What were your actual thyroid hormone tests, when you had them done? The symptoms you report are all those of hypothyroidism.
Just an AM cortisol is really not useful, because cortisol "should" be high in the morning and should start dropping off as the day goes on. Most useful is the 24 hr saliva test, because it tests 4 times through the day, so you can see whether your levels are increasing/decreasing as they should.
I'd be inclined to think your issues are more thyroid related than cortisol, but I could be wrong.
Have you been tested for insulin resistance/type II diabetes? Insulin resistance also causes belly fat.
Sounds like a cortisol problem to me. Your levels are off the charts. Do you have other hypothyroidism symptoms? Are you extremely cold all the time (especially your feet)? Are the outer 1/3 of your eyebrows missing or really sparse? Do you have any lumps on your throat around your thyroid that you can feel with your fingers, especially when you swallow? Is your heart rate slow? Do you get constipation often? Do your eyes bulge out at all (called exopthalmos)? But you can fall in the mid-range on thyroid tests and still have a thyroid problem. Get a second opinion.
hi barb 135 and uscgal. Thanks for your replies. im really confused now.
Yes i have most of the hypothyroid symptoms, cold all the time espc my feet! they are always like ice! outer edge of eyebrows are sparse, no lumps in throat. constipated? i dont feel so, but the most i go to the toilet is once a week!. eyes dont bulge out but a year ago i was diagnosed with onset gluacoma.
I think i had my Thyroid test maybe a year and half ago, could even be a bit longer, i had to go to medi checks as my docotor refused to tell me what my basic test was, all he would say was it was normal, and refused to do the advanced one, so i decided to go private for the advanced test
i downloaded the results to my computer, which has since been replaced, so i dont have the figures, but i do remember all the results were bang in the middle of all the ranges, its like they couldnt be any more perfect!
So after ruling that out, ive searched and searched for other things, the only thing i could come up with is the cortisol.
I understand i should really have cortisol at am and pm tested, but my thinking was if i got one reading maybe i could then go to my doctor and ask him to investigate further as without proof they wont do anything for weight related issues.
i know cortisol is supposed to be high in the morning and it drops, but also my thinking was if i had a reading at the top end or even higher, and i wasnt that stressed, then surely it is a sign i have a cortisol problem, as with me being BPD i do get very stressed a lot and in those cases i presume my cortisol levels would be so much higher!
to me it has to be a thyroid or cortisol problem, and to be honest now i would sway more on the cortisol side after reading people with bpd usualy have it and every time i exercise my weight goes up and everytime i am really stressed my weight goes through the roof even if im dieting and exercising!.
A second opinion is hard in my doctors practice on the NHS, i believe the area i live doesnt have much funding and weight problems ar bottom of the pile. i have tried a couple of doctors, one indian doctor pointed to my belly and said it was because i eat too many pies! and another english doctor said i must be cheating as slimming world works for him and its impossible to gain if you eat less and exercise! but they dont tell you about things like cortisol do they!
I have one last doctor to try , a woman doctor . i just wanted to see if anyone thought my reading of 519nmol/L was high enough to cause this, even in the morning when its supposed to be at its highest with normal morning range is supposed to be 64-536 nmol/L
Again, i didnt realise the test should be done at 8am, i didnt have it done till 10am, so my reading would have been higher at 8am, most likely over the 536 limit.
Does anyone have knowledge on cortisol?
One last question, if all my thyroid tests have come back in the middle range, how do i get a doctor to listen to me on symptoms alone? if they will only act with test results? the advanced tests are quite expensive and i cant afford to have them done again for them to come back perfect again!
Your made out its the worst thing in the world to be fat, yet when your trying and the weight wont come off no one will help you, no one believes you!
thanks again for all your help
I agree with you that it's probably a cortisol or thyroid condition. I have had an experience like you are having for years. No doctor believed me about having hypothyroidism because my tests fell in the mid-range. All the while I was getting more and more symptoms. Also my mother took Synthroid for hypothyroidism her whole adult life, and this condition tends to be genetic. Now, after so many years, I have a nodule on the right side, am having an ultrasound, and they are listening
My point is that you have to keep on trying until you find the right physician. It is your body and you have a right to get the proper treatment. Try the woman doctor. I eventually had to go to an endocrinologist. If that hadn't worked, I would have had to pay out of pocket to see a very good specialist that someone referred me to. Also be as informed as possible so you can call them on it when they try to brush you off. Go online and look at he normal ranges of TSH, T3 and T4 that you are supposed to have. I believe that when you are hypothyroid, your TSH levels are high (above 11), but your T3 levels are low, (without looking I believe they should be between 0.3-3.5).
I know the tests are quite expensive and I have had to wait until a doctor has wanted to order them so my insurance would cover it. If you can communicate your ever increasing number of symptoms, a doctor will eventually want to order those tests.
I don't know as much about cortisol, but it seems to me that your levels are high. And with your situation you are stressed enough for it to be elevated. Most people are these days which is one of the reasons other than diet why most people are overweight and carry weight around their bellies.
You're right about the medical profession's attitude about fat. It's a vicious circle.
I will see if I can get more info re: cortisol from those in and who teach my Differential Diagnosis class.
Hi, thanks for your help and support.
I have done so much research on hypothyroidism and cortisol, i had read that if the basic thyroid test came back normal then you could still have a problem and you had to get the advanced test for a better idea.
Which is why i then had to go private for it, i was thinking even if it was in the normal range i was hoping for it to be closer to the limit so i can then have something to take to the doctor, but when all the results were bang in the middle i was so disheartened. I thought it would have to be something else, but what!!!! if your now saying you can still have it if you have the symptoms but the tests are normal, then i dont know what to do!
The reason i was so adimant i had it was because my dads mum had hypothyroidism and my dad granddad on his dads side also had hypothyroidism and i know my great granddad was very fat and had a huge goiter as theres a picture of him.
Im trying to see if i can obtain another set of my results from medichecks, im not sure if they will have kept a copy after a year an half, i might have to email them, its worth a shot.
high cortisol can be caused by a number of things, glands going wrong, tumors,chemical functions going wrong, bpd, hyperthyroidism ( havent read hypothyroid can )
if you have an emotional disorder like BPD, or depression, anxiety and your body is exposed to high levels of stress for a long period of time then you can get cushings syndrom.
From what i read hyperthyroidisn can affect cortisol but i dont believe hypothyroidism can, so with my cortisol reading being on the high side then im hoping to see if my doctor will look into the cortisol and if it doesnt show anything up then, from what you have told my i should begin thinking about hypothyroidism again too especially with my family history
it just doesnt make sense to me, i think you are in america? as you were talking about insurance? but in the uk, the doctors are always saying how much fat people cost the NHS in knee, hip replacements, in diabetes related illnesses, in care, so if someone is trying to help their weight problem which i am, you would think at the veyr least they would want to listen and help and do tests as they are a lot cheaper than the listed things above happening to me!
im glad you seem to be getting somewhere now, i know what it feels like to know you have a problem as we know our bodies better than anyone and not to be believed and every time you go for help you get knock back after knock back until you get to the point where you just want to give up as you cant take any more, so i hope you get the help and support you need to feel better and get some improvement.
Lab tests that were done a year and half ago are no longer valid, as things can change quickly. You would need to get those tests done again. For thyroid tests, you need TSH, Free T3 and Free T4.
If you have hypothyroidism, TSH will, typically, be high, but not always. Recommended range for TSH is 0.3-3.0. Anything above that is considered too high. Free T3 and Free T4 are the actual thyroid hormones that the body produces. You produce mostly T4 and of the total T4 produced, most is bound by protein and can't be used... that's why you need to test the Free T4. Free T4 isn't used directly; it must be converted by the body (mostly in the liver) to T3. Again, most of the T3 is bound by protein and can't be used, so you need to test for Free T3, which is the hormone that the individual cells actually use. Ranges for Free T3 and Free T4 vary from lab to lab, but they are usually, something like 2.3-4.2 for Free T3 and 0.8-1.8 for Free T4.
You might also want to have get tested for thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). Elevated levels of either of those would be the basis for a diagnosis of Hashimoto's Thyroiditis, which is an autoimmune disease, in which the body see the thyroid as foreign and develops the antibodies to destroy it. Hashimoto's is the most common cause of hypothyroidism in the developed world. Autoimmune diseases tend to run in families, but not every member of the family always gets the same disease. For instance, I have Hashimoto's and Pernicious Anemia, my son has type I diabetes, and my daughter has lupus... all autoimmune.
Hypothyroidism CAN affect cortisol levels. What happens is that when the thyroid starts slowing down production of thyroid hormones, the adrenal glands try to take up the slack.
Symptoms of hypothyroidism can show up long before lab tests indicate an issue, therefore, many patients go undiagnosed for long periods of time. We do see a lot of people in UK, under the NHS, either not getting diagnosed or not being treated properly, because NHS guidelines call for testing only TSH and dosing according to that, as well.
For more information on thyroid function, you might want to check out the thyroid forum, which can be accessed via the following link:
What I meant about insurance is that over here, if a doctor orders the thyroid test because he needs the results to diagnose a thyroid condition so he can treat you for thyroid disease, insurance will pay for it. They won't pay for or even order it if you are just curious to see if you have slightly diminished thyroid function because you want to lose weight. Don't make that the primary reason that you want the test when you speak to your doctors. They're going to have to feel that they have to have the results to know what is going on with you. I hear the guidelines for the thyroid function test have been narrowed so more people fall outside of the normal limits. You need to know where you fall in the "normal" range. If it is in the middle or less, you could very well need help.
Synthroid (synthetic thyroid hormone), which is prescribed for hypothyroidism is a very serious treatment with serious side effects. Once you start taking it, your thyroid gland permanently stops producing thyroid hormone so you have to take it for the rest of your life. That's why doctors tend to ignore someone who is simply having a hard time losing weight as a reason to be treated for a slightly underactive thyroid. If your life is being made miserable because you are suffering from multiple symptoms all at once, express this to your doctor. They tend to take you more seriously if it appears that your condition is chronic and progressively getting worse.
It could be high cortisol levels, but if you have all but 1 of the symptoms I mentioned, it's more likely a thyroid problem. Fluctuating cortisol levels are part of the human condition as high cortisol is usually a response to stress. Stress management is usually the first step. If your levels are that high all the time, then that's another thing.
I completely agree with you as far as preventative health measures go. I know the attitude I run into is to only treat the symptoms, not necessarily the condition, and only what's immediate. You would think there would be more foresight.
Please let us know what the new doctor says, and good luck!
Hi barb, thanks for replying, and very interesting, for some reason i didnt think hypothyroidism was linked to cortisol, but your quite right.
The reason i was trying to find my old thyroid results was just to look at what my results were and what i was tested for. They could be completely different now who knows!!! I managed to find them, so below are the results along with the normal ranges the lab said were normal.
TSH = 2.0 mIU/L (normal range 0.27 - 4.2)
Free Thyroxine = 16.1 pmol/l normal range 12.0 - 22.0)
Total Thyroxine ( T4) = 112.0 nmol/L ( normal range 59.0-154.0)
Free T3 = 4.7 pmol/L (normal range 3.1-6.8)
Thyroglobulin Antibody = 19.4 IU/mL (normal range 0-115)
Thyroid Peroxidase Antibodies = 5.2 IU/mL ( normal range <34.0)
does that mean i wasnt tested for free t4? my free t3 was higher than the 4.2 you said it should be but on the report it says it is alloed up to 6.8?
will go and google the normal ranges now!
just googled the results and they all seem bang in the normal range, i suppose it may be worth having just the basic test again to see if the tsh level has gone up any as from what i read many places want the upper limit moved to 3, so at my reading of 2 if it has gone up, i suppose that would be something to think about.
Aslo think i figured it out, Free Thyroxine, is freet t4?!
Ranges do vary by lab because some parameters are measured in different units and they use different criteria. I was just giving a example of a range that we see all the time.
Yes, Free Thyroxine is Free T4.
Actually, your FT3 and FT4 are not bang in the middle of the ranges. Rule of thumb is for FT4 to be about mid range. Yours is only 40% of its range. Rule of thumb for FT3 is a upper half to upper third of its range. Yours is at 43%.
There is some disagreement as to whether or not those with a working thyroid need levels as high as those of us on medication, because you'd have "hormones on demand", while those on medication have to make sure we have adequate hormones for every situation we encounter.
Since your FT levels were both less than mid range on the last set of tests, I'd suggest having them done again. TSH is a pituitary hormone and there are a lot of things that affect, besides thyroid hormone, so I'd never rely on just that.
You might also consider redoing the antibody tests, even though they were negative on the last set. It's possible that they just hadn't ramped up good yet.
You might try to get your doctor to give you a trial dose of levothyroxine (equivalent to Synthroid) to see if helps alleviate your symptoms. It's incorrect that your thyroid will stop making hormones permanently if you take a thyroid medication. If you start a small dose and don't need it, your thyroid will pick back up.