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Old 04-24-2009, 05:39 PM   #1
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What does a cortisol test show?

I went to a new endo today who is definitely a keeper! She was everything we want in an endo, kind, compassionate, goes by symptoms, not just labs,really listens,was very impressed with my knowledge,the list goes on. She thinks I might have the two combined auto immune thyroid diseases,Hashitoxicosis possibly although I have been treated for Graves for the past 2 years. I am med sensitive and have been hypo on a real small dose of anti thyroid meds. My antibodies are high all around( as of Oct.'08) and she says it depends which one is in control as to the symptoms and labs you have. I have another appointment with her in 3 weeks to go over the new labs she asked for. She's checking the frees, the tsh,TBII, vitamin D and cortisol is checked too. What is this for? I am unfamiliar with this.Thanks for any info!

 
Old 04-24-2009, 07:09 PM   #2
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Re: What does a cortisol test show?

Cortisol is an adrenal hormone... a stress reaction steroid to be exact and it is important to your ability to respond to stress, trauma, and more. A side effect of cortisol is it acts as a T4 to T3 conversion brake. When you have too little you over convert T4 to T3 and have T3 toxicosis. You know about over conversion of T3.

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Old 04-25-2009, 11:44 AM   #3
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Re: What does a cortisol test show?

Oh okay Mkg, I get it. What would they do for it, anything? She told me stress was my trigger after i explained a few things about how this all started. I want to thank you also for heading me in this direction with the Hashi/Graves combo. You told me a while ago it's probably what I had and you were right.I have done some research on it and now it all makes sense as far as I wasn't the "classic" Graves patient. My first endo was baffled by me I think but couldn't admit he might not have known what was going on. Makes sense why he didn't treat me for almost 6 months.Glad I'm rid of him. Oh, she also is running the tpo's and tsi tests again. I had them in Oct.08 and they were high.She said having high antibodies (especially tpo's I guess, can make you forgetful. Oh yes, I can relate to that lately. If I don't have a pad and paper on me,I tend to forget about it.LOL!! I'm taking selenium which studies show do lower them by quite a bit if taken on a daily basis. Do you agree? Have any other info on this? Thanks for all your answers!

 
Old 04-25-2009, 05:05 PM   #4
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Re: What does a cortisol test show?

Treatment of adrenals can take a few forms. If you are low in cortisol.. really low.. they will supplement your by having you take hydrocortisone tablets at various times of the day. I have to take them at 6 am, 11 am, and 3 pm. Now if it is DHEA that is low.. you can take DHEA supplementation. Aldosterone can also be supplemented. Supplementation of adrenals is the same as supplementation of the thyroid you just add another hormone pill to your daily intake.
\
Now HIGH cortisol is a different beast. Most often it is suppressed with an anti-adrenal/pituitary drug. They do not like to do this long term. They also will check to make sure it isn't an adrenal flaw causing hyper cortisol production. If it is they may remove the adrenals and put you on cortisol and aldosterone supplementation to make up for your loss.

I was taking Selenium when mine jumped from 285 to 1675.. so I do not know if it was overly helpful. I still take it though. WHat saw a decrease in my TPOAb and TGAb has been addition of T4 supplementation as my thyroid dies off. The more T4 I can takie the lower my antibodies fall. This makes sense because antibodies are generated to attack and destroy functional thyroid tissue.. so removal, suppression or destruction of the thyroid is the best way to lower antibody levels.

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Old 04-27-2009, 05:28 PM   #5
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Re: What does a cortisol test show?

I think this is where block and replace might be helpful too as it puts your gland to sleep and it doesn't get over stimulated. yes, the replacement does help the antibodies to go down. That's weird about the jump in your tpo's. I know I read a study where it says it can decrease them by like 60 percent if taken for 3 months straight. There must be other factors. I'm just glad I found an endo who will let me stay on atd's if I need them. I posted this on another board and I got another answer from someone who is quite educated on antibodies too.. here is what she said"In contrast,TSH receptor autoantibodies(Graves disease) do not actually cause damage to a gland. But those Trab antibodies can interfere with tsh stimulation, thereby causing a HYPO phase of Graves. You can also find yourself "Euthyroid" with or without TSH showing. That's because the TRab antibodies are in total control of your gland --- some abs are "Stimulating" it, and some of them are "Blocking" any stimulation. This will put you in a "forced" state of euthyroidism making you assume you are now in remission, but the disease is actually still very active." She thinks some docs will say you have both when it's really this scenario and not that your gland is being destroyed by Hashi and you're hypo instead of hyper now. The high tpo's can mean just inflammation and the only way they can tell if you have Hashi is through a needle biopsy.Do you agree with this, I think she's right. She seems to really have a handle on the antibodies thing like you. So confusing....who really knows what's going on in that little gland? It's probably something real odd as I seem to get odd things...

Last edited by GravesGirl73; 04-27-2009 at 05:34 PM.

 
Old 04-28-2009, 05:36 AM   #6
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Re: What does a cortisol test show?

I agree with her description of the TSI (stimulating abs) and TRAb (blocking) abs. I do not agree with the call that TPOAbs are a sign on inflammation and not destruction. If you have TPOAbs yes you have inflammation, but that is caused by the systematic attack and destruction of thyroid tissue cells with unlucky active TPO. Same with TGAbs. There is nothing passive about the TPOAb and TGAb. They destroy thyroid tissue regardless of the patient. How long it takes depends on the patient and other factors. Some one that has Graves too will have counteracting effects due to TSI over stimulation of thyroid tissue. So even if your thyroid is dying off, half a hyperT thyroid can leave you in a Euthroid state.

Now there are cases where people have Hashimoto's, but their antibody levels are not high enough on that normal scale to be considered a positive confirmation. In those patients the only 100% way to identify Hashimoto's is by biopsy of the thyroid tissue.

MG
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Old 10-25-2010, 09:35 AM   #7
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Re: What does a cortisol test show?


I found this post.... lots of questions?
Gravesgirl-
How did you make out with your cortisol issues?
How did your endo check your cortisol- by blood or by saliva?

MG,
I have high AM and PM cortisol, normal reading during the day- by saliva. My endo checked blood level for cortisol and did STIM test- which she said was in normal range.
What is the drug or treatment for high cortisol you mentioned? I feel the adrenaline surges and it cause me anxiety and great fatigue after it passes.
Ideas or comments are always appreciated.

 
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