# Hypo and high cortisol?



## coops905 (Apr 14, 2014)

I was diagnosed with Hashis a year after my son was born. First TSH reading was 11, then a few weeks later TSH was 9 and TPO antibodies were just slightly above range. Primary doctor said I didn't need medication because it was self-correcting and TPOs were so low, and told me I shouldn't have any symptoms at that TSH level. But the whole reason I had come to her was debilitating exhaustion and a host of other hypo-like issues. So I went to an endo, who also said she was surprised I would have any symptoms with a TSH of 7 (by that time) but she said that it was reasonable to medicate if I desired.

Went on 60 mg of Synthroid and TSH went down to around 1.5. T3 was in upper end of range, and T4 was right below the middle. This was around 18 months ago. Doctor said I was fixed. I felt much better but not great.

About 7 months ago I switched to a holistic thyroid doctor and have been tinkering with medicine -- Switched to Armour, raised the dose several times to 2.5 grains. I am now feeling MUCH better and no longer feel disabled. For 7 months now, TSH is suppressed to 0.5. T3 is actually slightly above range, and T4 is upper-middle in range. But frankly, I still don't know if I feel quite as good as my pre-baby self. I often sleep 9 hours and wake up feeling fine, but I'd expect to feel so well-rested. And I never, ever just wake up naturally after 8.5 hours (which i think used to happen a lot). And my upper back and neck and jaw are still a little achy. It's just really hard to tell if there's something wrong, or if it's just because I'm 5 years older and watching a toddler all day. Also interesting is that I increased my dosage from 2 grains to 2.5, and didn't really feel any improvement in symptoms (all other previous increases had dramatic improvements for me) -- which suggests to me that I've maxed out. Also, I've never felt any hyper/overmedicated symptoms.

When I switched to my new doc 7 months ago, he did a whole blood panel and found that my cortisol was quite high. I believe it was around 20 and the range was up to 4? He tested again in January and it was unchanged.

I'm on oral contraceptives, which can raise cortisol - but not that much! My life is the opposite of stressful.... and yes, I eat too many sugars and drink a little alcohol, but not enough to explain this cortisol level.

I understand that hypothyroid can lead to high cortisol before adrenal crash. But my thyroid levels have been under control for 18 months, and in a really good place long before the second cortisol test. If the high cortisol was caused by low-functioning thyroid, wouldn't cortisol have gone down already? Or crashed?

My doctor is concerned something is going on and we are running another blood panel in a few weeks, so obviously he is my first line of recourse.

But just wondering if you all have any thoughts - -- should I just brace for adrenal fatigue? Or since my cortisol is still so high, do you think something else is going on? Should I be exploring pituitary tumor, cushings, adrenal tumor etc?


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## bigfoot (May 13, 2011)

I'll try to get back to this thread when I can... 

But for now a couple quick comments off the top of my head:

Ideally you want a 24-hour saliva or urine collection for cortisol testing -- broken into different collection time periods. If all they did was a simple cortisol blood test during your routine labs, that doesn't tell the whole picture. I'm thinking your holistic doc probably knows this, but just in case I wanted to throw it out there.

"Adrenal fatigue" is not really taken seriously by many mainstream docs, but truth be told, there's quite a bit of middle ground between full-blown Addison's and Cushing's. I also think there's a lot we don't know about this stuff yet.

They can check Prolactin levels and also do a scan to look for pituitary tumors, just to be safe and rule that angle out.

Vitamin C can be taken for low-functioning adrenals. Right on up to around 3,000 IU a day. If diarrhea starts, you can throttle down a bit. Also helps to split it up throughout the day. Usual disclaimer applies: starting or stopping any new vitamins and supplements should be run past a doc first. Always good to consult them first.

Low Vitamin D and low Vitamin B-12 can be tested for easily. So can stuff like Lyme Disease (especially if you are outside a lot in tick country) or EBV/Mono.

If you've never had one, a thyroid ultrasound is always good to get a baseline to work from. Especially if your thyroid area ever feels puffy/swollen, or if you suspect nodules or a goiter.

Obviously lowering caffeine, drinking lots of water, eating healthy, getting plenty of sleep and exercise are all good. You know, basically the stuff none of us have time for.


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