Any Insight?

[DrMariano2]

Got a few labs back, still waiting to hear from the doctor and figure this out.
Here are my levels maybe someone can shed some light on them.

Cortisol 9.6 ng/dL
SED rate 4
TSH 1.566 uIU/mL
Free T4 1.02 ug/dL
Ferritin 218.9 ng/mL

Any help is much appreciated. Thanks, Shaun.

Cortisol < 10 generally means a person is going to have difficulty in generating energy. The immune system may be in an activated state with significant production of inflammatory cytokines. Significant stress, i.e., norepinephrine signaling, infection, autoimmune illness, nutritional deficiencies, and other factors may contribute to lowered cortisol levels. SED (erythrocyte sedimentation rate) is a nonspecific marker for inflammation. It may not show any increase despite significant inflammatory changes in the person. It is useful in assessing some inflammatory diseases, though not all. TSH is the signal from the brain to the thyroid glands to produce more thyroid hormone. The brain is sensing low thyroid hormone levels in the brain compartment and thus asks for more. Using this as a measure for body compartment thyroid level is difficult since the brain and body can have two separate thyroid levels. Assuming there are no metabolic problems or mental or neurologic illness, then TSH can approximate the body’s need for thyroid hormone. Free T4 < 1.3 to me is one possible sign that the body compartment's thyroid level is low. Thus a person can be physically hypothyroid. It is better to obtain at least a Total T4 and a Free T3 to help determine this. T3 also would be useful if T4 to T3 conversion is a question. Ferritin is one way to gauge tissue iron levels as oppose to blood iron levels. Tissue iron level is important for energy production and metabolism. Enzymes which have iron as part of their structure (e.g. the Cytochrome enzymes) can’t be made if one is deficient in iron. Generally, I prefer men to have a Ferritin between 150-200 ng/mL. Other nutritional deficiencies can impair iron metabolism – for example, trapping iron in the storage Ferritin form, preventing it from being utilized by the cells. This is where high Ferritin levels do not necessarily mean Hemochromocytosis as much as impaired iron metabolism.

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