thyroid functioning

Hey guys I was wondering what thyroid tests I should get done in order to see if my thyroid is functioning properly. I keep getting these "crashes" which are a horrible feeling. I could be feeling great and all of a sudden I will get very lethargic, my mood turns miserable, almost a motion sickness feeling and some damn hot flashes! I know it could be a host of things but hope you guys can help me narrow it down. I did a 4 draw saliva test and my cortisol was low across the boards. I really need to solve this because it sucks when it happens! Thanks in advance guys!

DMan, thanks for posting ...

Here's what you need:
Free T4
Free T3
Reverse T3
TSH
Antibodies - Both TgAb and TPO

Also, get your iron serum, TIBC, and Ferritin. I will be interested in seeing your antibodies, just based on what you described. Also, if you get a chance, please post up your Cortisol results, and hopefully they included a DHEA correlation report with it?

Thanks Chris! I don't think they did DHEA correlation report. I'll post results and look for that. I do take DHEA at 50 mgs per day which has my levels in the upper 300's and low 400's. I havent tested in a while though.

REF:
Children and Adults:
8:00a.m.: 0.025 - 0.600
Noon: <0.010 - 0.330
4:00p.m.: 0.010 - 0.200
Midnight: <0.010 - 0.090
DRAWS
#1 Salivary Cortisol 0.133 ug/dL 01
Draw date/time: 08/11/15 - 08:00

2 Salivary Cortisol 0.159 ug/dL 01
Draw date/time: 08/11/15 - 11:55

#3 Salivary Cortisol 0.029 ug/dL 01
Draw date/time: 08/11/15 - 11:55

#4 Salivary Cortisol 0.067 ug/dL 01
Draw date/time: 08/12/15 - 00:00
12AM
01 ES Esoterix Endocrinology

Here are some more labs from 8/27/15

Glucose, Serum 94 mg/dL 65 - 99

Testosterone, Serum 906 ng/dL 348 - 1197

Free Testosterone(Direct) >50.0 High pg/mL 6.8 - 21.5

TSH 1.500 uIU/mL 0.450 - 4.500 01

Estradiol, Sensitive 38.5 High pg/mL 8.0 - 35.0 02

Hematocrit 47.0 % 37.5 - 51.0

RBC 5.30 x10E6/uL 4.14 - 5.80

DMan, as we chatted, I'm consumed with a business event the first few days this week. Will take a closer look once I get my group on their way, and I can relax just a few to focus on it ...

Based on your TSH of 1.5 it may not be an urgent thing to go for the rest of the Thryoid tests that Chris posted, 1.5 is certainly in the realm of being fine/normal. If it were higher I'd say to go for the other tests as soon as you can. Still won't hurt a thing to get all those numbers now rather than later.
As you note, it's a weird circumstance and I don't see any issues with any of the test results you posted. You're cortisol #s I think are actually better than mine.

Thanks guys! I just found some labs with t3 and t4 from a year ago. Trying to post it. Looks like my pregnenolone is always a very low reading of <5 with a ref range of 13-208. I did a MRI on my pituitary and have a 5mm lesion but not sure if that is affecting things. My prolactin is always in range and LH and FSH are in the middle range when I'm not on TRT.

D-Man, I put together a Circadian Graph of your cortisol results, which will give you a little more contrast on how the profile looks ... Best scenario you would "like" to see your morning results right towards the top, IMO 80% to 95% of the reference range. A steady, consistent decline, around the "Middle" of the reference range at Noon & 6:00 PM, then at the bottom end of the reference range for the last draw ...

Do yourself a favor and read-up on Pregnenolone Steal, and how it can play into this. IMO, your adrenals are no doubt needing to be addressed professionally, and variables like pregnenolone and DHEA will play into this, as well as how all that will create an additional reaction with the thyroid gland and productivity thereof.

It would have been good to see the DHEA saliva result, which could provide some more insight with a correlation analysis. This will also help determine what stage the adrenals (7 in total) might be at ... I think you're probably beyond the Maladapted phases, but the DHEA saliva w/ Cortisol saliva (at the same time) is needed. You probably should talk with a good physician on this, look at some of these other labs, along with ACTH, then determine with your physician what treatments /therapies might be appropriate.

To address the TSH ... This can be the most misleading test out there. Too many doctors have Epic Fail Syndrome by just looking at TSH and thinking everything must be "normal". In your case, there's a fair chance that FT3 could be pooling, meaning it's somewhat elevated and just sitting idle, unable to adequately get into the body. FT4 might be a bit lower, having a higher conversion rate to Reverse T3 to offset the elevated Free T3 (pooling).

Not saying this is your situation, BUT it could be. So when FT3 is increased, but pooling, the feedback loop with pituitary reacts with reducing TSH, because it is being told thyroid levels are at a certain serum level .. Make sense? Female patients with estrogen dominance will in many cases have TSH readings of < 0.500 when their actual thyroid hormone levels are in the tank. Run the labs and that will remove the speculation ...

Vince Carter said:

Based on your TSH of 1.5 it may not be an urgent thing to go for the rest of the Thryoid tests that Chris posted, 1.5 is certainly in the realm of being fine/normal. If it were higher I'd say to go for the other tests as soon as you can. Still won't hurt a thing to get all those numbers now rather than later.
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Click to expand...

So you would say it's a pretty safe bet that things are "fine/normal"?

Thank you Chris for taking the time to do the graph and give me detailed info.Much appreciated! Looking at the graph would explain my afternoon crash and also why I get energy back later in the evening. I've had labs that show low preg, prog, test and estrogen. I manage a pretty stressful account that keeps me in the "fight" response quite often. I do supplement with DHEA 50mgs/day which keeps my levels in the upper range. When I first started dhea I felt great. I was recommended to do 5mg hydrocortisone per day but I'm a little nervous. I've read some horror stories and I'm afraid of becoming dependent on it if you will. I think there are some natural supps out there to that can help. HCG I think can help also.How do I correct the preg steal? Thanks again for all your help!