Cortisol Results & Tolerating Thyroid Meds

[Bean101]

Blood cortisol fasting 8.40am

541 (133-537)

B12 526 (197-771)

Folate 16.8 ( 2.1-26.8)

Ferritin 142 )13-150)

TSH 0.01 (0.3-5.5)

FT4 16.1 (10-22)

FT3 5.2 (3.1-6.8)

Erfa 90mcg T3 7.5mcg

I changed over from T4/3 in April last year

I am feeling terrible, counting 37 hypo symptoms..

I wake up in the morning and can’t move.. I sleep 9/10 hrs it’s like I have been sedated.

I take one grain at 7am, 1/2 grain at 1pm with 5T3 and another 2.5T3 at 6pm

I can’t take anymore than 90mg NDT or I get heart palps same happens when I take 75T4

If I take 90 NDT and no T3 I am very weak and struggle to walk and feel breathless..

I am not sure which way to go.. probably going back on small dose of T4 and larger dose of T3. I have tried to reduce Erfa pm and take 5T3 at 11am and 5mcg at 4.30pm but it makes me feel sedated and I fall asleep..

could this be due to cortisol

Any advice would be greatly appreciated xx

Attached below are my other results

[Bean101]

Cortisol test

Cortisol Test

[Bean101 in reply to Bean101]

Cortisol test

Cortisol test

[dealsgap in reply to Bean101]

Your cortisol levels are low. The proof of this is your DHEA tests which are low. DHEA is made by the adrenals (which produce cortisol). Cortisol, along with iron is needed to convert T4 - T3 (in the liver). If you increase thyroid meds to get energy without addressing cortisol then you'll get "hyper" type symptoms. I had to go down the road of healing my adrenals first before addressing my thyroid.

[TiggerMe Ambassador]

I'd suggest taking your T3 first thing in the morning (I take it 4-6am if up for a pee) and before lunch when you cortisol levels are good as T3 is faster at getting into action and try taking the Erfa perhaps 1 grain with the second dose of T3 and the other half early evening or before bed as it takes longer to release the hormones due to being bound... here comes the science bit 😬

healthunlocked.com/thyroidu...

This is based on me having no experience of NDT only personal experience of T3/4 timings and cortisol levels (T3 does very little for me other than first thing as my cortisol levels drop off, so a single dose is far more effective than split dosing)

[Bean101 in reply to TiggerMe]

Thank you.. my saliva looks low am and blood high am.. do you know what that means? I would like to change back to T4/3, I’m not sure the best way to go about it!

[TiggerMe Ambassador in reply to Bean101]

Blood shows total cortisol and saliva shows free which is needed to work in partnership with T3 to be effective in the cells

So at the moment you are on 57mcg T4 & 21mcg T3

I'm going to park that there and go and look at your history...

[TiggerMe Ambassador in reply to TiggerMe]

Ok, not much to go on there, it really helps if you fill in your profile with doses and results.... so you were previously on 75mcg Aristo and 15mcg T3 but no results, B12 could still go a little higher, folate improved how about Vit D?

In the past I suggested you likely needed to increase the Aristo did you try that, how did you feel? Or did you just swap to this latest regime? healthunlocked.com/thyroidu...

NDT is T3 heavy so I'd suggest adding 50mcg Aristo to your current regime to see how that feels before then swapping totally back to T3&4 and I'd suggest 100mcg T4 and 15mcg T3 which you had previously been on and experiment with T3 as a single early dose along with T4 or split the T3 into 2 doses and see how that feels..... all total guess work but lets go back to where you functioned for a long time and tweak from there

[McPammy]

I had very low cortisol. At the time is was taking T4 levothyroxine for Hashimoto’s. I found out I’m a very poor converter of t4 to t3. Only converting 8% to t3. I was in a dreadful way. After going private and being prescribed T3 medication also. Suddenly my cortisol shot up from below range to high in the range at 9am. T3 boosted my cortisol levels very high. It’s now settled lower after tweaking my meds. I’m thinking you’re on slightly too much thyroid medication. Have you thought about reducing it to getting your TSH in range and your cortisol may drop also. You’ll get all sorts of symptoms with a low TSH level. Remember high thyroxine levels can cause lots of symptoms similar to being under medicated.

[TiggerMe Ambassador]

You last posted to say 75mcg Aristo wasn't hitting the mark and we suggested an increase

I expect it's the time travel causing havoc April 3024 😂

Symptoms don't sound great and I'm still suspecting your fT4 being too low could be partly to blame though you also have room to increase your fT3, what where your levels when you felt reasonably well?

Free T4 (fT4) 16.1 pmol/L (10 - 22) 50.8%

Free T3 (fT3) 5.2 pmol/L (3.1 - 6.8) 56.8%

Could it be sex hormones dropping?

Do you have a CRP result? Ferritin looks reasonable but could be a false high if inflammation is present 

I don't think your current regime is making best use of the dose, did you swap anything around?

[Bean101 in reply to TiggerMe]

Dr didn’t do CRP

Sex hormones are none existent

I have been mostly housebound for years, so I’m not sure at what level I have felt well

I have held off starting progesterone and oestrogen due to not being optimal in Thyroid meds

[TiggerMe Ambassador in reply to Bean101]

So you've never been on more than 75mcg? Many people try to deal with one thing at a time but the thing is hormones all need balancing as they bounce off each other.

If you could look back through all the tests you have had and add them to your profile along with the dose at the time that would really help shine a light

[dealsgap]

You'll have to prepare yourself for a long/slow process. Healing adrenals could take a year or longer it's not done overnight. My understanding is you can go down the hydrocortisone or ACE (adreanls cortext extract) route. I took ACE supplements (gradually increasing dosage) while watching to see how my body reacted. If I got heart palps/started sweating I knew I was taking too much and backed off. Re-taking the cortisol saliva tests every 6 months or so to see if my adreanls were responding. Blood cortisol is 'not' a good representation.