Hypothyroidism and Cortisol levels. Eltroxin 0.15MG

Two questions:
What hormone levels warrant a dosage of 0.15MG of Eltroxin/Levothyroxine?  
Is there a relationship between hypothyroidism and low cortisol?

(I received an urgent call from my thyroid specialist for me to start taking this medication, and am away from my doctor's hometown- so I can't ask about my diagnosis until 6 weeks or so).


My story:

- I am a 23yr old female.

- I am under "investigation" for psoriatic arthritis, as the pain in back and legs is severe.  I have moderate psoriasis on my legs, elbows and scalp, and nail pitting.  I use corticosteroid ointment.

- Currently, I am not using any other medications.  I use to take meloxicam, which was useless for me.

- I have multiple nodules, an enlarged left lobe, and heterogenous echotexture to my thyroid gland.  They have been monitoring it (alongside some abnormal lymph nodes) biannually.  

- My TSH, Free T3, T4 etc was within normal range half a year ago.  I remember my TSH being 3.77.

- I have low cortisol (shown via morning cortisol, blood work).

- Severe fatigue, pain, sleeping and memory problems.


I WILL BE SO VERY GRATEFUL FOR ANY INSIGHT YOU MAY HAVE.  I'M IN THE DARK WITH WHAT'S WRONG WITH ME.

[SwanSong]

Here's a possible answer for your low cortisol level:

http://www.medhelp.org/posts/Family-Medicine/Low-cortisol-level/show/227411

A low cortisol level is a manifestation of adrenal gland disorders. It is associated with more than one disorder.

Symptoms are:
Muscle pain and weakness; Joint pain; Loss of appetite; Weight loss; Craving for salt; Fatigue; Low blood sugar; Low blood pressure; Depression; Irritability; Mood swings.

Severe cortisol deficiency symptoms: Pain in the legs; Lower back and stomach pain; Vomiting; Diarrhea; Low blood pressure; High potassium levels; Lack of menstruation.

My mother had a very low cortisol level and it was caused by Addison's Disease. Later she got Hashimoto's as well Type I Diabetes.

I would say that maybe a low cortisol and a high TSH together might be cause for a high starting dose of thyroid medication. 150 mcg to start is quite high. Your doctor obviously has a reason to start you on the high dose. I would certainly ask him/her when you get back to your hometown.

[stella5349]

The cortisol is very important in knowing where you are at. When the adrenals are weakened most likely the thyroid will konk out too - and if you are suseptable - antibodies of thyroid - or other things ( your arthritis issues) could raise those things once the body has lost its ability to fit off things with the adrenals and thyroid giving in.

Its common and linked together that if you can get the endocrine system back up and running right - many things "disappear" that causes individual symptoms.

[kritty2009]

Wow, those symptoms fit.  Every one of them.
Last year, I thought I was dying.  Vomiting ~twice a week/nauseous every morning.  Doctors said I was just stressed/overworked, since I was double majoring in university.  Everyone's a psychiatrist, right?  I guess the way I had described the pain made them think I was a hypochondriac.  It's not like putting pressure on my legs or back hurts me.  It's the radiating, tight, aching kind.  Anyway, calling me "just depressed" was genius, because here I am with bloody legs (psoriasis), a strange hobble walk, constant nausea, no energy, and no diagnosis.  Of course I'm depressed.  Plus I was losing weight rapidly, despite limited exercise, while having a swollen/bloated belly (is that a symptom?).  The only symptom that doesn't fit is the lack of menstruation, because I was spotting often.
The nausea passed, and now I'm feeling really moody, still in pain, and VERY forgetful....staring at walls, dazed.  Serious sleeping problems.  I was really worried because I couldn't fathom how anyone would employ someone with so little energy.  Maybe the meds will make me a productive person again.

[kritty2009]

Is the next step (with low cortisol testing) an MRI or ultrasound of the adrenals and/or pituitary?  Or will I have to request this kind of testing?