First, what are adrenal glands and their function in the body.

The adrenals sit just above the kidneys in the loin, one on each side. Their tasks are many and varied; and are so important, that if you lose your adrenals, you die within three days. The inside of each adrenal produces adrenalin, which is the hormone that gives us a sudden burst of energy or strength when confronted with a crisis situation – the “fight or flight” scenario. It is the rim, or cortex, of each adrenal, that most concerns us for the present. It produces a number of complex hormones with vital roles to play, and are essential in the system’s response to prolonged stress; e.g. infection, injury, starvation, massive exertion. The first group is the glucocorticoids (mostly hydrocortisone), whose job is mostly to stimulate conversion of protein to glucose; and maintain the tone of the vascular (or blood vessels) system.

The second group comprises the mineral corticoids, which regulate the proper balance in the body of sodium and potassium, and are therefore to do with fluid retention and blood pressure. Aldosterone is the chief. The third type are the androgens, (male sex hormones), and are represented by Dehydroepiandrosterone, (DHEA for short), and androstendione. These have as their main job, the promotion of repair and growth in the tissues.

Fourthly, are the oestrogen’s, that back up the oestrogen made by the ovaries – as, for example, in the menopause. Other hormones are suspected, but not yet isolated. The output of these hormones is cyclical, with maximum level early in the morning, and least at night.

Our deepest concern here, is the crucial importance of the adrenal cortex hormones in the system’s response to stress. Briefly, there is a rapid increase of the glucocorticoids, to enable the body to cope. It is the failure of this mechanism to work properly, in the presence of general stress, or the stress of illness, that we are concerned with in the use of replacement cortisone therapy.

One of the must have tests is to check FT4 and FT3 at the same time as well which will give a true picture if a person is hypo or hyper. Apart from FT3 and FT4, following tests should also be ordered to complete the picture.

• low energy
• fatigue and tiredness

Other symptoms include:

• weight gain
• cold hands and feet
• depression
• slowness of thought
• headaches
• facial swelling
• fluid retention
• dry skin
• brittle nails
• constipation
• irregular menstrual cycles
• and fertility problems

The body temperature may be low and the patient prefers to set the room thermostat very high and still feels cold.

Normal Lab values as follows;

This may vary slightly depending on type of the test and lab used.

TSH and other blood test ranges for the UK are as follows;

• Thyroid-Stimulating Hormone (TSH)
  Evaluates overall thyroid function.
• Total Thyroxine (T4)
  Evaluates the total amount of T4 produced by the thyroid gland.
• Free Thyroxine (T4)
  Evaluates the amount of T4 available to the cells and tissues.
• Free Tri-iodothyronine (T3)
  Measures the amount of T3 (the active form of the hormone) available to the cells and tissues.

This test does not require fasting. Take your medications as prescribed. However, do not take your supplements on the day of the test.

Active thyroid hormone (nicknamed T3, short for triiodothyronine) sets the body’s metabolic rate, sort of like a volume dial. One might say T3 determines how hard or how fast each cell works to do its job. Every cell of the body is affected by T3.

The thyroid glands (there’s one gland on each side of the windpipe) produce approximately 10% of total T3 plus an inactive form called T4. Tissues of the body absorb T4 and convert it to T3.

As T3 is active hormone, FT3 test must be requested to evaluate actual condition of hypothyroidism.