Do you think my husband should be tested for Hashimoto

[Rooney01]

7 months ago my husband had numbness on one side of his face.  To make a long story short.  He finally had an MRI that was diagnosed as a pons stroke by the radiologist.  The neurologist did not think so.  Other possibility was a focal inflamatory process or neoplasm.  Meanwhile, all this time his persisted with a low grade fever from 99 -100.9.  Saw an endocronologist Found low vitamin D, high cholestrol, elevated THS, and low cortisol.  They gave him synthroid 50mg, cholestrol meds and Vit D.  The endo seems to be concentrated on the cortisol at the moment.  It is hard to test because he works nights.  We go back in July taking a 24 hour urine test and to see how he is doing on the meds.
I understand Hashi's can come on gradually over years. 5 years ago he became extremely allergic to wheat to the point of anaphylexis 5 times before we found the source.  I have read a lot of doctors put Hashi patients on gluten free diets (he is on now).  He also has a very good BP 120/70 area but a rather low pulse of 55-60.  He has some aches and pains (thought that was age), has major problems with sleep (thought that was night work) dry skin and stiff joints.  He has lost about 30 pounds prior to the synthoid and now skin is saggy and looks like he has aged 10 years.  People are noticing how bad he looks.  
April test
Vit D 26.1 range 32-100
T4 total 6.5 range 4.5-12.0
TSH 7.71 range 0.49-4.67
Cortisol 5.0 range 6.7-22.6
Cholestrol 245 triclyceride 76 HDL 44 LDL 186 LDL/HDL ratio 4  Put on Cholestrol meds
Next test TSH was high also so put on Synthroid 50mg.
Had cortisol stimulation test that was normal .  Then he tested the cortisol again 8.5/8.6 (up 7 hours) and testosterone FSH 5.7 LH 4.2 Testosterone was 436, free testosterole 43.7 range 46-224.  
Had pituitary MRI because they were convinced He had a tumor but nothing there.  Can you always pick up a pituitary and/or hypothalmic tumor on a MRI scan or can they be too small or hide

[Rooney01]

Taking synthroid for 2 months.  Returned to dr office.  He said last visit his testosterone was 475 but his free testosterone was low.  When we asked what he thought was going on, he said aging.  The thyroid was low and testosterone low so he wanted to put him on testosterone.  We get home and they called saying not to take the testosterone and come back in to have a thyroid stimulation test.  His cortisol was critical 1.0/1.1.  We took the test 1 1/2 weeks ago.  I called and they told me dont call them, they would call us.  Now we are very confused.  This is the second time the cortisol has been low.  Last time 3.5.  also took a 24 hour urine test for the adrenals.  This is a big endocrine place.  Looks like the results would be back and we would know something.  Any ideas?

[Mark Lupo, M.D.]

It appears that he has had proper testing for adrenal insufficiency.  MRI is very sensitive for pituitary and hypothalamic tumors.  It would be unlikely to have a pituitary cause of hypo-adrenal status with what you described but the endocrinologist can confirm this.  The elevated TSH with a low normal T4 is consistent with primary thyroid failure and the medication appears appropriate.  His testosterone was normal as well which points towards normal pituitary function.  He may need a general internal medicine evaluation for the weight loss however.