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Diagnosed With Hyperthyroidism. Radiotherapy And Surgery Done. Found Low Cotisol, Tsh Level. Any Treatment?

Posted on Fri, 10 May 2013

Question: My uncle diagnosed craniophryngioma with hyperthyroidism.Surgery had been already took place after that radiotherapy was also done in smooth manner.Before 2-3 days back we have done some test where observertions are ass Follows:
T3- 87.4 , T4- 8.27 , TSH- 0.013 (Ref range:- 0.28 To 4)
Cortisol- 0.43 (Ref Range 6.2 To 19.4)
We obeserve that Cotisol and TSH are on Lower side
Please suggest further treatment

Answered by Dr. P.V Pradeep (1 hour later)

Hi XXXXXX,

Please mention the dose of thyroxine (Eltroxin) your uncle is taking now.

Is he having any symptoms since his cortisol is low

Please reply

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. P.V Pradeep (1 hour later)

Etroxin 100mcg daily

Symptoms:-
Constipation
Increased Sensitivity to cold
Fatigue / feeling slowed down
Paleness /dry skin
Sadness/Depression
Weakness
Puffy face
Decreased taste and smell

Answered by Dr. P.V Pradeep (1 hour later)

Hi XXXXXX,

Your TSH levels are below normal. I would suggest lowering of thyroid supplements. If I were to be your treating doctor, I would suggest 75 microgram tablet. Please discuss with your treating doctor and lower your medication.

Your cortisol seems fine, you need not worry and continue the same medication.

Let me know if you need clarifications.

Warm regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. P.V Pradeep (31 minutes later)

As per report test for cortisol shows as follows:-
Cortisol- 0.43 (Ref Range 6.2 To 19.4)
Once again we are asking that cortisol level is low whether this would impact functionality of Body

Answered by Dr. P.V Pradeep (29 hours later)

Ideally, for estimating cortisol, you have to shift the patient to another steroid called hydrocortisone and then skip one dose before measuring it. I don’t know how your test was performed. Since the dose of Omnacortil provided is adequate and since there are no symptoms of hypocortisolemia, I suggest you to just continue present dose and I don’t want to confuse you further.

Hope this helps. Take care!

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Shanthi.E