What does the following cortisol level indicate?
TSH 0.251 range 0.45-4.50
T3 115 range 71-180
FT4 1.67 range 0.82-1.77
T4 Direct 1.67 range 0.82-1.77
The FT3, RT3 and Vitamin D will follow in the coming days.
I am very worried about my cortisol level since I really don't know what this means. Is this something that I should be worried about?
You can decrease the synthyroid dose
Welcome to HCM. Thanks for posting the question.
Your TSH is low and T4 is higher side of normal. You can decrease the dose slightly.100 mcg Monday through Friday and 112 mcg on Saturday, Sunday should be fine. RT3 and T3 are usually not recommended for follow up.
Cortisol is a hormone produced by adrenal gland. This hormone can be decreased in adrenal insufficiency (tiredness, low blood pressure, increased skin pigmentation are common symptoms) or increased in a condition called Cushing's syndrome (weight gain, skin thinning, diabetes and high BP are symptoms). Hypothyroidism is usually associated with low cortisol levels.
There is no need to worry about this before getting the reports. Cortisol levels is just a screening test. If low or high we have to do special tests(stimulation or suppression tests).
Hope I have answered your question. If you have any further concerns I will be happy to help you.
Wishing you good health.
Dr Ajish TP
Better to retest
The cortisol value is on higher side. It could be due to stress. You can repeat it at a later date, preferably fasting, at 8 am.
If your physician feel you are having features of cortisol excess he can do a dexamethasone suppression test- which we usually do to screen cortisol excess. Here you have to take 1 mg of dexamethasone tablet at 11 pm and do a serum cortisol next day morning.
In your case I strongly think the increase in cortisol be due to stress.
Dr Ajish TP
I totally agree with you. These hormone levels are pulsatile and may show abnormal results in random sample.
If your endocrinologist was suspecting tumour ( cortisol excess) he would have directly gone for cortisol suppression tests as we don't do random cortisol to look for cortisol excess.
The tumours usually have much higher values.
So don't worry, if you don't have symptoms you can repeat it at a later date.
Dr Ajish TP
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