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What Does This Thyroid Report Indicate?
Question: After receiving no benefit from the minimal labs my family doctor ran, I went to a wellness clinic. My results (according to them) showed adrenal fatigue (cortisol 5.0, 5-23ug/dl and DHEA 38, 56-283ug/dl), low iron (ferritin 61, 10-204), thyroid problem (TSH 2.81, 0.45-4.67 and Thyroid peroxidase Antibodies 191.3, 0-3.9) My testosterone was also 7ng.dl, 9-55 and my progesterone was 0.5 (I don't know the range) The wellness doc talked about leaky gut, gluten free diets, and gave me supplements for iron, adrenal support, probiotic, and vit-D.
I got a rx for Nature -Thyroid 65mg. and progesterone 120mg. Does this sound reasonable? I'm nervous about cutting my family doctor out of the loop but I'm feeling a little desperate to feel better. My main symptoms were extreme fatigue, body aches, constipation, loss of body hair and muscle tone, weight creeping up 5 more lbs every year despite diets/exercise (at 5'7 my weight has gone up from 150 to 162 in 3 years), cotton head (brain fog), low libido, etc.
I got a rx for Nature -Thyroid 65mg. and progesterone 120mg. Does this sound reasonable? I'm nervous about cutting my family doctor out of the loop but I'm feeling a little desperate to feel better. My main symptoms were extreme fatigue, body aches, constipation, loss of body hair and muscle tone, weight creeping up 5 more lbs every year despite diets/exercise (at 5'7 my weight has gone up from 150 to 162 in 3 years), cotton head (brain fog), low libido, etc.
Brief Answer:
Endocrine
Detailed Answer:
Your thyroid blood test is considered normal but considering you have compelling symptoms of an underactive thyroid it would be worthwhile checking a blood test for thyroid hormone levels called free T4. Sometimes when there is a pituitary problem the TSH may appear normal but thyroid hormone levels are low. Furthermore your cortisol levels are low but may I know if these were tested at 8 am in the morning ? Also in order to interpret the blood cortisol result it is important to know if you have a normal sleep wake cycle ? I mean to ask if you go to bed at night and wake up in the usual hours of 6 am to 9 am or thereabouts ? The cortisol levels can be interpreted only in this context. If indeed you have a conventional sleep-wake pattern and if the blood sample was drawn in the early morning then the value of 5 is quite low. It needs to be confirmed whether you truly have 'adrenal insufficiency' The best way to go about this is to perform an ACTH stimulation test. It is a specialized test that requires correct performance and interpretation preferably by an endocrinologist
Endocrine
Detailed Answer:
Your thyroid blood test is considered normal but considering you have compelling symptoms of an underactive thyroid it would be worthwhile checking a blood test for thyroid hormone levels called free T4. Sometimes when there is a pituitary problem the TSH may appear normal but thyroid hormone levels are low. Furthermore your cortisol levels are low but may I know if these were tested at 8 am in the morning ? Also in order to interpret the blood cortisol result it is important to know if you have a normal sleep wake cycle ? I mean to ask if you go to bed at night and wake up in the usual hours of 6 am to 9 am or thereabouts ? The cortisol levels can be interpreted only in this context. If indeed you have a conventional sleep-wake pattern and if the blood sample was drawn in the early morning then the value of 5 is quite low. It needs to be confirmed whether you truly have 'adrenal insufficiency' The best way to go about this is to perform an ACTH stimulation test. It is a specialized test that requires correct performance and interpretation preferably by an endocrinologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your prompt reply. I have several follow up questions. The wellness clinic doctor said the thyroid antibodies means I have Hashimoto's. He indicated a gluten free diet could help calm that down. Does that sound accurate?
The serum cortisol test was done at 9am. I usually go to sleep at 11pm and wake at 7-8am. I actually wake frequently from about 3am until morning. I seldom feel rested.
I know the labs included a free t3 test for not a free t4. The t3 was 3.1 (2.4-4.2)
Wellness clinics seem to be springing up and I keep hearing about functional medicine as opposed to western medicine. Is this well regarded or have I bought into some "snake oil"?
The serum cortisol test was done at 9am. I usually go to sleep at 11pm and wake at 7-8am. I actually wake frequently from about 3am until morning. I seldom feel rested.
I know the labs included a free t3 test for not a free t4. The t3 was 3.1 (2.4-4.2)
Wellness clinics seem to be springing up and I keep hearing about functional medicine as opposed to western medicine. Is this well regarded or have I bought into some "snake oil"?
Brief Answer:
Follow up
Detailed Answer:
1 There is no published medical evidence showing that a gluten free diet calms down the Hashimoto's. In fact I have never even heard of such a comment before
Hashimoto's thyroiditis is a medical condition in which the body's own defenses ('immune system') produces antibodies such as thyroid peroxidase auto-antibodies, which have a tendency to make the thyroid under-active.
However, in your case, it has not affected the thyroid function yet because the first sign of that is an abnormally elevated TSH.
So the best advice for you is to monitor your TSH every year.
Sometimes, uncommonly though, there are individuals in whom this test comes back 'False-positive' ie you dont have Hashimoto's but still you test positive for these antibodies.
Most endocrinologists worldwide would not prescribe any thyroid medicine in your circumstance, leave alone nature-thyroid
2 The serum cortisol at 9 am is also on the lower side. It can either be repeated or one can directly proceed to the ACTH stimulation test. When I see someone like you I also tend to order
Prolactin
FSH
LH
The latter two are helpful only if your periods have stopped.
I am very well aware of the concept of this so-called 'functional medicine'. Most doctors trained in allopathic modern medicine find no scientific basis in many things practiced by these type of healthcare providers.
Follow up
Detailed Answer:
1 There is no published medical evidence showing that a gluten free diet calms down the Hashimoto's. In fact I have never even heard of such a comment before
Hashimoto's thyroiditis is a medical condition in which the body's own defenses ('immune system') produces antibodies such as thyroid peroxidase auto-antibodies, which have a tendency to make the thyroid under-active.
However, in your case, it has not affected the thyroid function yet because the first sign of that is an abnormally elevated TSH.
So the best advice for you is to monitor your TSH every year.
Sometimes, uncommonly though, there are individuals in whom this test comes back 'False-positive' ie you dont have Hashimoto's but still you test positive for these antibodies.
Most endocrinologists worldwide would not prescribe any thyroid medicine in your circumstance, leave alone nature-thyroid
2 The serum cortisol at 9 am is also on the lower side. It can either be repeated or one can directly proceed to the ACTH stimulation test. When I see someone like you I also tend to order
Prolactin
FSH
LH
The latter two are helpful only if your periods have stopped.
I am very well aware of the concept of this so-called 'functional medicine'. Most doctors trained in allopathic modern medicine find no scientific basis in many things practiced by these type of healthcare providers.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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