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Cortisol, thyroid results

(18 Posts)
TenancyTroublesAgain Sat 27-Jan-18 09:04:54

Had a private blood test after years of chronic fatigue, brain fog, increasing memory problems and generally feeling crappy, always diagnosed as depression but several years and antidepressants later and not a hint of change... Blood tests through my GP usually came back normal apart from a while ago I had low vitamin D, B12 and folate. Which now say normal after supplementation.

Something that I'd never had tested before is cortisol - I had a morning fasting test and it came back as 105, the range is 166-507.

Other results out of range are:

HbA1c - 26 (29-42)
Creatinine - 108 (59-104)
Basophils - 0.30 (range 0.02-0.10)

I'm waiting for the doctors comments on it but does anyone here have anything to add, mainly about lower cortisol?

TSH and FT4 are:

TSH - 2.94 (0.27-4.2)
FT4 - 18 (12-22)

Thanks!

TenancyTroublesAgain Sat 27-Jan-18 09:10:49

Oops also

Low density lipoprotein - 1.8 (2.5-4.5)

ElphabaTheGreen Sat 27-Jan-18 09:15:30

Your cortisol level is what might be described as 'sub-optimal' rather than drastically low. Do you take any oral steroids or have you ever had any joint injections? Nerve blocks? Those would give you lower cortisol levels, apart from the usual suspects causing primary or secondary adrenal insufficiency.

I can't comment on the other numbers, sorry. Your cortisol level will almost certainly trigger a referral to an endocrinologist (unless you're on any steroidal meds) and s/he would do a full work up of thyroid, pituitary and diabetes indicators.

TenancyTroublesAgain Sat 27-Jan-18 09:19:53

Thanks,

I've never had any oral steroids or nerve blockers etc

ElphabaTheGreen Sat 27-Jan-18 09:27:04

OK - you'll probably get referred to an endocrinologist then who'll order something called a short synacthen test. This basically involves three blood tests first thing in the morning, with an injection after the first blood test, to see if your low cortisol is caused by your adrenal glands not working (a primary adrenal insufficiency, usually Addison's Disease) or your pituitary gland not stimulating your adrenal glands sufficiently (secondary adrenal insufficiency, which can be due to a range of different things).

TenancyTroublesAgain Sat 27-Jan-18 17:12:17

Thank you, I'll go to my GP asap! Fingers crossed this is an answer after years of almost entirely normal results!

mumof06darlings Sun 28-Jan-18 01:32:14

Do you mind me asking how did you go about having a private blood test

TenancyTroublesAgain Sun 28-Jan-18 02:15:18

Pm'd you smile

TenancyTroublesAgain Tue 30-Jan-18 20:20:39

The doctors comments have now come through

They didn't even comment on the 2.94 TSH despite it being above optimal levels, but I'm not surprised.

They said the cortisol is on the low side but it could be because I had it at 10am instead of 9am. (?!) It's not even in range...

ElphabaTheGreen Wed 31-Jan-18 06:47:53

Yes, but cortisol starts declining from the time you wake up, so they do have a point.

As a comparison, my 9am cortisol was 22, and a subsequent one was 14, which triggered emergency investigations, leading to a diagnosis of Addison's Disease. As I said above, 100 would be considered sub-optimal rather than low enough to cause major concern.

Not wanting to put a dampener on things, but even if you did have some kind of adrenal insufficiency, it might be a diagnosis but not necessarily a cure. I spend my life planning around fatigue, unfortunately, even with steroids three times a day.

If your GP doesn't feel your results warrant an endocrinologist referral, can you go private?

TenancyTroublesAgain Fri 02-Feb-18 12:35:31

Yeah true. I think I'll order a full thyroid panel and another cortisol test, possibly a multi-part saliva test.

My experiences with GPs has left me not wanting to go there unless I have a problem that they can't argue. :/

Surfingwhippet Fri 02-Feb-18 16:38:49

The best thing to test your adrenals is the short synacthen test which pp mentioned above. That will test how well your adrenals are working.
They take a baseline test (mine was done at 9am) then they stimulate your adrenals and take another 2 tests. The second should be double the reading of the first.
My results were 0 at first test and 0 after ½ hour

ElphabaTheGreen Fri 02-Feb-18 18:46:55

A saliva test for cortisol? No doctor will take that seriously. Just get a morning cortisol test done at the right time.

TenancyTroublesAgain Sat 03-Feb-18 03:52:24

Yeah ok, I'll get the blood test done again. I was just going off what the two private companies offer for adrenal testing, saliva tests are said to be be considered reliable now compared to before, that's why I considered it. But bloods is still better.

woosey35 Sun 04-Feb-18 20:40:20

My daughter has adrenal insufficiency. Her level when first diagnosed at 2.5yrs, was 16!! It’s now 0!! She’s on hydrocortisone 4x day.
I’d definitely be asking your gp to look into another morning cortisol, preferably 8-9am, and then finding the cause for a low cortisol result.
As another PP mentioned, yes it does decline after you wake etc BUT you seem to have all the symptoms of adrenal insufficiency so it really shouldn’t be left.

Good luck and let us know how you get on.

TenancyTroublesAgain Mon 05-Feb-18 09:21:50

Wow that is low! I hope it's working out for her?

My appointment is in an hour, I fully expect the doctor to refuse to refer me or run the blood tests himself again, saying they're not THAT low... I'll buy a hat and eat it if I get somewhere.

10 years of being fobbed off with "it's hormones, you don't do enough exercise, it's the depesssion" later and I'm more than fed up... I've gone from being an unemployed, friendless couch potato to working, reasonably active, lost weight and have a decent social life now... I have also tried numerous antidepressants over the years because they refuse to test or do anything else. Incidentally they never did a thing. Also tried long term counselling which didn't change my physical symptoms either. I'm not going back on antidepressants unless this and my sleep apnea test comes back normal...

I'm working part time alongside people in their 60s and 70s and I crash and can't even bring myself to even talk after an hour or two while they're all going about normally... I'm early 20s sad

TenancyTroublesAgain Mon 05-Feb-18 09:22:57

Sorry I went off on a tangent there.

TenancyTroublesAgain Wed 14-Feb-18 13:13:59

I've been referred to an endo! Fingers crossed!

Also checked some previous blood test results, my TSH used to consistently be 0.9, and now it's 2.94.

I don't know if this means anything.

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