was the blood draw for this test? Was it fasting? And is it her first thyroid test?

[AKatieD in reply to greygoose]

Thanks for the speedy reply.

Yes, normal thyroid protocol for doing blood test (8.30 am fasting) and this is first one.

She has not been feeling well and I am hypothyroid and carry haemochromatosis gene so thought it would be a good idea to test her just in case ( did iron test too but it haemolysed so need to redo).

I thought perhaps cortisol high due to the B12/ folate/ PA making her unwell?

[greygoose in reply to AKatieD]

More likely due to the thyroid failing. I don't know anything about the relationship of cortisol to B12/folate but I do know that when the thyroid starts to fail, the adrenals take up the slack by making more cortisol.

FT4: 17.1 pmol/l (Range 12 - 22) 51.00%

FT3: 5.9 pmol/l (Range 3.1 - 6.8) 75.68%

And, looking at those percentages through the range, the FT3 is higher through the range than the FT4, which is not normal, and another sign that her thyroid is failing.

However, a doctor would just look at those results and see that everything is in-range and tell her there's nothing wrong with her. Doctors do not know how to detect the signs of a failing thyroid.

So, for the time being, there's not much she can do except keep on testing and see how things evolve.

She should also get her vit D and ferritin tested because these could also be low and causing symptoms.

[AKatieD in reply to greygoose]

Thanks, I meant just being ill might cause the high cortisol and that the low B12/ folate might be enough to do that (rather than knowing there is a direct relationship). But as you say it maybe thyroid too.

Vit D and ferritin also low (in above results).

[greygoose in reply to AKatieD]

I think it's more likely to be the thyroid.

[AKatieD in reply to greygoose]

Ok, thanks, struggling with cortisol problems at the moment myself too

[AKatieD in reply to greygoose]

What would you expect to see for TSH if her thyroid was not starting to struggle?

[greygoose in reply to AKatieD]

It would be around 1 but never over 2.