Hypothyroidism or adrenal insufficiency?

[san58]

I am 58years old and have hypothyroidism, and my latest results came back;
FreeT4  13.1 pmol/l    TSH 16.40 mIU/l    
I am concerned I have adrenal insufficiency,as I have complete exhaustion, find it hard to wake up, let alone get through the day.   All my white blood cells are low and I have neutropenia. My muscles are so painful, and sore to touch. They fasiculate, my CKmm is 414. I also get numbness and tingling.   Terrible back pain just above the waistline.  Cholesterol at 9. Alk Phos 144.  Suffer horrendous vertigo with sickness, terrible funny headaches and eyesight goes blurry. I could go on but I am so fed up of it all.  Feel I have suffered for over 10 years, after a perriod of extreme prolonged stress. I was rushed into hospital once unconscious for 7 hours, was found cold, with blue lips, was given equivalent of 30 teasp. sugar and heaps of salt. When I got to hospital I was still unconscious, and hypoglycaemic, they gave me Saline,  next day they tested for Addisons. Negative result. Now am I right in thinking that after all that salt and sugar a test so soon after treatment would be useless.  I have been tested for diabetes also negative. I was started on thyroxine about 3 years ago and the dose keeps on going up, now at 150mg a day, the dosage stays fine for a few months then I just seem to need more. ...Please give me some advice!  By the way my son has Addisons and Type1 Diabetes.  Also my mother had all these symptoms when she died. My older sister also suffers from most of them.

[Mark Lupo, M.D.]

The high TSH means the dose of thyroid medication should be increased.
If you tested negative for Addisons (despite the salt/sugar load) - it's not likely Addison's, but you could talk to your endocrinologist about re-testing.
May need rheumatology testing given the high CK and muscle symptoms.
Also consider hematology evaluation for the low WBC.

[san58]

Thank you so much for your well structured fast reply.
Kind regards.