Brief Answer: Endocrine Detailed Answer: 1 The TSH target is between 0.4 - 2 in general, including those who have had their thyroid removed. However, it is relaxed ie greater than 2 in those who have osteoporosis, irregular heart rhythm problems or chest pain from heart block. 2 Low insulin by itself does not mean much. In fact there is no recommendation to test it for clinical purposes ie for changing patient care. It is typically done along with blood glucose, as part of the evaluation to look for high levels in the face of low blood sugar problem in non-diabetics. 3 High cortisol could indicate stress or if tested in a more complex way, it can indicate Cushing's disease, a rare condition that causes weight gain and other serious complications. 4 Low cortisol can be indicative of adrenal insufficiency. This must be diagnosed correctly because it can be a life threatening condition

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Brief Answer: Follow up Detailed Answer: 1 The TSH of 0.04 along with the free and total T3 values that you have shared prompt further testing to include Total and free T4. if you are taking medications like corticosteroids (prednisone etc) or opioid pain killers then the TSH can be suppressed like this without representing a true anomaly. If the free and total T4 are on the higher side then it means that you are likely getting a dose of thyroid medication that is greater than what your body needs. The exception to this is if you had thyroid surgery for common type of thyroid cancer in which case such a TSH is desirable 2 Do you mean 7.50 am by 750, in the context of cortisol? If so, a value of 23 is good. Adrenal insufficiency is most unlikely with such a result. 3 Calcium and parathyroid have no connection in this situation 4 To answer your question about bones and HRT, first you need to get your bone density checked if deemed necessary by your doctor 5 Iron levels are typically not checked in the context of thyroid, adrenal and calcium 6 Muscle weakness can be from thyroid, adrenal or vitamin D problems. You may wish to get your 25 hydroxy vitamin D levels checked 7 Thyroid and kidney are usually unrelated

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Brief Answer: Second follow up Detailed Answer: I have noted your lab results. I recommend the following blood tests to see if the thyroid condition is due to Hashimoto's. TPO (Thyroid Peroxidase) antibodies Thyroglobulin antibodies If any one of these 2 is positive then you have autoimmune cause for the underactive thyroid. The cortisol results are widely discrepant. In conventional units, if the morning cortisol is greater than 15 mg/dl then 'adrenal insufficiency' is extremely unlikely. You may discuss the ferritin with your primary care doctor

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Brief Answer: Thyroid cancer history Detailed Answer: In view of the thyroid cancer history you must follow up with an endocrinologist in person to determine the best course of action for your individual circumstance. For example there are tumor markers like thyroglobulin that need to be monitored along with neck ultrasound. The expert will then decide the bet dose of thyroid medication for you

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