Everything is low! I got nuthin'.
It a shame my body can't convert fat to all these things I'm low in, I'd be so skinny!
I did a 4x cortisol test, thyroid panel and hormone panel and it's all low except estrogen.
Cortisol is low, DHEAS is low, Testosterone is low, progesterone is low-normal especially in ratio to estrogen and my FT3 is low with a normal TSH, normal FT4 and high antibodies.
Here's my labs:
25-Hydroxy Vitamin D: 95 ug/dl
Iron, Serum: 45 ug/dl
Ferritin, Serum 12 ng/ml
TIBC: 449 ug/dl
UIBC: 410 ug/dl
Iron Saturation: 10%
Female, Age 31, Pre-menopausal
Estradiol: 2.5 (1.3-3.3)
Progesterone: 128 (75-270)
Ratio: Pg/E2: 51 (100-500)
Testosterone: 15 (16-55)
DHEAS: 6 (2-23)
Cortisol Morning: 4.9 (3.7-9.5)
Cortisol Noon: 1.7 (1.7-3.0)
Cortisol Evening: 0.9 (0.6-1.9)
Cortisol Night: 0.4 (0.4-1.0)
Free T4: 1.8 (0.7-2.5)
Free T3: 2.5 (2.5-6.5)
TSH: 1.3 (0.5-3.0)
TPO: 110 (0-150)
The iron has been an ongoing thing. I was anemic last year with a serum iron of 18, and it has taken me this long to get to just a mere 45. Ferritin has gone from 3 to a whole 12. Whoopee. I malabsorb iron badly. I am taking very large doses of it and the doctor back then literally said to me to come back when my anemia was so bad I needed a blood transfusion, he couldn't help me until then. I tried to explain my malabsorption (I have a part of my small intestine bypassed) and about IV infusions of iron but he shook his head and told me to just eat more spinach. :annoyed: So I know all about the iron problem but I can't do much about it.
Anyway, I am told the TPO indiciates Hashimoto's despite the large range. The doctor at the lab says he considers anything above 70 to be very suspicious and I should stop eating gluten. I already don't eat it because when I do I get migraines, bloating, gas, nausea and I get so sleepy I'm practically narcoleptic. He also said cortisol was low despite being in range, because in the morning and noon it should be at the very top of the range and it seems my cortisol rises a little in the morning but totally poops out by noon. And that's how I feel.
I don't know if it was the chicken (adrenals) or the egg (thyroid) that came first but this chick is exhausted and confused about what to do. I've tried all the advice on adaptogen herbs and licorice and I can't tolerate anything. I end up with panic attacks, some of them very severe. Just 1mg of supplemental DHEA was like "Hey that's some nice energy... oh wait, i'm feeling a little too strung out here, I hope I come down fro- ZZzzzzzzzz." Total sleep attack. The exception has been bio-identical progesterone for the estrogen dominance. I don't feel a thing expect a little buzzed in the head and maybe a little headachy. After a week of it I think a feel a little more energy. I am not taking the typical 20mcg dose either, I am only taking 5mcg.
I was given Naturethroid and 25mg hydrocortisone daily to start but I'm scared of it. I react so badly to everything, last thing I need is to end up the ER over it. And I'm scared the hydrocortisone is going to make me gain weight quickly. I've already put on 5-10lbs right around the middle on a 1200 calorie diet!
I got brave yesterday and took 1/16 grain of Naturethroid with no effect. I may try 1/8 again this evening and see if that bothers me. I am supposed to start at 1/4 grain but I couldn't bring myself to start there.
A grain of Naturethroid contains roughly 37mcg T4 and approx. 9mg. of T3. The human body 'spits out' about 18 to 29mg. of T3 a day.
Free T3 is generally acceptable about 3/4 of the lab range...you can see yours is very low. Your TSH, while being 'normal' isn't very good either..would be much too high for ME. As far as taking hydrocortizone..up to you..but your morning cortisol is kind of 'lowish'.
1/4 grain of naturethroid isn't enough to even raise the body temp..most start at one grain, split...half in am, half in afternoon, about six to seven hours later. so..um..yeah..you're not going to get much 'effect' until you reach the one grain mark. If your doctor goes by TSH, you won't get well replaced on naturethroid, as it and all the porcine NDT's lower the TSH WAY down (mine is about .22 but my doc uses FT's as a measure of titration for incoming thyroid hormone).
I'm starting low on Naturethroid to see if I wind up hitting a level of intolerance. With the poor adrenals and the low iron, I expect it at some point. With my history of not tolerating most things I try, I really expect that point to come sooner rather than later. I'd rather find out at 1/2 grain with some mild but obvious symptoms than take 1 grain and wind up with severe intolerance symptoms. So that's why I'm starting so ridiculously low... just to see if I tolerate thyroid meds at all. If I do, THEN I will move on to actually trying to treat stuff. As I understand it, intolerances and paradoxical reactions are a classic adrenal fatigue symptom. I've got most of the others, too. I just don't know if my adrenals went first and dragged my thyroid down or if my thyroid went first and dragged down my adrenals. I was told it doesn't matter now, with low adrenal function they have to be supported in order to deal with a better functioning thyroid or it'll make them worse. I wanted to avoid hydrocortisone... I tried everything else from Isocort to glandulars to herbs. All backfired.
Do you think T3 only is better than NDT for me? My doctor isn't a TSH worshipper. Treats by Free numbers and symptoms. Naturethroid was my idea. After reading alot of Mary Shomon and Stop The Thyroid Madness, I wanted to try NDT and not synthetics.
Get a second opinion. I read all of the same stuff you did on Shomon sites.
I just stopped Naturethroid. I was being overdosed with trying to get to one grain a day (I was taking one grain split a day and was severely ill). I lasted 18 days. I was diagnosed hypothyroid... low T3 (at low end of normal range), normal low T4 and normal TSH my new blood work after treatment revealed hyperthyroid. Yes, there is a lot of experienced people out here and their advice helped me greatly, but really its about listening to your body. Everyone reacts differently. 1/4 grain may not affect one person and greatly affect another. I am only telling you of my experience. But it wouldn't hurt to go to another doc. My second opinion was chosen from Mary Shomon's list of endocrinologists. It wouldn't hurt. Hope you feel better.
Actually, IMHO and after seeing a ton of patient's cortisol results...yours isn't even CLOSE to the lows I've seen. BUT..your ferritin is horrid! What are you taking as far as iron? And you know you have to take the iron six hours away (before/after) the thyroid hormone. Right?
Many low iron patients are on ferrous sulfate (cheap, doesn't work well)... but there are really absorb-able irons out there. Poly Iron 150 comes to mind cuz it doesn't cause tummy upset.
The hydrocortizone doesn't make you gain weight...depends on what you eat WITH it. I take daily steroids (Prednisone) and my adrenals are overdriven but I have to take it for a blood disorder...I don't gain weight..I just adjust my carbs.
I think NDT is the best way to go if you need both T4 and T3 (right now you need T4 too...but you'll want to test almost exactly four HOURS after you take your Naturethroid...or there won't be any T3 TO test in your bloodstream if you don't do it this way. No earlier than five hours, no later than five and a half will show just how much T3 you are getting and how much will be 'bound up' by incoming steroid and iron. :)
Once your iron and ferritin start coming up (you DID get tested for pernicious anemia...right?) and you can gradually see that it's not impeding your thyroid incoming...you should be well on your way.
SIX? Umm, I'm told 2 hours and that's as good as it gets, honestly. I digest quickly because my re-routed stomach. Besides, I chew up my thyroid meds. My absorption of most things SUCKS and I take sublingual or transdermal as often as I can. If I followed ALL the don't take X within __ hours of Z, I'd never be able to take anything. My list of necessary supplements is long because I will have lifelong nutrient malaborption. I take something every hour almost.
And I do take alot of B12 because I don't absorb that one either. It stays high, like 1200-1600 range. Where I want it.
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