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TSH level of 88 & cortisol level of 30??

Hi,
I'm a 38 year old female. I recently gained about 30 pounds in 4 months along with a long list of other symptoms...too many to list!  My doctor had blood work done, as well as a thyroid ultrasound. The ultrasound came back that my thyroid was grossly enlarged, but no tumors. My bloodwork showed my TSH level at 88, also, my Cortisol level was at 30, as well as a lot of my vitamin levels were extremely low to zero. I have an appointment with an endocrinologist in a few weeks, but my doctor mentioned that my thyroid is obviously a problem, but in addition, the cortisol level points to Cushings disease. Are these 2 seperate illnesses or does one correlate to the other?
Also, what is a "high" level or TSH and Cortisol? I know the reference range, but I would like to know if my levels are unusually high.
The doctor started me on Synthroid 75, and I've now lost 6 pounds since I started taking it (10 days ago).
Does anyone have any experience with Cushings and an enlarged thyroid?
This is all very new to me so any advice or information would be so appreciated.
Robin
3 Responses
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649848 tn?1534633700
COMMUNITY LEADER
Neither a swollen thyroid nor a TSH of 88 is "alarming", though they are both concerns.  

Have you had antibody tests done to determine whether or not you have Hashimoto's Thyroiditis or not?  Typically, the only relation between thryoid issues and Cushings is if you have Hashimoto's, since both are autoimmune. If you've been hypo for a long time, the adrenals will try to take up the slack for the thyroid, by producing more cortisol to keep you going.

If you have any thyroid blood work results (other than TSH) that you could post, that would be a huge help.  Be sure to post reference ranges, too, since those vary lab to lab and  have to come from your own report.

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Avatar universal
Hi Barb135,
I have a complete blood workup done. I will copy and paste the results. The standard ranges are listed first, then my result is to the right. It's alot, but since I'm not sure what is relevant, I'm putting everything:

Glucose  65 - 99 mg/dL    93
BUN  6 - 20 mg/dL      16
CREATININE, SERUM  0.57 - 1.00 mg/dL     0.73
EGFRNonAF   >59 mL/min/1.73     105
EGFRAF   >59 mL/min/1.73    121
BUN/Creatinine Ratio   8 - 20     22
Sodium   134 - 144 mmol/L     138
Potassium   3.5 - 5.2 mmol/L     4.3
Chloride   97 - 108 mmol/L     99
CO2   19 - 28 mmol/L     26
Calcium   8.7 - 10.2 mg/dL     9.3
Total Protein 6.0 - 8.5 g/dL       7.5
Albumin   3.5 - 5.5 g/dL     4.4
Globulin, Total   1.5 - 4.5 g/dL     3.1
A/G RATIO   1.1 - 2.5     1.4
Total Bilirubin   0.0 - 1.2 mg/dL     0.4
Alkaline Phosphatase   39 - 117 IU/L     49
AST (SGOT)   0 - 40 IU/L     17
ALT   0 - 32 IU/L     13
TSH   0.450 - 4.500 uIU/mL     88.030
WBC   3.4 - 10.8 x10E3/uL     5.8
RBC   3.77 - 5.28 x10E6/uL     4.45
Hemoglobin   11.1 - 15.9 g/dL    13.7
Hematocrit   34.0 - 46.6 %     40.8
MCV   79 - 97 fL     92
MCH   26.6 - 33.0 pg     30.8
MCHC   31.5 - 35.7 g/dL     33.6
RDW   12.3 - 15.4 %     13.6
PLT   155 - 379 x10E3/uL    317
NEUTROPHILS   40 - 74 %    55
Lymphocyte   14 - 46 %     35
MONOCYTES   4 - 12 %    7
EOSINOPHILS   0 - 5 %    2
BASOS   0 - 3 %   1
Neutrophils Absolute   1.4 - 7.0 x10E3/uL    3.2
Lymphocytes Absolute   0.7 - 3.1 x10E3/uL    2.0
Monocytes Absolute   0.1 - 0.9 x10E3/uL    0.4
Eos (Absolute Value)   0.0 - 0.4 x10E3/uL    0.1
Basophils Absolute   0.0 - 0.2 x10E3/uL    0.0
VITAMIN K1   0.28 - 1.78 ng/mL    <0.13
Vitamin C   0.2 - 2.0 mg/dL    0.0
INR   0.8 - 1.2    1.0
Prothrombin Time   9.1 - 12.0 sec    10.3
Vitamin B-12   211 - 946 pg/mL    800
Vitamin D 25-OH Total   30.0 - 100.0 ng/mL    24.9
Cortisol, Plasma   2.3 - 19.4 ug/dL    30.0

URINE LABS
Blood   Negative    Moderate
Protein Urine Random   Negative mg/dL    30

Also, no, I haven't had any antibody tests yet. I have my first endo appointment in about 3 weeks.

Thanks so much for any insight...I just have very limited knowledge about any of this since I've never had any previous problems like this until a few months ago.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
A couple of things jump out at me.

First is the TSH.  Unfortunately, your doctor didn't test the Free T3 and Free T4, so we have no idea where those are.

You Vitamin C os very low, as is vitamin K and vitamin D, plus your cortisol level is high.  Was this a morning, fasting draw?  

Do you supplement vitamin C, K and D?  

You need to get the thyroid antibodies, Thyroid Peroxidase Antibodies (TGab) and Thyroglobulin Antibodies (TGab) tested to confirm Hashimoto's.

One cortisol test is not nearly enough to diagnose Cushings, but of course, it should not be ruled out until all possible tests have been completed.

"The three most common tests used to diagnose Cushing's syndrome are the 24-hour urinary free cortisol test, measurement of midnight plasma cortisol or late-night salivary cortisol, and the low-dose dexamethasone suppression test. Another test, the dexamethasone-corticotropin-releasing hormone test, may be needed to distinguish Cushing's syndrome from other causes of excess cortisol."
http://endocrine.niddk.nih.gov/pubs/cushings/cushings.aspx
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