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Cortisol and thyroid results? What do you think?
hello there, so iv been battling weird symptoms of dizzy spells, vertigo, cant sit or stand up for long without faint feeling, extreme fatigue, hot flushes (im male), plus many more.
i decided to get some private tests done as the doctors mainly just tell me its stress etc but i am being treated for pots as i get blood pooling in my feet when upright but i feel it could be something else, can i please get some advice/guidance on my results below pleasssse?
Saliva Cortisol 24 test
Morning 11.7 12.0 - 22.0 Low
second 5.6 5.0 - 9.0 normal
third 5.1 3.0 - 7.0 normal (had to go for a nap because of extreme fatigue)
bedtime 1.8 1.0 - 3.0 normal
THYROID PROFILE
THYROID STIMULATING HORMONE 1.45 mIU/L 0.27 - 4.2
FREE THYROXINE 12.8 pmol/l 12.0 - 22.0
FREE T3 6.1 pmol/L 3.1 - 6.8
i decided to get some private tests done as the doctors mainly just tell me its stress etc but i am being treated for pots as i get blood pooling in my feet when upright but i feel it could be something else, can i please get some advice/guidance on my results below pleasssse?
Saliva Cortisol 24 test
Morning 11.7 12.0 - 22.0 Low
second 5.6 5.0 - 9.0 normal
third 5.1 3.0 - 7.0 normal (had to go for a nap because of extreme fatigue)
bedtime 1.8 1.0 - 3.0 normal
THYROID PROFILE
THYROID STIMULATING HORMONE 1.45 mIU/L 0.27 - 4.2
FREE THYROXINE 12.8 pmol/l 12.0 - 22.0
FREE T3 6.1 pmol/L 3.1 - 6.8
Sorry for the slow response. I was doing some reading on cortisol and DHEA. Could you please post the actual test results and reference ranges and measurement units for both your cortisol test and your DHEA test. Also, what time of day was blood drawn for those?
Beyond the POTS effect, some of your symptoms may well be due to hypothyroidism. Your basal temperature points to that possibility as well. Your thyroid is obviously working, but the problem may be external to the thyroid. If the low cortisol, or perhaps low ferritin is causing pooling of T3, then that needs to be addressed first to see what your Free T4 and Free T3 levels become afterward, and how you feel when Free T3 starts getting into cells adequately.
So do try to get tested for ferritin and a full iron test panel, as listed above. When I know more about your cortisol and DHEA results, perhaps we can figure out a strategy for that.
As mentioned I think you are going to need a good doctor, and I know how difficult that is in the UK. Do you think you could go private if you knew of an Endo that was also a good thyroid doctor
Beyond the POTS effect, some of your symptoms may well be due to hypothyroidism. Your basal temperature points to that possibility as well. Your thyroid is obviously working, but the problem may be external to the thyroid. If the low cortisol, or perhaps low ferritin is causing pooling of T3, then that needs to be addressed first to see what your Free T4 and Free T3 levels become afterward, and how you feel when Free T3 starts getting into cells adequately.
So do try to get tested for ferritin and a full iron test panel, as listed above. When I know more about your cortisol and DHEA results, perhaps we can figure out a strategy for that.
As mentioned I think you are going to need a good doctor, and I know how difficult that is in the UK. Do you think you could go private if you knew of an Endo that was also a good thyroid doctor
Hey there gimel, thank you so so much for your reply i really apprecate it, i actually had the DHEA done with the cortisol but i forgot to post it stupidly ...
DHEA Mean 0.71 0.40 - 1.47 (normal)
DHEA Cortisol Ratio 2.93 2.0 - 6.0 (normal)
its so hard because im in england and health care is free, i guess theirs a budget or something so you have to push super hard and hope they believe you and refer you etc. iv started taking my basal temperature as iv herd it shows good infomation about your thyroid, so far my results are
day 1 96.63 f (35.9 C)
day 2 97.20 f (36.2 C) (tried again 10 minutes later and was back in the 96s)
the pooling you mentioned would defiantly makes alot of sense as i do get the anxiety stuff sometimes, as im sitting here typing i just get a super hot face, like a hot flush yet im male, as it happens alot now it doesn't worry or panic me anymore so i know its not general anxiety etc, the worst symptom for me is how i cant sit up or stand for long, even in a car i feel super ill just from sitting up :S.
thank you for saying you think its more then just pots as i do to
so if the T3 is highish and the T4 is low but they are still both in range, doesnt it mean the thyroid is working normally? as its telling the T4 to convert to T3 ?
DHEA Mean 0.71 0.40 - 1.47 (normal)
DHEA Cortisol Ratio 2.93 2.0 - 6.0 (normal)
its so hard because im in england and health care is free, i guess theirs a budget or something so you have to push super hard and hope they believe you and refer you etc. iv started taking my basal temperature as iv herd it shows good infomation about your thyroid, so far my results are
day 1 96.63 f (35.9 C)
day 2 97.20 f (36.2 C) (tried again 10 minutes later and was back in the 96s)
the pooling you mentioned would defiantly makes alot of sense as i do get the anxiety stuff sometimes, as im sitting here typing i just get a super hot face, like a hot flush yet im male, as it happens alot now it doesn't worry or panic me anymore so i know its not general anxiety etc, the worst symptom for me is how i cant sit up or stand for long, even in a car i feel super ill just from sitting up :S.
thank you for saying you think its more then just pots as i do to
so if the T3 is highish and the T4 is low but they are still both in range, doesnt it mean the thyroid is working normally? as its telling the T4 to convert to T3 ?
Following is info on the best levels for cortisol. Compared to that info your results are much too low in the early part of the day.
8 am: at the literal top of the range.
11 am-noon: in the upper quarter, and often about a quarter below the top.
4-5 pm: mid-range
11 pm to midnight: at the very bottom.
Looking at your thyroid test results, your Free T4 is much too low in the range. Optimal is middle of the range, at minimum. Your Free T3 is at about 80% of its range, which is a good level; however, with low cortisol you can have something called "pooling of T3 in the blood". Your low Free T4 may be due to your body trying to achieve adequate T3 through conversion of T4, to maintain thyroid effect, but it may not be getting to cells.
Further info.
Cortisol is required to sensitize thyroid receptors to thyroid hormone. Therefore low cortisol disrupts normal thyroid signaling leading to hypothyroid.
Here is info from another source.
"If it is converted, but the T3 cannot enter the cell walls due to adrenal insufficiency, the T3 cannot be used. In either case, T4 and TSH blood tests will appear normal, but the patient may feel really unwell.
The reaction varies with degrees of adrenal insufficiency. Symptoms may include: a sudden feeling of exhaustion, nausea, headache, inability to concentrate, trembling, muscle weakness, loss of peripheral circulation leading to numbness, lack of muscle control, giddiness, slurred speech, and cognitive impairment."
I also have seen that many POTS patients also experience fatigue, headaches, lightheadedness, heart palpitations, exercise intolerance, nausea, diminished concentration, tremulousness (shaking), syncope (fainting), coldness or pain in the extremeties, chest pain and shortness of breath. But just from the cortisol results and your FT4/T3 levels, I think it is more than just the POTS.
So if it were me the first thing I would do is to do a bit more testing. Specifically I would test for ferritin, and a full iron test panel (serum iron, TIBC, and % saturation), as well as a test for DHEA (since your cortisol levels were low). Good iron levels are needed in the production of cortisol via the adrenal cortex. An iron-containing protein is present in high amounts in the adrenal cortex and is involved in the synthesis of corticosterone. So by having low iron, you can potentially lower your cortisol levels.
While this is being done you also need to try to find a good doctor that is knowledgeable enough to address your issues. .
8 am: at the literal top of the range.
11 am-noon: in the upper quarter, and often about a quarter below the top.
4-5 pm: mid-range
11 pm to midnight: at the very bottom.
Looking at your thyroid test results, your Free T4 is much too low in the range. Optimal is middle of the range, at minimum. Your Free T3 is at about 80% of its range, which is a good level; however, with low cortisol you can have something called "pooling of T3 in the blood". Your low Free T4 may be due to your body trying to achieve adequate T3 through conversion of T4, to maintain thyroid effect, but it may not be getting to cells.
Further info.
Cortisol is required to sensitize thyroid receptors to thyroid hormone. Therefore low cortisol disrupts normal thyroid signaling leading to hypothyroid.
Here is info from another source.
"If it is converted, but the T3 cannot enter the cell walls due to adrenal insufficiency, the T3 cannot be used. In either case, T4 and TSH blood tests will appear normal, but the patient may feel really unwell.
The reaction varies with degrees of adrenal insufficiency. Symptoms may include: a sudden feeling of exhaustion, nausea, headache, inability to concentrate, trembling, muscle weakness, loss of peripheral circulation leading to numbness, lack of muscle control, giddiness, slurred speech, and cognitive impairment."
I also have seen that many POTS patients also experience fatigue, headaches, lightheadedness, heart palpitations, exercise intolerance, nausea, diminished concentration, tremulousness (shaking), syncope (fainting), coldness or pain in the extremeties, chest pain and shortness of breath. But just from the cortisol results and your FT4/T3 levels, I think it is more than just the POTS.
So if it were me the first thing I would do is to do a bit more testing. Specifically I would test for ferritin, and a full iron test panel (serum iron, TIBC, and % saturation), as well as a test for DHEA (since your cortisol levels were low). Good iron levels are needed in the production of cortisol via the adrenal cortex. An iron-containing protein is present in high amounts in the adrenal cortex and is involved in the synthesis of corticosterone. So by having low iron, you can potentially lower your cortisol levels.
While this is being done you also need to try to find a good doctor that is knowledgeable enough to address your issues. .
Sorry i forgot to paste my antibody results
THYROID ANTIBODIES Thyroglobulin Antibody 25.3 IU/mL 0-115(Negative)
Thyroid Peroxidase Antibodies 13.0 IU/mL 0 - 34
THYROID ANTIBODIES Thyroglobulin Antibody 25.3 IU/mL 0-115(Negative)
Thyroid Peroxidase Antibodies 13.0 IU/mL 0 - 34
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