Thryoid or Adrenal problem????

[andeflora1]

I am new to this whole thyroid thing....

I have horrible dry itchy skin, im always exhausted, hair is falling out, scalp is flaking and itchy all of the time (I have tried all the different shampoos my hair stylist told me to with no help), my periods are all over the place, and in 2 mths I have gained 20lbs. And in the last 4 years I have gained 70lbs. Until I was 23 I was 106lbs and wore a size zero. No matter how many miles I run a day or how many salads I eat I keep gaining weight...

I had labs done recently that conflict with the previous tests
Free T4 1.18 (.82-1.77)
TSH 1.1 (.5-4.5)
Cortisol 17.6 @ noon (2.3-11.9)
T3 141 (71-180)
sedimentation Rate 6 (0-20)

thyroid stim immunoglobulin are still out

PREVIOUS Test (2 weeks earlier)
Free T4 .8
TSH .8

1 Month ago DHEA-S 288 (45 - 270)

Typically someone would have high cortisol low DHEAS or vice versa. AND if someone had high TSH they would have low Free T4 or vice versa. Why are mine low/low and adrenal elevated/elevated? What could this be? I do have most of the hypothyroidism symptoms... exhaustion, rapid weight gain, dry itchy skin, dry hair, nails constantly breaking etc. But I see now that those are also symptoms of adrenal gland issues. I feel crazy with all of these symptoms and the test all coming back all over the place.

Why have these changed so much? I started taking birth control pills after the first set of test, would that change the tests? Also why is my cortisol elevated... what would make it a little higher than normal?

[andeflora1]

Ok so my endo ran all kinds of labs and I am not sure what any of these mean.
30 yr old Female with endometriosis and confirmed NO pcos. I did have precocious andrenarche as a child that was not treated.

Doc is ruling out secondary hypoT and checking out my adrenal glands.

Here are the new test.... would you look at and tell me what you think?

All test were at 8 am
(17-OH Progesterone ACTH Stimu.)
17-OH Progesterone Baseline 65 range 30-100
17-OH Progesterone Stimulated 64 range (it just says not estab.)

Coritsol 15.2 Range 6.2-19.4
TSH 0.8 range .5-4.5
Free T4 1.13 range .82-1.77
Free Testosterone 0.7 range 0-2.2
Testosterone, Serum 78 range 6-82
DHEA 393 range 31-701
DHEAS 377.7 range 45 - 270
Luteinizing Hormone (LH) 10.6 range 2.4-12.6
FSH, Serum 3.9 range 3.5-12.5
Prolactin 12.1 range 4.8-23.3
Estradiol 208.9 range 12.5-166.0

My previous test were 1 month ago:
Free T4 1.18 range .82-1.77
TSH 1.12 range .45-4.5
cortisol 17.6 range 2.3-11.9 (PM)
T3 141 range 71-180

2 Month ago DHEA-S 288 (45 - 270)


It looks like my DHEA-S is going up, is that normal?

And my cortisol is higher at noon than at 8 am????

17-OH Progesterone Stimulated went down from the baseline, I thought if it was stimulated it should go up????

[Mark Lupo, M.D.]

The thyroid labs looks fine.
Would consider additional testing to exclude Cushings (excess cortisol production) - usually a 24 hour urine for cortisol is the best test.