cortisol test

[ConfusedH]

Hi

I have had a 9am cortisol blood test which the doctor has marked as normal the results are 148mnol/L and range is 133-537.

I know it says in range but have it also says <320 should be in interpreted for a pretest. My FT4 is low 10.9 range is 12-22 all other tests seem ok

My folate was 2.6 normal range of 3 + I am on folic acid for it and they are now >20.0 ug/L

I’m waiting for TF3 results and TPO still

[SlowDragon Administrator]

what time of day was cortisol test done

You need FULL Thyroid and vitamin testing before seeing a THYROID specialist

Below range Ft4

Deficient folate - now on folic acid supplement?

What are most recent vitamin D, B12 and ferritin results

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

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

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

[ConfusedH in reply to SlowDragon]

Thank you so much for this. My folate was 2.6 normal range of 3 + I am on folic acid for it and they are now >20.0 ug/L

I’m waiting for TF3 results and TPO still.

The blood test was 9am

[SlowDragon Administrator]

cortisol test obviously low

Suggest you investigate further with private cortisol and DHEA saliva test

regeneruslabs.com/products/...

portal-app.inspira-regeneru...

[ConfusedH in reply to SlowDragon]

thank you for this. I was confused how it says in range and the doctor has said no further action

[SlowDragon Administrator in reply to ConfusedH]

Being fobbed off

[J972 in reply to ConfusedH]

That’s disgraceful, you deserve better. Can you ask to see a different GP at the surgery? Seldom have I seen a lower result on the forum.

[radd]

ConfusedH

FT4 10.9 pmol (12-22)

Cortisol 148nmol/L (133-537)

Your GP is wrong to dismiss your cortisol result because the diurnal variation in levels mean cortisol should be highest in mornings and lowest late evening. Also If you are on oestrogen HRT there is a chance your cortisol level is actually lower than your lab result as increases in hepatic production of cortisol-binding globulin often increase control levels (but not the ‘free’ usable type).

However, you have ongoing under-range FT4 levels that will be stressing adrenals ridiculously. You can not know if you have an actual adrenal problem or if this low cortisol level is the result of inadequate thyroid hormones.

Because your TSH is also low its looks as if you have pituitary or hypothalamus dysfunction. This is known as ‘central hypothyroidism’ and is only really understood by those specialist with an interest in thyroid physiology. You said you were getting another opinion and are awaiting for FT3 and TPOAb results.

Meanwhile to identify what is going on with adrenals I would ask GP for further tests on anything directly affected by cortisol action such as electrolytes, urea, and blood glucose. Also possibly liver function, calcium and FBC as your new endo will likely want these anyway.

[ConfusedH in reply to radd]

Thank you so much for this

I feel like I’m going mad! Then question if I am.

[Hedgeree]

Hi ConfusedH,

From personal experience I know how ill I felt with a low and below range FT4. I was also told that it was normal for me as I'd had those levels for many years.

It is difficult when you feel so unwell but you have to keep going and see another GP if you have one. It shouldn't be a battle but it is.

[ConfusedH in reply to Hedgeree]

Did you manage to get someone to listen in the end?

[Hedgeree]

Yes I did but it took a while. I wrote to the practice manager and the gp regarding their under treatment of my possible thyroid problem.

Eventually I got an NHS referral to an endo, they discovered a 'lump on my thyroid' (their words) I had a partial thyroidectomy and was prescribed levothyroxine post operatively.