The problem with the anemia, CRP, ESR, neutrophils etc. is that they are all raised throughout the winter months (October - March) but then become normal again during the summer months (April - September). This happens every year without fail, and I'm not doing anything to improve any aspect of it, i.e. treating the anemia.
As for the Cortisol, I stupidly forgot to include the fact that I've also had both saliva and 24 urine cortisol tests done. The 24 urinary free cortisol showed mildly elevated levels, but the saliva showed low. So on the recommendation of someone I tried some cortisol replacement, something called NutriAdrenal, but that made me MUCH worse. Felt really uncomfortable and unsettled, had racing thoughts and bad insomnia whilst I was taking those. So I sort of came to the conclusion that it was low cortisol.
Could raised cortisol be causing all my issues?
I agree that your labs indicate iron deficiency.
A single cortisol test isn't enough to go by, because cortisol is supposed to be higher in the morning and get lower as the day goes on.
You may have to order a saliva test online, as many doctors won't order them.
Your labs show iron deficiency anaemia. Anaemia is a cause of inflammation and therefore is also a cause of elevated CRP, ESR, ALT and neutrophils.
Your symptoms don't give any indication of diabetic issues. I had many symptoms with a normal fasting glucose however my oral glucose tolerance test (OGTT) showed pre diabetic range at 10.7mmol/l and close to a diagnosis of diabetes - 11.1mmol/L or more.
I found this info about cortisol lab tests...
"You should never guess if you have high cortisol. Symptoms of high and low cortisol can be the same. Additionally, you should never assume you have high cortisol because “blood results” show it. Blood is measuring both bound and unbound, which means your blood lab result can look high, when in reality, you could have normal or low cortisol results as accurately revealed by saliva testing. This has been very common!"
I think the glucose fasting test I had done has ruled out diabetes. At least no docs have thought it was and seemed happy with the result (4.4 nmol/l)
Have you looked into any type of diabetes being the issue?
Thanks again for the reply!
The T3 and T4 were both Free. I've updated the results with ranges now:
TSH – in first few weeks of illness it was 2.2, now 5 and half years later it is 1.4. (Range 0.3 - 6.0)
Free T3 – 4.8 PMOL/L (Range 3.5 - 6.5)
Free T4 – 17.4 PMOL/L (Range 10.5 - 20)
Free T4 (for a second time) - 19.4 PMOL//L (Range - 12 - 22)
Parathyroid – 2.8 PMOL/L (Range 1.6 - 6.9)
Cortisol – 901 NMOL/L (Range 138 - 690)
ESR – 60 mm/hr (Range 0 - 10)
C-Reactive Protein – 77 mg/l (Range 0 - 8)
Neutrophils – 12.4 x10^9/L (Range 2.0 - 7.5)
Platelets – 460 x10^9/L (Range 140 - 450)
MCV – 73.0 fL (Range 77 - 98)
MCH – 22.9 pg (Range 27 - 34)
MCHC – 29.6 g/dl (Range 31 - 36)
Serum iron – 4.4 UG/L (Range 14 - 31)
Iron Saturation – 11% (Range 20 - 55)
Haemoglobin – 11.8 G/DL (Range 13 - 17)
B12 - 756 (Range 180 - 900)
Urine metadrenalines – normal.
Anti-nuclear antibodies – negative.
Smooth muscle antibodies – negative.
Mitochondrial antibodies – negative.
Gast PL Cell antibodies – negative.
Liver Kidney microsomal antibodies – negative.
Endomysial antibodies – negative.
DNA binding antibodies – negative.
Rheumatoid Factor – 7.88 (< 11 = negative)
Borrelia (Lyme disease) antibodies – negative.
Infectious Mononucleosis – negative.
Coxsacki B Virus – negative.
Toxoplasama antibodies – negative.
IgG – normal.
IgA – normal.
IgM – normal.
Chromongranin A & B – normal.
Compliment C3 – 1.38 g/l (Range 0.90 - 1.80)
Compliment C4 – 0.28 g/l (Range 0.10 - 0.40)
Glucose fasting test – 4.4 nmol/L
Insulin-like Growth factor 1 - 43.3 nmol/L (Range 23 - 70)
Insulin-like Growth factor 2 - 67.3 nmol/L
Thanks!
We need reference ranges for the lab results. Normal ranges vary lab to lab so they have to come from your own report.
Of course, being a thyroid forum, we're most interested in the thyroid related tests, but some of the others can be "telling" for other issues that often accompany thyroid conditions.
Specifically, were the T3 and T4 test for Free T3 and Free T4 or were they for Total T3 and T4? They aren't the same tests. Test for Total T3 and Total T4 aren't very useful; if the lab report doesn't specify "Free T3" and "Free T4", then they are totals.
Additionally, what was the exact vitamin B12 level? B12 is one of those that you can be "normal" according to the range, but if the level is low in the range, you have trouble.
Thanks Barb135 and Red_Star for both your replies. I stupidly forgot to include any of my (many) blood test results. Here's what I've had done so far:
TSH – in first few weeks of illness it was 2.2, now 5 and half years later it is 1.4.
T3 – 4.8 PMOL/L – normal.
T4 – 19.4 PMOL/L – normal.
Parathyroid – 2.8 PMOL/L – normal.
Cortisol – 901 NMOL/L – high.
ESR – 60 mm/hr - high.
C-Reactive Protein – 77 mg/l - high.
Neutrophils – 12.4 x10^9/L - high.
Platelets – 460 x10^9/L - high.
MCV – 73.0 fL - low.
MCH – 22.9 pg - low.
MCHC – 29.6 g/dl - low.
Serum iron – 4.4 UG/L- low.
Iron Saturation – 11% - low.
Haemoglobin – 11.8 G/DL - slightly low.
B12 - normal.
Urine metadrenalines – normal.
Anti-nuclear antibodies – negative.
Smooth muscle antibodies – negative.
Mitochondrial antibodies – negative.
Gast PL Cell antibodies – negative.
Liver Kidney microsomal antibodies – negative.
Endomysial antibodies – negative.
DNA binding antibodies – negative.
Rheumatoid Factor – normal.
Borrelia (Lyme disease) antibodies – negative.
Infectious Mononucleosis – negative.
Coxsacki B Virus – negative.
Toxoplasama antibodies – negative.
IgG – normal.
IgA – normal.
IgM – normal.
Chromongranin A & B – normal.
Compliment C3 – 1.38 g/l – normal.
Compliment C4 – 0.28 g/l – normal.
Glucose fasting test – normal.
Insulin-like Growth factor 1 & 2 – normal.
As well as my Cortisol blood levels being raised, I also have had a urine cortisol test come back as slightly raised, but have done the salivary adrenal profile with the 4 samples throughout the day and that came back low. So I'm utterly confused when it comes to Cortisol.
Adrenal fatigue symptoms include low blood pressure, low body temperature, difficulty falling asleep, waking up in the middle of the night, afternoon slumps, sensitivity to noise, muscle weakness, super sensitive skin, poor tolerance of heat, oily hair. Seborrheic dermatitis may be caused by oily skin or hair.
A seasonal affective disorder study showed cortisol levels were lower in winter. Worsening adrenal fatigue during winter might explain your labwork (cortisol is an anti inflammatory).
CRP and ESR are inflammatory markers; elevated platelets can be due to a generalized inflammatory state; ALT is a more specific indicator of liver inflammation than AST; inflammation of tissues can also lead to a high neutrophil count.
I listed the home tests for adrenal fatigue on another answer...
http://www.medhelp.org/posts/Adrenal-Insufficiency/adrenal--fatigue-or-thyroid-issues/show/1655386
The symptoms that could be thyroid related are hair loss, strong heart beat, low temp, dermatitis and weakness.
The daily "slump" could stem from an adrenal issue.
Then increased blood levels of some things could be related to differences in exercise, between winter/summer. CRP is an indicator of infection or inflammation in the body.
The type of music you're listening to could cause your hr to raise or lower.
If you haven't already, you should ask your doctor to run a thyroid panel, consisting of Free T3, Free T4, TSH, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). The Free T3, Free T4 and TSH will help determine actual thyroid function. The antibody tests will confirm/rule out the presence of Hashimoto's Thyroiditis.
You might also ask to have some adrenal testing done.