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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Comment on Adrenal and Thyroid
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Comment on Adrenal and Thyroid
by wonderme, Apr 27, 2006 12:00AM
Dr. Mark and all,
Can you please comment on lab ranges--specifically I'd like to know if a range is, say for cortisol, 4-22 and you test at 10 and feel TOTALLY exhausted, irritable, foggy, unmotivated, etc., then isn't it possible that your body chemistry just requires you to be at the higher end of the "normal" range?
I mean if I had tested at 21 or 22 the doctor would have said I was normal but at 10 I have all these symptoms so why not try raising the cortisol?
Likewise, my TSH has fluctuated between 1.1 and 2.0 (most recent 1.58; range .4-5.5) and my Free T4 has never budged off 1.1(range 0.8-1.8). Free T3? Who knows since I can't seem to get tested for it. My Total T3 is in the "normal" range but it is my understanding that this test is not useful b/c it is not the T3 (unbound) that the body uses.
Free T3 is what the body uses (even more than T4) and gives you energy, metabolism, clear headedness, etc. Why do I keep hitting resistance with getting this test.
And if this is not thyroid or adrenal than what other differential diagnosis/testing would you suggest? I've been checked for lyme, EBV (had past infection).
Also, I have huge abdominal bloating/bulging. I have never had this before--except when 4 months pregnant! It is up to my rib cage to below my navel. I am and have been constipated for years. I -- at the advice of my doc -- take fiber pills to increase regularity...is this somehow causing this? I have taken them on and off for years and have only started with the belly since Nov. when I went off the pill (not preg.).
Please advise
Can you please comment on lab ranges--specifically I'd like to know if a range is, say for cortisol, 4-22 and you test at 10 and feel TOTALLY exhausted, irritable, foggy, unmotivated, etc., then isn't it possible that your body chemistry just requires you to be at the higher end of the "normal" range?
I mean if I had tested at 21 or 22 the doctor would have said I was normal but at 10 I have all these symptoms so why not try raising the cortisol?
Likewise, my TSH has fluctuated between 1.1 and 2.0 (most recent 1.58; range .4-5.5) and my Free T4 has never budged off 1.1(range 0.8-1.8). Free T3? Who knows since I can't seem to get tested for it. My Total T3 is in the "normal" range but it is my understanding that this test is not useful b/c it is not the T3 (unbound) that the body uses.
Free T3 is what the body uses (even more than T4) and gives you energy, metabolism, clear headedness, etc. Why do I keep hitting resistance with getting this test.
And if this is not thyroid or adrenal than what other differential diagnosis/testing would you suggest? I've been checked for lyme, EBV (had past infection).
Also, I have huge abdominal bloating/bulging. I have never had this before--except when 4 months pregnant! It is up to my rib cage to below my navel. I am and have been constipated for years. I -- at the advice of my doc -- take fiber pills to increase regularity...is this somehow causing this? I have taken them on and off for years and have only started with the belly since Nov. when I went off the pill (not preg.).
Please advise
Doctor's Answer
by Mark Lupo, M.D., Apr 30, 2006 12:00AM
, Apr 30, 2006 12:00AM
TT3 is useful in most patients. Your thyroid tests verall sound normal - ?antibodies.
problem with cortisol is it needs to be a dynamic test -- ie ACTH stim test to make any sense of it. And with the treatment being steroids, I would not treat unless absolutely necessary.
Your symptoms may not be endocrine in nature - they are non specific to any particular disease. Make sure you get regular exercise and a balanced diet with lower calories taken in than burned off.
problem with cortisol is it needs to be a dynamic test -- ie ACTH stim test to make any sense of it. And with the treatment being steroids, I would not treat unless absolutely necessary.
Your symptoms may not be endocrine in nature - they are non specific to any particular disease. Make sure you get regular exercise and a balanced diet with lower calories taken in than burned off.
I tried to explain to my GP that it is NOT normal to change from a 'pear' to an 'apple' virtually overnight. the 4x adrenal saliva test was worth its weight in gold, get it done if you havn't all ready.
my levels are on STM.
Berlioz