Unfortunately a misdiagnosis can happen in the management of hypothyroidism and other thyroid disorders. If you go to a doctor with hypothyroid symptoms, you may be given replacement hormones without first determining what’s causing your thyroid issues.
Or, if you have hypothyroid symptoms but your lab tests are normal, your doctor may not realize you’re experiencing thyroid issues in the first place. You may even receive treatment or medication to deal with the symptoms you’re experiencing—like an antidepressant to address depressive symptoms—but you won’t receive anything that will help your thyroid disorder.
The problem with this approach is that thyroid physiology is complex.
The production, conversion, and uptake of thyroid hormone in the body involves several steps. A malfunction in any of these steps can cause hypothyroid symptoms, but may not show up on standard lab tests.
All cases of hypothyroidism do not share the same cause—and, as you might guess, they require different treatments.
In this article, I’ll present five patterns of thyroid dysfunction that may not show up on standard lab tests. If you have one of these patterns, your thyroid isn’t functioning properly and you will have symptoms. But depending on the tests your doctor runs, you may not get a diagnosis of hypothyroidism; and, if that’s the case, you won’t receive the treatment you need.
Free eBook
Want to learn more about the thyroid?
Find out how a thyroid imbalance could be causing your biggest health problems.
"*" indicates required fields
I hate spam, too. Your email is safe with me. By signing up, you agree to our privacy policy.
A standard thyroid panel usually includes TSH and T4 only (while some panels will also look at free T3, free T4, and check for thyroid antibodies). The ranges for these markers vary from lab to lab, which is one of two main problems with standard lab ranges. The other problem is that lab ranges are not based on research that tells us what a healthy range might be, but on a bell curve of values obtained from people who come to the labs for testing.
Now, follow me on this. Who goes to labs to get tested? Sick people. If a lab creates its “normal” range based on test results from sick people, is that really a normal range? Does that tell us anything about what the range should be for health? (For more on the problems with standard lab ranges, watch this great presentation by Dr. Bryan Walsh)
Are you experiencing hypothyroidism symptoms even though your lab work is normal? You may still have hypothyroidism, though it may not show up on standard labs. Check out this article for more. #functionalmedicine #chriskresser
The Five Thyroid Patterns
1. Hypothyroidism Caused by Pituitary Dysfunction
This pattern is caused by elevated cortisol, which is in turn caused by active infection, blood sugar imbalances, chronic stress, pregnancy, hypoglycemia, or insulin resistance. (1) These stressors fatigue the pituitary gland at the base of the brain so that it can no longer signal the thyroid to release enough thyroid hormone. There may be nothing wrong with the thyroid gland itself. The pituitary isn’t sending it the right messages.
With this pattern, you’ll have hypothyroid symptoms and a TSH below the functional range (1.8 – 3.0) but within the standard range (0.5 – 5.0). The T4 will be low in the functional range (and possibly the lab range too).
2. Under-Conversion of T4 to T3
T4 is the inactive form of thyroid hormone. It must be converted to T3 before the body can use it. More than 90 percent of thyroid hormone produced is T4.
This common pattern is caused by inflammation and elevated cortisol levels. T4 to T3 conversion happens in cell membranes. Inflammatory cytokines damage cell membranes and impair the body’s ability to convert T4 to T3. (2) High cortisol also suppresses the conversion of T4 to T3. (3)
With this pattern you’ll have hypothyroid symptoms, but your TSH and T4 will be normal. If you have your T3 tested, which it rarely is in conventional settings, it will be low.
3. Hypothyroidism Caused by Elevated TBG
Thyroid binding globulin (TBG) is the protein that transports thyroid hormone through the blood. When thyroid hormone is bound to TBG, it is inactive and unavailable to the tissues. When TBG levels are high, levels of unbound (free) thyroid hormone will be low, leading to hypothyroid symptoms. (4)
With this pattern, TSH and T4 will be normal. If tested, T3 will be low, and T3 uptake and TBG will be high.
Elevated TBG is caused by high estrogen levels, which are often often associated with birth control pills or estrogen replacement (i.e. Premarin or estrogen creams). To treat this pattern, excess estrogen must be cleared from the body.
Like what you’re reading? Get my free newsletter, recipes, eBooks, product recommendations, and more!
4. Hypothyroidism Caused by Decreased TBG
This is the mirror image of the pattern above. When TBG levels are low, levels of free thyroid hormone will be high. You might think this would cause hyperthyroid symptoms. But too much free thyroid hormone in the bloodstream causes the cells to develop resistance to it. So, even though there’s more than enough thyroid hormone, the cells can’t use it and you’ll have hypothyroid—not hyperthyroid—symptoms.
With this pattern, TSH and T4 will be normal. If tested, T3 will be high, and T3 uptake and TBG will be low.
Decreased TBG is caused by high testosterone levels. (5) In women, it is commonly associated with PCOS and insulin resistance. Reversing insulin resistance and restoring blood sugar balance is the key to treating this pattern.
5. Thyroid Resistance
In this pattern, both the thyroid and pituitary glands are functioning normally, but the hormones aren’t getting into the cells where they’re needed. This causes hypothyroid symptoms.
Note that all lab test markers will be normal in this pattern, because we don’t have a way to test the function of cellular receptors directly.
Thyroid resistance is usually caused by chronic stress and high cortisol levels. It can also be caused by high homocysteine and genetic factors. (6)
Thyroid Treatment Depends on the Right Diagnosis
The five patterns above are only a partial list. Several others also cause hypothyroid symptoms and don’t show up on standard lab tests. If you have hypothyroid symptoms, but your lab tests are normal, it’s likely you have one of them.
Not only do these patterns fail to show up on standard lab work, they don’t respond well to conventional thyroid hormone replacement. If your body can’t convert T4 to T3, or you have too much thyroid binding protein, or your cells are resistant, it doesn’t matter how much T4 you take; you won’t be able to use it.
Unfortunately, if you have one of these patterns and tell your doctor your medication isn’t working, all too often the doctor’s response is to simply increase the dose. When that doesn’t work, the doctor increases it yet again.
As I said at the beginning of this article, the key to a successful treatment is an accurate diagnosis. Without understanding precisely what’s causing the problem, you may end up with a treatment that isn’t well-suited to your specific situation.
The good news is that, once the correct diagnosis is made, patients respond very well to treatment.
Better supplementation. Fewer supplements.
Close the nutrient gap to feel and perform your best.
A daily stack of supplements designed to meet your most critical needs.
Chris,
I was diagnosed with Grave’s Disease in December of 2010. I had Radioactive Iodine (RAI) treatment in December of 2011, which ablated my thyroid gland. I was immediately put on Synthroid afterwards to normalize my thyroid hormones. I conceived in October of 2012. During my pregnancy, my thyroid levels were completely normal (within mid-range) so I stopped taking Synthroid for the duration of my pregnancy. I felt BETTER THAN I EVER HAVE while I was pregnant. I lost 20 lbs within the first two months of being pregnant. My headaches were gone, I had NO brain fog, or ANY other hypo symptoms. I’ve done research and concluded that it was because of my elevated HCG levels. I was 175 when I was 6 months pregnant, 185 when I gave birth. After the birth of my child in August of 2013, I was not put back on Synthroid because my levels were still normal. I decided to go on a diet to lose about 15 lbs of baby weight. I was only able to lose 4 lbs in 4 months eating 1200-1500 calories a day. Still – I was just happy to NOT BE GAINING WEIGHT 🙂
I went back to the Dr. for a checkup on my thyroid levels in April of this year, and my T4 was low at .7 (.6-1.75 NG/DL) I’ve also gained 17 lbs since January 3 of this year while dieting – that’s almost a pound per week!!! I’m sure it’s related to my low Thyroid levels, especially since I’ve had ALL my previous symptoms come back.
My doctor will NOT prescribe Synthroid to me because she say’s my levels are in “normal” range. She is aware of my RAI treatment, and my previous doctor’s recommendation to be on Synthroid for a LIFETIME due to me having Grave’s Disease.
What are your suggestions? I feel like my doctor is not doing the right thing by keeping me off Synthroid.
Thank you for this very helpful article–I just found out that half my thyroid is atrophied. Just starting my info gathering, so I really appreciate this.
I have fibromyalgia but believe I may also have hypothyroidism. I have severely swollen glands under my chin. I am cold all the time. I the last six months I have developed a chronic vomiting problem. Whatever I eat it seems to come back up. I cough incessantly and choke while drink eating or jist swallowing saliva. My cough is continual. Of course I am always tired but can’t sleep at night without sleeping pills. The nausea seems constant. My GP seems to think I am a hypochondriac and my rheumatologist was annoyed when I brought in a list of 19 symptoms to be addressed. I know my body better than they do and I KNOW something is wrong other than the fibromyalgia. Can anyone help me? Give me suggestions? Thank you
Hi there – I have had lymes disease (bullseye rash, tested positive twice etcetera) and now seem to be in an epic endless post lymes syndrome with all the joy that this entails. My thyroid tested fine last December but a lot of what I’m experiencing also seems to correlate with low thyroid. Could lymes trigger low thyroid and it not show up? I never used to get ill and now I feel ill all the time, I can’t exercise because I get lymes crashes and I’ve out on so much weight. I’m a bit desperate.
Thanks in advance for any comments or help that might be offered. Jess
MY DAUGHTER HAS GAINED 27LBS IN 5 MONTHS ALL IN THE BELLY, THE DOCTOR DID A FEW BLOOD TESTS AND HER T3 UPTAKE IS 29, HER HEMOGLOBIN A1C IS 5.5 AND HERGLUCOSE PLASMA IS 77 I WAS TOLD SHE IS FINE,,,,,BUT IS SHE, AGAIN SHE IS ONLY 8.
Dear Chris,
Such helpful work you are doing– Thank You.
I have a puzzle for you! I work with an “integrative” MD– my initial comprehensive thyroid labs (two consecutive) revealed normal levels on all: TSH, Free T4, Total T4, Reverse T3, T3 Uptake, Free T3, but LOW Total T3. I have many low thyroid symptoms and have for many years. I do not have elevated Testosterone (actually, low), or elevated Cortisol (although my cortisol 4 pt. test indicated some adrenal fatigue.) I have been taking cytomel for a year- felt a little better for a while, but no longer. My last labs indicated LOW TSH, Lower T4, ELEVATED Free T3, and normal levels of Total T3. I don’t believe the medication is my solution. Any ideas on what it could be? Not even Dr. Kharrazian’s book can help me with this one.
I would really like to know what one may do if reason #5 is the issue. It doesn’t seem like there is a way to fix that, or is there?? I am pretty sure that is my exact issue. Not 100% though. I do have lower T3 and elevated reverse T3 too. My TSH and T4 is basically in the normal range, all for functional med. parameters.. I have a few hashi’s antibodies, but they are not high.
This article is riddled with misleading information. I realize there are an army of people suffering symptoms, but this site is not accurate.
1. Reference ranges are not determined from ill individuals.
2. TSH and FT4 values do vary between labs; the reference ranges also vary along with the values (it is not once size fits all with the wrong ranges applied blindly)
3. Bell curves are not used to establish reference ranges (except where values are clearly normally distributed, an rarely even then).
4. FT3 is helpful for detecting hyperthyroidism, but is not a panacea for detecting occult thyroid disease.
5. T3 uptake testing is fraught with confounding, some of which you list and pathological conditions (estradiol, binding protein concentrations, contraceptives).
6. There seems to be a complete misunderstanding of free hormone and bio-availability. Binding proteins high, low, or in between do not affect free thyroid hormone concentrations, which are the only factor that really matters.
Readers, seek medical information from reputable sources (Pubmed, well-known tertiary care center websites, UptoDate, Quackwatch), not an acupuncturist with an opinion!
Hmmm… let’s see. Quackwatch – a website run by a retired psychiatrist with LOTS of opinions, but apparently a guy who hasn’t even treated a patient in over 20 years!
20 years is an eternity in the development of thyroid disease treatment. The information on Quackwatch on hypothyroidism is pathetically outdated and misguided. Dr. Barrett seems more interested in attacking those with opposing viewpoints than he is in actually helping anyone.
Fair point about QuackWatch. Cut that from the reputable sources list. The rest of the comment stands.
What’s the difference in between T3 uptake and reverse T3? Please clarify.
I’m having a bad reaction (last 5 days) to a new batch of a natural thyroid medication (with a tighter +/- than Armour). With my usual dosage, felt like ADHD going nowhere and not able to communicate, hyper symptoms and then depressed in afternoon, like spent. Great small company, called them up. Don’t even know of or the specifics of how to find a good “compounding pharmacy”, if needed or how to advocate for that if necessary???
I’m due for my annual panel and I want everything tested and not sure what would be helpful; please advise. I probably need to be specific and relentless. I was originally diagnosed with Hashimoto’s and was allergic to Levethroid. I went off of everything and was put on a natural thyroid I had researched because they said I had to be on thyroid medication and my numbers were that of a coma (this was years ago). I had to start with baby dosages of the natural thyroid.
Anyway, what do I prioritize? So, TSH (given), free T3 & T4, do i want reverse T3? How’s that different from T3 uptake? Is there a reverse T4? Do I want TBG?
They don’t like it when I tweek my medication down or up, but I need to function in my body. I couldn’t drink a cup of coffee until this afternoon and stayed home from work today. Basically my feelings are the tests so far, don’t seem to give an accurate picture of what is available, resisted, and used by my system, and I would like a more complete picture to better understand how to compensate.
Thank you, thank you. I have been so frustrated with my doctor. For three years she has been checking my TSH at my annual exam. It has been trending lower and lower but is still in the “normal” range. This last test was 0.58. She keeps saying, “It’s normal,” but I have just about every hypothyroid symptom. I can’t even get her to do other tests. Pattern #1 sounds just like me. I was beginning to think I was crazy. Do you think an endocrinologist would be willing to look into this? The last time I went to an endocrinologist she wouldn’t look past my pre-diabetes diagnosis. With a simple google search I find that the two can be related. Do you have any recommendations for what I can ask to get the ball rolling in the right direction?
Chris
Thanks for your thyroid series, first and foremost.
Secondly, do you have any insight for people that are low across the board ie TSH .006 T3 low T4 low? This seems a perplexing situation as the normal ‘see-saw’ effect isn’t occurring. My current physician is stumped and I’m suffering a bit without the answers I need (waiting to get into a new endocrinologist).
Many thanks!
“…. we don’t have a way to test the function of cellular receptors directly.”
Have you heard of Wilson’s Temperature Syndrome? Dr. Wilson asserts that body temperature is the best indicator for poor T4-T3 conversion when all other tests are in the normal range. He treats this condition in a novel way – time-released T3, once every 24 hours. This is designed to “reset” a person’s thyroid system and they often go off medication completely.
Who makes time released T3? and where do you get it? Is it by prescription only? If so, then many of us will not be able to get it because many Drs only prescribe synthroid or its generic equivalent and that’s assuming your Dr is running the proper Thyroid tests. Not everyone has time or money to keep switching Drs in hope of finding one who knows what they’re doing or seeking medical care outside of the US.
you can find a practitioner to work with at http://www.wilsonssyndrome.com/
This therapy needs to be done with trained supervision.
Thank you for the comments. I have heard of Wilson’s yes. I do take time released T-3 every 24 hours, and it works great for me. When I first took it, it was as though I had experienced energy for the first time. I need to take only 5 mcg for it to work well for me. I started with 2.5 mcg.
I do get it by RX only and it cost me $44.00 per month, or about $110 for three months’ supply. I get it at a pharmacy locally and it is prescribed by a CNP whom the pharmacist knew and directed me to her. I do know that it is very hard to find appropriate practitioners, ones who will listen well. I just kept asking until I found help. There are organizations of holistic practitioners you can google search. There is also ‘ Institute of Functional Medicine’ to find someone in your area. Often times now there is a division of a mainstream practice that has gone ‘eastern medicine’ and they will help you. I live outside Mpls-St. Paul and I found help in a few places but not many who were willing to formulate the dose, but rather to take over from another practitioner’s RX. It is very hard. If you want specific names of my pharmacist and my practitioner, you may email me at [email protected] and I will give you the names. Maybe you could do something via phone/Skype. I do not know if they would demand you see them in person. But anyway I would share with you if interested. Jan Marie
I am asking for help from anyone on this site who has knowledge of thyroid issues involving sporadically very high and very low testosterone lab results. I see that SALLY posts a low and has a lot of knowledge.
I discovered thyroid cysts in 2006 and was deemed to be euthyroid, which I was not and am not. I am hypothyroid but have a low TSH ranging from .4 to .7. I had a high rT3 two years ago and supplement T-3 solved that. I also take 5 mcg of T-3 (bio-identical compounded) in the morning now and at night I take Young Living’s THYROMIN one capsule supplying 550 mcg of Iodine and T-3 and T-4 and some essential oils to support the thyroid. I have good energy most of the time, in fact almost great. I still do have some occasional fatigue but nothing really bad. I still work all day long with the fatigue. Before taking thyroid supplementation I worked on the adrenals and supported them. I do not see any signs of having high cortisol even though I have central weight gain and an untypical big waist (historically I have had a very small waist). I had a very stressful event (in fact horrific) in August of 2011 and a few months later began losing hair. I had very thick hair prior. The issue that triggered this loss is still not resolved, but I do not have exposure to it, but rather it is in my psyche. I work hard at not thinking about it. I am happy and my health is remarkable for being a senior. With the hair loss I worked on anything that needed to be remedied in supplements and did all the appropriating testing to maintain. I looked at vit D3, iron, zinc, magnesium, copper, all vitamin levels. I have supplemented everything humanely possible using science not guesswork. I still have not regrown my former very thick hair. I still do have a bit of fatigue but not much. TO NOTE: I have very high and very low testosterone readings and I cannot make any sense of it. I also have low normal DHEA. I am currently supplementing 5 mg of DHEA daily. I am taking progesterone to correct estrogen dominance. Maybe I am not taking enough progesterone at 1/5 of a ML two times a day. I use to supplement bi-est but quit that long ago. I do like sweets and have worked hard at controlling the intake. I have an fasting insulin of 6 which is perfect. I just had an MRI and so far it does not look like I have a tumour on my pituitary.
Could I have something malfunctioning in my pituitary that causes my Testosterone to go wildly up and down, test results a month to two months apart? I also have VERY hard time to lose weight. I am overweight by about 30 lbs. I am not grossly obese but have central weight gain and a large waist. I sleep very well and so I do not suspect cortisol involvement. When I did have cortisol issues I would awake in the middle of the night and sleep was bad.
I just cannot find any practitioner, not even my functional medicine doctor, who can tell me WHY my Testosterone goes up and down and how this can be tied in with lack of hair regrowth and inability to lose weight even when on a nutritarian awesome diet. I am so at loss to get some help.
Anything anyone can contribute would be so appreciated. I plan to call Chris and see if he will consult in regard to this. In the meantime I read a lot and am trying to get help.
Thanks so much for any consideration………..Jan Marie
Hi Jan Marie,
I like yourself would fit into the category of senior. I don’t have thyroid issues that I know of although I think my thyroid has always been a bit sluggish as I have fought the battle of the bulge all my life. However, ever since menopause, my body has a distinct tendency to put extra weight around my middle. This is a common occurrence with age and I don’t think it is necessarily linked to hypothyroidism. It is, as I understand it, caused by an abundance of androids in the system that are no longer being suppressed by other hormones. This is also a cause of hair loss. I myself have experienced hair thinning for several years now and, due to taking certain medications, experienced severe hair loss for several months. I am now remedying the situation with a Thera-Dome (a helmet similar to a bike helmet that is outfitted with infared lights inside and worn several times a week on the head for 20 minutes) and it seems to be working. My hair stopped falling out which is the first stage, my individual hair shafts are thickening again which is the second stage, after the first month already and new hair growth should begin soon during the third stage of improvement. So I am pleased with the result. As for the weight around my middle, I am currently on the HCG diet which I have done before and lost 20 lbs on, but which also had the wonderful effect of reducing my middle area first instead of last as is usual with other diets. You can read up on it if you do a search on Dr. Simeon’s Pounds and Inches. His manuscript is freely available online. This all takes work of course and will most likely not do anything to correct a thyroid imbalance. But I suspect those two complaints are more about age related symptoms than thyroid issues I wish you luck with your thyroid and research on thyroid and hormone balance. I just wanted to suggest a couple of quick fixes for those age related issues.
Interesting convo! A little health history: I’m 53, have had bad headaches since 13 (which evolved into migraines at 24 after an auto wreck) and bad neck/shoulder pain since my teens. I have been told since my twenties that I have arthritis and subsequently fibromyalgia and one doctor told me I have spondylitis. I am proven by MRI to have degenerative disc disease and some reversing of the cervical lordosis, etc. I just hurt a lot.
I also had a sigmoidectomy for colon prolapse in 2007 and uterine ablation for polyps and severe menstrual problems. I have had one miscarriage, but surprisingly to doctors, two children, including one at the age of 39! When my son was born in 1987, I was very toxemic.
I have even had “unknown seizure” episodes, not epileptic, just uncontrollable jerking of the arms, legs and tongue until I could not talk, walk or hold anything in the early to mid 2000s.
I began having hypo thyroid troubles at around 19, which flipped into hyper or normal until it went severely hyper with a goiter and Grave’s disease at the age of 23. I was given I- 131 uptake (nuclear capsule) (in 1984) after a round of heart medication, etc. in order to “kill off” the overactive thyroid. After that, of course, it became hypo. However, it has flipped between hypo and hyper since that time. The first endo told me I had abnormal thyroid binding globulins (sorry if that is not spelled correctly) and that it may have thrown off the test. Of course, free tests have become the standard now.
I have ranged in doses from 1.5mcg to 1.00, .112, .125, .50, .75 and currently .88. I have diagnosed with bipolar, although the first psychiatrist told me he felt it was a very hyper thyroid causing the problem at the time.
I have definitely been through a ton of stress in my life. Still am to a degree,as my husband just came through prostate cancer last year, and just things of life. And yes, I have tried supplements off and on, perhaps not long enough though.
I rely on Ambien to sleep, but hate it and am stopping soon; hopefully something better will help me sleep.
I have been to the stopthethyroidmadness.com and I know it’s said that hypothryoid can mimick a lof of other diseases or be the cause of them. I seriously wonder at times if I truly have bipolar, and if some of what I have gone through is just stress related. I would love to think I could reduce this pain by normalizing the thyroid! That would be a miracle.
In January, my new doctor, who knows I have had a whacky thyroid history and believes in frequent testing, included some things on the thyroid panel I have never seen before, when I looked them up, at least one or two was in relation to Hashimoto’s dx. This month, he tested for TPO, third generation TSH and a TSI. These are all new to me also.
I am kind of wondering why my doctor is ordering these different types of panels lately, knowing that this hypothyroid is secondary to the nuclear radiation I had years ago. This is a very confusing issue I think, but glad some people are talking about it.
Hey, this article is exactly what I’ve been looking for…. just one quick question…. what test should I ask my doctor to preform? I want to go to the office completely informed and armed with the proper information to help with my diagnosis..
So which test are required to accurately find hypothyroid condiditons
I have a question reg.
Hypothyroidism caused by pituitary dysfunction
This pattern is caused by elevated cortisol, which is in turn caused by active infection, blood sugar imbalances, chronic stress, pregnancy, hypoglycemia or insulin resistance.
I did saliva test last year when I felt ‘outside’ myself. My health has been declining for a couple of years, since 2005 as a matter of fact. It started off by anxiety, panic attacks (no reason really). I have been struggling with added on symptoms throughout the years. I am today 46. Thyroid disorders run in my family (my mothers side) and this is what I suspect to be the culprit. Here are some of the symptoms I have been struggling with the past years:
– panic attacks/anxiety
– dizziness
– shivering/tremors/shaking/sweating
– rapid heart beat (85 and up, in 2010 heart monitor showed 100 beats/min during rest/sleep)
– low blood pressure
– hungry fast after eating a meal
– migraines optho only
– sweating
– blurry vision/floaters
– nearsighted
– pressure behind eyes/eyes easy watery (have no allergies)
– seizure (first/recent)
– immunity lowered since 2005
– between 2003 and 2007 I had lactating breast, no pregnancies. Gone now.
The saliva test showed increased cortisol in morning and very much so at night, right before bed. I also am feeling hungry soon after I have eaten, even though I eat big meals, and do not gain weight. Thyroid tests within normal range at all times. 3 years ago, one time it was at 2.30 Tsh. Glycemic testing all ok, 99.
I know all this may sound confusing, but its tough to start at one end and make sense for you all. What I am thinking is, reactive hypoglycemia or thyroid issues? My FREE t4 tests have always been fine….Any advice? I want to get back to my normal self.
Forgot to add, the question was, if my cortisol is higher than normal, should then the pituitary function be tested? What do you recommend?
Here is what the report from my saliva cortisol lab wrote (I don’t eat any medication beside magnesium at night): DHEAS is within mid-normal expected age range. DHEAS is highest during the late teens to early twenties (10-20 ng/ml) and drops steadily with age to the lower end of range by age 70-80. Cortisol is high in the morning, normal throughout the day, but rises to a very high level at night. The very high night cortisol unlikely indicates stress-induced adrenal cortisol production (levels are much higher than high physiological range) and more likely reflects evening use of some form of medication that either contains a glucocorticoid or stimulates the adrenal glands to produce high levels of cortisol. Glucocorticoids could include cortisol (hydrocortisone) itself or synthetic analogues (Prednisone, Betamethasone) commonly used for asthma, autoimmune diseases (e.g. Lupus, rheumatoid arthritis), or other inflammatory conditions. While physiological levels of cortisol are essential for normal immune function and the normal cellular actions of other hormones, particularly insulin and thyroid, long term endogenous production of cortisol by the adrenal glands, or use of excessive amounts of glucocorticoids (natural or synthetic) can lead to immune suppression, inability of normal tissues to utilize glucose for energy (insulin resistance), functional thyroid deficiency (normal thyroid levels but thyroid deficiency symptoms), and excessive breakdown of normal tissues (catabolism) which include muscle wasting, thinning of skin, and bone loss. Exposure to high levels of glucocorticoids, whether produced endogenously (within the body) or taken as medication, increases risk for serious long term health issues (rapid aging, osteoporosis, cardiovascular disease, obesity, diabetes, immune suppression). Some of the most common symptoms/conditions associated with high cortisol include sleep disturbances, fatigue, depression, weight gain in the waist, anxiety, bone loss, functional thyroid deficiency (normal thyroid levels but thyroid deficiency symptoms, and insulin resistance/metabolic syndrome.
I’ve been having almost all of the symptoms of hypothyroidism for years. Specifically weight loss problems. I eat very healthy and watch calories very carefully. My two thyroid tests came back negative. I was so frustrated.
I also suffer from extreme fatigue and chronic stress. The stress was so bad I got alopecia areata.
Could this be a misdiagnosis? If so how do I treat this?
Mark,
Have your son been tested for food allergies, had a bio scan, and also does your son play videogames or watch a lot of cartoons?
w/r
Lisa
hi i am from israel/
i have lat oncet 21 oh hyd. def.
what can i do abut it
what other disorders can i have?
thank you shoshana