14 doctors weighed in:

I am have symptoms of low thyroid and adrenal fatigue.My total t3-66.1, cortisol-22.13, tsh&ft4-normal.Dr. Says no tx.Should i see an endo/2nd opinion?

14 doctors weighed in
Dr. Quang Nguyen
Internal Medicine - Endocrinology
5 doctors agree

In brief: Discuss with doctor

Agreed with dr. Lewy-weiss.
You should talk to your current doctor about your concerns to hear the reason why he/she made the recommendation that he/she did. This person knows ur symptoms and history best to make this determination. In general, a mildly elevated cortisol is "transient" and most likely will be normal the next time it's checked. Don't jump to treatment without knowing the diagnosis.

In brief: Discuss with doctor

Agreed with dr. Lewy-weiss.
You should talk to your current doctor about your concerns to hear the reason why he/she made the recommendation that he/she did. This person knows ur symptoms and history best to make this determination. In general, a mildly elevated cortisol is "transient" and most likely will be normal the next time it's checked. Don't jump to treatment without knowing the diagnosis.
Dr. Quang Nguyen
Dr. Quang Nguyen
Thank
Dr. Vered Lewy-Weiss
Pediatrics - Endocrinology
5 doctors agree

In brief: Second opinion

If measured in ng/ml then 22.
13 is above and beyond expected norm. Over-production of cortisol also causes one to feel tired. T3 (liothyronine) isn't useful in evaluating hypothyroidism except rarely. Endocrinologists look at TSH and ft4 for this.There are so many other things which could give you the symptoms you're having. If you maintain your focus on thyroid and adrenal you might be missing something else.

In brief: Second opinion

If measured in ng/ml then 22.
13 is above and beyond expected norm. Over-production of cortisol also causes one to feel tired. T3 (liothyronine) isn't useful in evaluating hypothyroidism except rarely. Endocrinologists look at TSH and ft4 for this.There are so many other things which could give you the symptoms you're having. If you maintain your focus on thyroid and adrenal you might be missing something else.
Dr. Vered Lewy-Weiss
Dr. Vered Lewy-Weiss
Thank
1 comment
Dr. Vered Lewy-Weiss
Your cortisol level doesn't necessarily imply that you're chronically over-producing. This could just be an outstanding stress response.
Dr. Su Fairchild
Integrative Medicine
4 doctors agree

In brief: Yes

Actually you may be better off seeing an integrative medicine doctor. You definitely need treatment, and some important thyroid labs were not done.
Adrenal support needs to be in place before or together with thyroid support.

In brief: Yes

Actually you may be better off seeing an integrative medicine doctor. You definitely need treatment, and some important thyroid labs were not done.
Adrenal support needs to be in place before or together with thyroid support.
Dr. Su Fairchild
Dr. Su Fairchild
Thank
Dr. Michael Rothman
Internal Medicine
1 doctor agrees

In brief: T4/T3 conversion NG

The elevated cortisol inhibits the hepatic transformation of T4 to t3 (liothyronine).
Normally the T4 is deioidonated to T3 (liothyronine) to produce the active thyroid hormone. However the presence of high cortisol impairs this process. The TSH and ft4 are nl b/c the thyroid itself works fine, it is the liver that is not ok. Find and fix cause of cortisol elevation (various stressors) and possibly use T3 (liothyronine) supplementation.

In brief: T4/T3 conversion NG

The elevated cortisol inhibits the hepatic transformation of T4 to t3 (liothyronine).
Normally the T4 is deioidonated to T3 (liothyronine) to produce the active thyroid hormone. However the presence of high cortisol impairs this process. The TSH and ft4 are nl b/c the thyroid itself works fine, it is the liver that is not ok. Find and fix cause of cortisol elevation (various stressors) and possibly use T3 (liothyronine) supplementation.
Dr. Michael Rothman
Dr. Michael Rothman
Thank
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