Cortisol, thyroid results

[TenancyTroublesAgain]

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]

Oops also

Low density lipoprotein - 1.8 (2.5-4.5)

[ElphabaTheGreen]

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]

Thanks,

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

[ElphabaTheGreen]

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]

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

[mumof06darlings]

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

[TenancyTroublesAgain]

Pm'd you :)

[TenancyTroublesAgain]

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]

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]

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]

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]

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

[TenancyTroublesAgain]

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]

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]

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 :(

[TenancyTroublesAgain]

Sorry I went off on a tangent there.

[TenancyTroublesAgain]

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.

[LineofDuty]

TENANCY - Your thyroid stimulating hormone is TOO HIGH. That indicates an underactive thyroid. The higher the TSH value, the more effort your body is making in trying to keep your thyroid gland working.

[TenancyTroublesAgain]

Yeah I agree! Hopefully the endo appointment comes soon, I'm just dead tired.

[TenancyTroublesAgain]

4 month waiting list. :(

[Oh2beatsea]

Your HbA1c is fine. The higher it is, the more likely you are to develop diabetes. Pre diabetes is diagnosed at 42 so you are all fine.
Your Thyroid results are fine too. At 2.94 you are within the range. T4 is in range too. A lot of GPs (wrongly) don’t treat the Thyroid until your TSH is greater than 10.
I would spend your money checking B12, Ferritin and Folate, Vit D again if it was a while ago that you had them done. Although your B12 might have been in range, there is an optimal level for health / energy.

[TenancyTroublesAgain]

@Oh2beatsea Thank you, I want to ask what the rise in my TSH might be due to? All my life it was 0.9 then suddenly it's risen to 2.94, a level that I've seen mentioned countless times as being suboptimal? I will request the full tests including antibodies either way because unless they test everything, they can't rule it out. :)

[TenancyTroublesAgain]

Had some results back

TSH - 0.8
Cortisol - 238
FT4 - 16

My TSH has been that number every blood test I've had over the years so I was surprised it went up to 3 a few months ago, but seems to be back to normal?! I'm still going to probably order a full thyroid panel + relevant vitamins to see how it's all REALLY functioning.

However my morning cortisol was a bit too low again... he's doing an SST to rule out further problems.

[PinkGlitter22]

Hello Tenancy, I know I'm late to this thread but I was wondering how you were getting on because I have many similar symptoms to you and I was also wondering if I may have thyroid or cortisol problems. I'm going to get some private blood tests this week (probably with medichecks), and would be really interested to hear about your progress.

[MyRelationshipIsWeird]

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.

Could be Hashimotos - usually characterised by ups and downs in your thyroid function, before finally giving up the ghost and failing.

Doctors won't usually treat while its fluctuating as I guess meds would need adjusting often to prevent over-treatment.

Have you had thyroid antibodies tested?