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.
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.
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