Hello,
Is it possible to someone to give an opinion on the results for my short synacthen test please?
Cortisol (Basal Sample) 339nmol/L
Cortisol (30 minutes) 527nmol/L
Cortisol (60 minutes) 630nmol/L
Normal Response: cortisol >=415nmol/L at any time
I think that it is a normal result but was just after some confirmation. Thanks!
This shows a slightly low cortisol base level but a good reaction to ACTH so your adrenals are able to work well, do you have reasonable levels of salt and Vit C in your diet (adrenal food)
Sorry, I should have said welcome aboard 🤗
Are you currently being treated for a thyroid condition?
Yes, I was on the thyroid Uk site as a member before for a year or so but closed the account so opened a new one again recently and havent put any information on yet. I have hashimotos and started levothyroxine last October - currently take 6X100mcgs and 1X75mcgs a week.
Are you feeling well on this dose? Have you also optimized your ferritin, folate, B12 and Vit D?
Managed to get B12 up, Vitamin D could be better and struggling to get ferritin up even though I take iron spray every day. Folate is low so just started supplementing that. I couldnt say I ever fell well! Just increased to 100mcgs x6 weekly last week. will get my updated thyroid results and vitamins resulted posted soon and can get advice then. Thank you!
This is a handy calculator for dosing Vit D... grassrootshealth.net/projec...
Many of us opt for a heme iron which is more effective as doesn't need converting and it's easier on the system
I did try heme iron and it gave made my gastritis really bad - i stopped for a while and tried again and same thing happened. I posted on site before about it and no one had experienced anything similar.
I'm not sure why this would be, gastritis is certainly common when using ferrous supplements but as heme needs no conversion it is easier on the system, what are your B12 levels?
pmc.ncbi.nlm.nih.gov/articl...
Hi TiggerMe, Im not getting alerts when someone has replied to me so only seeing this now! VITAMIN B12 - Active - 99.5 (>37.5)
It gets a bit glitchy sometimes, often using the refresh button brings them up but you should still receive emails?
So B12 is around 50% so could be higher, have you any recent thyroid results?
Current thyroid results from 19th November 2024 Medichecks :
T4-15.2 T3-4.3 and TSH 0.419.
NHS bloods done on 3rd November 2024 T4-18.2 T3-4.3 and TSH 0.17 so changes in T4 and TSH in a few weeks.
Both Medichecks and NHS results have the same ranges of TSH 0.27-4.2 T3 3.1-6.8 and T4 12-22.
I'm guessing both taken pre 9am fasted, last dose 24hours before?
Medichecks
TSH 0.419 mIU/L (0.27 - 4.2) 3.8%
Free T4 (fT4) 15.3 pmol/L (12 - 22) 33.0%
Free T3 (fT3) 4.9 pmol/L (3.1 - 6.8) 48.6%
T4:T3 Ratio 3.122
NHS
TSH 0.17 mIU/L (0.27 - 4.2) -2.5%
Free T4 (fT4) 18.2 pmol/L (12 - 22) 62.0%
Free T3 (fT3) 4.7 pmol/L (3.1 - 6.8) 43.2%
T4:T3 Ratio 3.872
So both a little on the low side, do you have antibodies as this can alter things depending on diet as gluten and or dairy can effect things?
yes before 9am and last dose 24 hours before. im gluten free but have dairy. Thyroid Peroxidase Antibodies 9.2 (0-34) Thyroglobulin Antibodies 323.00 (0-115)
Ok, so it suggests your dose is still settling in as your fT4 was starting to dip and TSH starting to rise. You upped your dose 10 days ago so whilst you stick with this for the next 6 weeks it's a good time to concentrate on upping your B12, Vit D and folate which should all help to improve your ability to get the most out of your dose as these optimise and if you can add some chicken liver pate a couple of times a week to help with the ferritin?
You might want to try dairy free? I found a striking difference within 3 days
Just realized you have updated your Bio 👏
VITAMINS -
FOLATE - 10.2 (>7) Aiming for double figures
VITAMIN B12 - Active - 99.5 (>37.5) Aiming for 150
VITAMIN D - 50.5 (50-250) Aiming for 125 so a loading dose of 50,000iu a week for a few weeks then dropping back to 4-5000iu a day to maintain (use the calculator I posted above) Use one with K2 MK7 also magnesium helps uptake
ZINC 8.9 (<10.7) Low, do you have an albumin result? Zinc binds to albumin
p.s don't stress about the weight it'll come off as you optimize things 🤗
Thank you so much for all the info. Can I ask what sort of double figures for the folate? I dont seem to have albumin result - have been taking a zinc spray for the last couple of weeks and folate too - also b12 and vit d spray with K2. I crave sugar all the time then get heart palps and feel rubbish afterwards - will try to cut out dairy - love milk in my coffee tho!
I've found Tiger Nut Drink works for me but Rude Health do a whole range... though I find almond creates a snow globe effect in hot drinks 🤮
Thanks for your reply. I take a liquid Vitamin C and always have plenty of salt cause I have low blood pressure. I had this test done privately and would have to pay to go back to see the doctor to discuss the results so not sure whether I would need to do that or is the result okay?!
feethead
Why did you do the SST? Had you previously had a low early morning (8-9am) cortisol blood test?
What time was the baseline drawn for the SST?
TBH, as long as you hadn’t used anything that could have artificially elevated your cortisol level (such as HRT, oral contraceptives, steroids, adrenal cortex etc), there is nothing untoward in those SST results. However, generally a SST is most useful if either there has already been an early morning cortisol blood test OR the baseline is done 8-9am, AND an ACTH blood test is done just prior to starting the SST.
For completeness, at 8-9am, a cortisol level of > 300nmol/L is interpreted as "Recognise that adrenal insufficiency is very unlikely" according to the latest NICE guidelines. As cortisol levels follow a circadian pattern, any cortisol blood test later in the day (including a baseline for the SST) that is > 300nmol/L would be very unlikely to result in any further investigation.
Unless the baseline for the SST is drawn at 8-9am, the SST is only used to suggest whether a previously identified adrenal insufficiency is likely to be primary or non-primary, and even that isn't definitive. The ACTH test makes the interpretation more definitive, but still not quite 100%. Given that your baseline is > 300nmol/L at an unknown time, and the response to synthetic ACTH was adequate, in the absence of any other information, it looks fine.
Your results look good to me. I’ve had a few SST’s. My starting 9am cortisol was very low 155 ( range 150- 650) a few years ago. The false ACTH worked and my adrenals sprang into action. I did feel great for 24hrs hours afterwards, then back to low cortisol. I didn’t have Addisons thankfully. What my problem turned out to be was very low T3 3.9 ( 3.7-6.0). I was already taking levothyroxine T4 and my T4 level was high but not over medicated. I was prescribed T3 liothyronine alongside liquid levothyroxine medication. Oh boy what a complete change. Suddenly I had energy and strength. I could barely walk prior. Within 6 weeks after further blood tests my cortisol at 9am shot up to 450 from a low of 155. And my T3 shot up also from 3.9 to 5.6 (3.7-6.0). I felt and still do feel brilliant. So, my issue was too low T3 from very poor conversion from T4 to T3. I had the DIO2 gene test also which revealed I have the faulty gene causing the poor conversion. My t3 is now always around 85% through the range from prior being 8%. So, have you checked your t4 to T3 conversion rate, if not please do. It might be your answer as it was mine. 6 years on now for me and I can’t believe some days how awful I felt in my 40’s and 50’s when under medicated or not offered T3, I feel much younger now in my 60’s and full of life with combined medication t4 plus t3. I get a whole list of bloods checked by my gp now every 3 months. Always my 9am cortisol is around 300 and my TSH is just in range with t4 mid range and T3 top of the range.
Hi McPammy, current results from 19th November 2024 by Medichecks T4-15.2 T3-4.3 and TSH 0.419. NHS bloods done on 3rd November 2024 T4-18.2 T3-4.3 and TSH 0.17 so changes in T4 and TSH in a few weeks. Both Medichecks and NHS have the same ranges of TSH 0.27-4.2 T3. I have had 3 low dhea results this year which is why I was advised to take the short synacthen test - also low testosterone. My T3 was around 3.8 in October 2023 - peaked at 5.4 in June then started to go down again despite increasing levothyroxine.
Short synacthen test results 
Short Synacthen test results
Short Synacthen test
Short Synacthen results 
Understanding synacthen test results please
