• Log in with Facebook Log in with Twitter Log In with Google      Sign In    
  • Create Account
  LongeCity
              Advocacy & Research for Unlimited Lifespans

Photo

Adrenal Insufficiency, has anyone recovered?


  • Please log in to reply
34 replies to this topic

#1 Knickerbocker

  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 18 August 2012 - 03:24 AM


Hi all,

I've been struggling with CFS for years and lately symptoms of low cortisol, history includes high EBV titers, concussion and past corticosteroid use. CBC, lipids, and metabolic panel are normal. One oddity is that I've had chronically elevated Folate levels for years.

Anyway, To investigate a suspected adrenal issue my Endo ordered an AM cortisol test, and ACTH test, values below:

Cortisol AM: 4.1 Range: 6.2 - 19.4 ug/dL
ACTH: 14.2 Range: 7.2 - 63.3 pg/ml

From this test he believed I could have adrenal insufficiency and scheduled an ACTH stim test to confrim. I should have those results next week.

Anyway, I was wondering if anyone here has had clinical primary, secondary, or tertiary adrenal insufficiency? And if anyone has been able to recover I'd be particularly interested in those who were able to recover without the use of synthetic corticosteroids.

Thank you.

#2 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 19 August 2012 - 10:47 PM

Hi Knickerbocker,
First I am no a Dr but, even if the Stimulation Test is Neg, I would not stop looking for an answer. Second, with a low ACTH like 14.2, you may have secondary AI. The test that is most sensitive for Secondary AI is the Metyrapone Test. Yes, this test is available as I have called the company who now sells it. If you and your doc agree, you can also complete the Insulin Tolerance Test which, is a little more stressful. I have had the ACTH and the Metyrapone Test.


In the diagnostic workup of suspected adrenal insufficiency, the results of overnight metyrapone testing correlate closely with the gold standard of HPA-axis assessment, insulin hypoglycemia testing. Combining 11-deoxycortisol measurements with ACTH measurements during metyrapone testing further enhances the performance of the test. Impairment of any component of the HPA-axis results in a subnormal rise in 11-deoxycortisol levels. By contrast, standard-dose or low-dose ACTH(1-24) (cosyntropin)-stimulation testing, which form the backbone for diagnosis of primary adrenal failure (Addison disease), only assess the ability of the adrenal cells to respond to ACTH stimulation. While this allows unequivocal diagnosis of primary adrenal failure, in the setting of secondary or tertiary adrenal insufficiency, metyrapone testing is more sensitive and specific than either standard-dose or low-dose ACTH(1-24)-stimulation testing.

Sorry, almost forgot the link to the above.
http://www.longecity...__gopid__529951

Regards

Edited by searching4health, 19 August 2012 - 10:48 PM.


sponsored ad

  • Advert
Click HERE to rent this MEDICINES advertising spot to support LongeCity (this will replace the google ad above).

#3 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 20 August 2012 - 12:03 AM

http://www.mayomedic...&unit_code=8547

#4 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 20 August 2012 - 11:23 PM

Thank you for the information Searching4health. If I am not properly diagnosed I will definitely look into theMetyrapone test. Are you currently being treated for adrenal insufficiency? If so, how is it going?

#5 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 20 August 2012 - 11:55 PM

Thank you for the information Searching4health. If I am not properly diagnosed I will definitely look into theMetyrapone test. Are you currently being treated for adrenal insufficiency? If so, how is it going?



Hi Knickerbocker,
My symptoms have been varied from low Blood pressure, syncope, seizures, lightheadedness. Positive Tilt tableTest, Pluse dropped to 30bpm Hypoglycemia. I have had 3 ACTH Test completed and my corisol more than doubled, rules out primary. The metyrapone test and IIT will rule in or out AI. What are your symptoms? ANy blood work you can share?


Kind
Regards
Ben

#6 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 21 August 2012 - 12:39 AM

Thanks for the speedy response Ben. We definitely have similar symptoms: Lightheadedness, hypoglycemia (particularly when I wake and between meals), periods of orthostatic intolerance(haven't done the tilt table test, unfortunately) and low blood pressure issues. However, I have no history of seizures. I also have bad anxiety, fatigue of course, and have been dealing with frequent periods where my legs are extremely stiff when I'm walking.

All of my bloodwork is "normal" according to test ranges with the exception of :

Very high folate levels, low cortisol and Low normal potassium and sodium.

My Thyroid labs were within range, but I've heard you want to be in the upper end of the free t3 & t4 range to feel optimal , not sure how true that is.

TSH: 1.06 Range: .358 - 3.740

Free t4: 1.01 Range: .76 - 1.46

Free t3: 2.9 Range: 2.0 - 4.4

I had Vitamin D deficiency a couple years ago but supplementation and exposure got me in range as of my last test:

Vitamin D 44.8 Range: 30 -100

Have you had iron, ferritin, and b12 levels tested? They can be causes of Orthostatic intolerance. My b12 was in range but I've heard that the definitive test for b12 deficiency is Serum MMA and Homocysteine levels, which I haven't had done. You may want to look into this.

Are you taking any supplements?

#7 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 21 August 2012 - 06:23 AM

Thanks for the speedy response Ben. We definitely have similar symptoms: Lightheadedness, hypoglycemia (particularly when I wake and between meals), periods of orthostatic intolerance(haven't done the tilt table test, unfortunately) and low blood pressure issues. However, I have no history of seizures. I also have bad anxiety, fatigue of course, and have been dealing with frequent periods where my legs are extremely stiff when I'm walking.

All of my bloodwork is "normal" according to test ranges with the exception of :

Very high folate levels, low cortisol and Low normal potassium and sodium.

My Thyroid labs were within range, but I've heard you want to be in the upper end of the free t3 & t4 range to feel optimal , not sure how true that is.

TSH: 1.06 Range: .358 - 3.740

Free t4: 1.01 Range: .76 - 1.46

Free t3: 2.9 Range: 2.0 - 4.4

I had Vitamin D deficiency a couple years ago but supplementation and exposure got me in range as of my last test:

Vitamin D 44.8 Range: 30 -100

Have you had iron, ferritin, and b12 levels tested? They can be causes of Orthostatic intolerance. My b12 was in range but I've heard that the definitive test for b12 deficiency is Serum MMA and Homocysteine levels, which I haven't had done. You may want to look into this.

Are you taking any supplements?


Hi,
Ft 4 .73 .6 - 1.10
Ft 3 3.27 2.3-4.2 pg/m I am on 3 Grain Naturethroid
I also have high folate 2x of max.
Elevated B6
B12 high normal
RBC magnesium mid range
Iron is just a tad obove range
Ferritin Normal
Homocystine is normal
Normal Zinc and Copper
Elevated Testosterone
high normal estrogen E2 on Arimidex to keep it down.
Vit D3 78


A decent place to start for anxiety is a measure of your neurotransmitters via Urine (24hr) These include
What is your Sodium @ 140 or higher?
GABA Dopamine and Norepinephrine Epinephrine are a few Neurotransmitters. You maybe like and have possible low Gaba levels as its an inhibitory neurotransmitter,ie natural valium for the brain.

I am waiting for my doc to see the best way to test the neurotransmitters like Gaba as is suspect they are super low because if i have a stiff drink at night, i feel like a million bucks in the Am. Also, Benzos dont have the same effect.
I cant wait to here about your acth test results.

#8 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 21 August 2012 - 10:08 AM

I agree, I must be low on GABA as I see clear benefits when taking supplements which affect GABA levels, as well as benzos of course.

My latest sodium was 139, potassium 3.9 but ive had several tests where sodium was in the neighborhood of 135 and potassium owas hovering around 3.5.

How was your hypothyroidism diagnosed ? Did you have elevated tsh or just low free t3/t4 levels?

Is it possible your thyroid meds are too much of a strain on your adrenals?

I wonder what the cause of this elevated folate is. My b12 was elevated as well but it's funny considering I have many symptoms of b12 deficiency.

Your labs look pretty solid, so it definitely seems like you simply have an adrenal issue going on, or autonomic dysfunction. Did the dr say you have POTS from the tilt table result? Have you tried an ssri? Supposedly quite helpful for dysautonomia.


#9 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 21 August 2012 - 09:44 PM

Hi Knickerbocker,
Actually my adrenals are very strong, if not a little over active. I would have your DHEA-S checked if you think you have AI. Are you male or femaie? Is this an acute issue or congenital? The reason I am asking is sex hormones do play a role. My hypo thyroidism has been trial and error. TSh is like judging the temp of the room with a Thermometer, which sounds correct, but what if the thermometer was reading 80 degrees, yet you could hang meat in the room? I I feel good with an upper level of FT4 and mid Ft3.

Below is what I have come up with so far. I need to reduce T3 and increase Ft4 via synthroid or whatever. The brain needs T3, however it cannot pass the Blood Brain Barrier. T3 must be made from T4 by conversion. With a low cortisol level, I wouldnt do anything in regards to the Thyroid. Think of the thyroid as the Accelerator and the adrenals (cortisol) as the brakes.

How is your Diet by the Way?
I see you are in New York. I have seen a great doc there who thinks outside of the box. Look up Allen R Jacobs online. He is extremely kind and smart and not a quack like many out there.
Good luck

Edited by searching4health, 21 August 2012 - 09:44 PM.


#10 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 21 August 2012 - 10:04 PM

This is a little hard but, you might wanna try it.


Pupil Dilation Test
Another way to test for adrenal dysfunction is the pupil dilation exam. To perform this on yourself, you’ll need a flashlight and a mirror. Face the mirror, and shine the light in one eye. If after 30 seconds the pupil (black center) starts to dilate (enlarge), adrenal deficiency should be suspected.
Why does this happen? During adrenal insufficiency, there is a deficiency of sodium and an abundance of potassium, and this imbalance causes an inhibition of the sphincter muscles of the eye. These muscles normally initiate pupil constriction in the presence of bright light. However, in adrenal fatigue, the pupils actually dilate when exposed to light.



Under-active adrenal glands are evident in about two-thirds of CFS patients. The majority of patients I see for chronic illnesses, including are suffering from it. They have literally burned their stress-coping organ out. Amid years of poor sleep, unrelenting fatigue, chronic pain, excessive stimulants, poor diet, and relying on a plethora of prescription medications, the adrenal glands and the hormones they release have been used up. Once adrenal exhaustion sets in, it’s not long before the body begins to break down. Getting “stressed out” and staying “stressed out” is the beginning of chronic illness.

Adrenal fatigue is known to cause:
• hypoglycemia (low blood sugar)
• hypotension(low blood pressure)
• neural mediated hypotension (become dizzy when stand up)
• fatigue
• decreased mental acuity
• low body temperature (a sign of low thyroid function)
• decreased metabolism
• a compromised immune system
• decreased sense of well-being (depression)
• weight loss
• hyperpigmentation (excess skin color changes)
• loss of scalp hair
• excess facial or body hair
• vitiligo (changes in skin color)
• auricular calcification (little calcium deposits in the ear lobe)
• GI disturbances
• nausea
• vomiting
• constipation
• abdominal pain
• diarrhea
• crave salty foods
• muscle or joint pains

The Adrenal Gland
The MedullaIn the inner region of each adrenal gland is what’s known as the medulla. The adrenal medulla produces norepinephrine and epinephrine (adrenaline). These hormones are known as catecholamines. The medulla hormones are primarily involved in acute (immediate) responses to stress.

Epinephrine…
• increases the speed and force of the heart beat.
• increases systolic blood pressure (the top number -120/80)
• increases pulse rate
• increases cardiac (heart ) function
• dilates (opens) the airways to improve breathing
• increases the rate and depth of respiration to allow more oxygen to reach the bloodstream
• mobilizes sugar from the liver to the blood stream in preparation of the fight or flight response
• regulates circulatory, nervous, muscular, and respiratory systems when needed.
• inhibits the muscle tone of the stomach, so you may feel a “knot” in your stomach during times of stress.
  • Informative x 1
  • WellResearched x 1

#11 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 21 August 2012 - 11:12 PM

I was able to get my results early as I have a family member who works at the hospital. I will see my endo friday. Anyway, I am thoroughly confused as the results seem to conflict my original cortisol test. I will note that I didn't sleep at all before the test, not even a minute, and was highly stressed out.

Baseline cortisol: 21.4 range: 2.3 -19.4 ug/dl
30 mins: 33.0
60 mins: 35.1

So are my adrenals ok? or did the fact that I didn't sleep and was running on pure adrenaline that day mean the test is invalid. Very confused.


I am a male, I've had fatigue issues my whole life, but the severity and these "low cortisol symptoms" have seemed to pop up over the past 4 years or so. I do need to check my sex hormones as I havent recently but past results showed them to be normal and I was still having symptoms. Maybe I'll pay a visit to your dr., my current endo is decent but not very progressive.

Edited by Knickerbocker, 21 August 2012 - 11:15 PM.


#12 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 22 August 2012 - 12:35 AM

I was able to get my results early as I have a family member who works at the hospital. I will see my endo friday. Anyway, I am thoroughly confused as the results seem to conflict my original cortisol test. I will note that I didn't sleep at all before the test, not even a minute, and was highly stressed out.

Baseline cortisol: 21.4 range: 2.3 -19.4 ug/dl
30 mins: 33.0
60 mins: 35.1

So are my adrenals ok? or did the fact that I didn't sleep and was running on pure adrenaline that day mean the test is invalid. Very confused.


I am a male, I've had fatigue issues my whole life, but the severity and these "low cortisol symptoms" have seemed to pop up over the past 4 years or so. I do need to check my sex hormones as I havent recently but past results showed them to be normal and I was still having symptoms. Maybe I'll pay a visit to your dr., my current endo is decent but not very progressive.



Well, when told too, your adrenals can pump out plenty of Cortisol, so you know the gland is working. What you dont know if the pituitary is telling your Adrenals to increase cortisol production by releasing ACTH. What they gave you via IV is 1000x more than what your PItuitary normally puts out.
Well you do not have primary that is for sure.
I dont see him anymore as i am in NE PA and he does not take insurance.
The first time I saw him, we spend > 1.5hrs. There is the difference,he takes 10 patients aday vs 50-60 like the others. His specialty is Neuroendocrinolgy. Check him out on Youtube. I highly recommend him.
Here is his education:
Fellow in Neuroendocrinology
Beth Israel Hospital/
Harvard Medical School,
Boston, MA, 1994-1995

Fellow in Behavioral Neurology
Beth Israel Hospital/
Harvard Medical School,
Boston, MA, 1993-1994


See how my cort more than doubled!

Below are my results
10:00am

base cort 13.5

30min 24.1

60min 31.9

90min 38.3


8:56am 11/11/05

Total cortisol 20.4 MCG/dl Ref 4.0-22.0


10:40am 5/27/2006

ACTH 15 PG/ML Ref Range 7-50PG/ML


8:04am 3/16/11

Cortisol 20.7 Ref Range 6.7- 22.6




Latest results
ESTRADIOL 42 13-54 PG/ML
TOTAL TEST 861 250-100NG/DL
TESTOSTERONE ,FREE 177.0 46- 224
TESTOSTERONE, BIOAVAILABLE 356- 110-575NG/DL
SHBG 23 10- 50 NMOL/L
ALBUMIN 4.4 3.6-5.1G.DL
IODINE SERUM 60 52-109
SELENIUM 131 63- 160 MCG/L
ZINC, RBC 12.2 9.0 -14.7 MG/L
COPPER, RBC .54 0.53- 0.77 MG/L
T4 TOTAL 7.05 6.1-12.2 UG/DL
T3 ,FREE 2.85 2.10- 3.90PG/ML
T3, REVERSE 29 11-32 NG/DL
FERRITIN 48.3 24-336 NG/ML
B12 777 180-914PG/ML
MAGNESIUM ,SER 2.2 1.8-2.5 MG/DL

#13 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 22 August 2012 - 12:53 AM

Just found my Tilt Table Test.

TIme

blood & Pulse taken every 2 min laying down

101/51 p68

109/44 p66

103/47 p64

106/53 p70

93/70 p70

102/44 p68


same as above except upright

106/63 p73

100/60 p88

111/60 p89

107/58 p85

no reading pulse 30 ( passed out)

Nope its not pots, because with pots, you have an increase in HR. The cardologist put me on
metoprolol which made me a zombie.

#14 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 22 August 2012 - 01:05 AM

Hopefully that Dr. takes my insurance, seems like he definitely knows his stuff. I wont see my endo until friday but I am assuming he'll just send me home with a clean bill of health.

So what do you/ your doctor think is causing your symptoms? I would have a guessed your AM cort wouldn't have been so good considering your symptoms. Can you still have secondary AI with normal AM cort?

are you attributing your symptoms solely to thyroid or are you stumped yourself?

#15 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 22 August 2012 - 01:15 AM

You are dealing with some wicked hypotension there. When I was feeling better than I am right now several months ago my bp was about 120/80. At this level I had no lightheadedness. Now it's in the neighborhood of 100/60 and I feel quite lightheaded. I can only imagine how I'd feel at a diastolic level in the 40's as you experienced in the test. Does your BP fluctuate throughout the day or does it stay low?

Are you taking any supplements?

Edited by Knickerbocker, 22 August 2012 - 01:22 AM.


#16 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 22 August 2012 - 01:22 AM

Well, its really hard to say. My history is kind of weird. When I was born, I was breech and the birith was very difficult. I guess I didnt wanna come out for a very long time and my mother started loosing blood, then my and my mothers heart rate dropped. Well they were trying to get me out via Forceps and could have caused some of my problems. Well. finally they performed an Emergency C-Section. When I was ~ 2yrs old I would have starring spells and sometimes pass out while in the high chair and sometimes while at school. I believe its Temporal Lobe Epilepsy, but what do I know. All i know is I have a really horrible memory and have staring spells. I have had a neuropsych exam and my IQ was 80. I know I feel much better when my Ft4 is at least 50percentile. Now, am trying to put all of the pieces together. If I drink or am super calm, I can function and remember what I am doing, but If there is any extra stimui, I become retarted. This is why I thought it was adrenals. I will get an answer one way or the other.

Good Luck
Ben

#17 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 22 August 2012 - 01:28 AM

You are dealing with some wicked hypotension there. When I was feeling better than I am right now several months ago my bp was about 120/80. At this level I had no lightheadedness. Now it's in the neighborhood of 100/60 and I feel quite lightheaded. I can only imagine how I'd feel at a diastolic level in the 40's as you experienced in the test. Does your BP fluctuate throughout the day or does it stay low?

Are you taking any supplements?



Well now its much better and does not dip. My thought was that my blood pressure was dropping, so my adrenals had to pump out more adrenaline to keep my from passing out. Well I thought this adrenaline was causing the brain fog and sweating Episodes.
I am not taking any supplements except Vitamin D and eating fairly well. I know nutrition well to know I need to keep my lean protein intake up high as possible to feel my best. I also have chronic constipation. I take magnesium when I remember usually in the form of Magnesium OIL.

#18 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 22 August 2012 - 02:31 AM

Well the supplements are definitely working as your D and magnesium levels are great.

Alcohol supposedly raises levels of norepinephrine, serotonin ,dopamine and gaba. Have you experimented at all with antidepressants to tinker with your levels? I definitely think we both have gaba issues, perhaps pregabalin or gabapentin might help us? I definitely find benefit in taking low dose clonazepam, especially with brain fog, however I am avoiding benzo's at the moment.


Anyway, best of luck and let's both continue to report back our findings. I hope we both find our answers soon, and I'm sure we will.

#19 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 22 August 2012 - 02:55 AM

Yes, I do believe its a Gaba issue, which all fits with the shitty memory and anxiety. I just started reading about Gabapentin via a book called the Edge Effect. I took the test which is available online and scored very defiecient in Gaba. I have taken Aricept before and it really worked great for a month or so, but then it seemed to wear off, ie Honey Moon peroid. Anyway, I was a little low in serotonin and really off the charts for Gaba. Well I have tried many drugs from Dexadrine, Adderall, Ritalin, xanax, provigil,Wellbuterin, Effexor, and now on Lamictal, which I am not so sure its working or not @ 200mg/day. I have basically 2 Neurologist, one in Allentown and the other @ Thomas Jefferson. I have an 48hr ambulatory EEG @ the end of the month which I doubt will show anything, but we will see. Ohh yeah, I have a starter pack of Namenda. I really think its not a acetylcholine issue, but a Gaba issue. I plan on going natural if possible. After the EEG, i will try Inositol at a fairly high doseage and L-Theanine, which helps with Gaba and anxiety. Look up L-theanine and Gaba. Last ditch effort would be to do a PET Scan to find an abnormal metabolism of some sort or TLE.

#20 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 22 August 2012 - 09:23 PM

I was able to get my results early as I have a family member who works at the hospital. I will see my endo friday. Anyway, I am thoroughly confused as the results seem to conflict my original cortisol test. I will note that I didn't sleep at all before the test, not even a minute, and was highly stressed out.

Baseline cortisol: 21.4 range: 2.3 -19.4 ug/dl
30 mins: 33.0
60 mins: 35.1

So are my adrenals ok? or did the fact that I didn't sleep and was running on pure adrenaline that day mean the test is invalid. Very confused.


I am a male, I've had fatigue issues my whole life, but the severity and these "low cortisol symptoms" have seemed to pop up over the past 4 years or so. I do need to check my sex hormones as I havent recently but past results showed them to be normal and I was still having symptoms. Maybe I'll pay a visit to your dr., my current endo is decent but not very progressive.




Hi Knickerbocker,
I am sure you know already but, make sure you always get a copy of the labwork that is done so you can interpret what is happening clinically. For instance, My FT4 is normal at .74 Range .60 - =1.10, but I feel horrible with a FT4 in the lower range. My main point is, dont bypass normal as being unremarkable.

#21 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 23 August 2012 - 12:10 AM

Yes that is a great tip, luckily I have done a pretty good job of getting copies of most of my blood test records.

I have to say, I am so confused about the free thyroid numbers. My tsh has always been great, however my free t3 and t4 have never been in the top third of the range as I've heard is optimal. I wonder if simply optimizing those numbers would solve a lot of my issues.

I found some blood work from a few years ago, I was given the all clear from my Dr. with these values, your thoughts?:

AM Cortisol: 11.1

Dhea-s: 380 (280-640)

Prolactin 7.6 (3.7 - 17.9)

TSH: .80 (.34- 5.6)

Free T4: .84 (.58-1.64)

free T3: 2.7 (2.5 - 3.9)

total testosterone: 602 (260-1000)

Free Testosterone: 74.2 (50-210)

#22 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 23 August 2012 - 02:15 AM

Yes that is a great tip, luckily I have done a pretty good job of getting copies of most of my blood test records.

I have to say, I am so confused about the free thyroid numbers. My tsh has always been great, however my free t3 and t4 have never been in the top third of the range as I've heard is optimal. I wonder if simply optimizing those numbers would solve a lot of my issues.

I found some blood work from a few years ago, I was given the all clear from my Dr. with these values, your thoughts?:

AM Cortisol: 11.1

Dhea-s: 380 (280-640)

Prolactin 7.6 (3.7 - 17.9)

TSH: .80 (.34- 5.6)

Free T4: .84 (.58-1.64)

free T3: 2.7 (2.5 - 3.9)

total testosterone: 602 (260-1000)

Free Testosterone: 74.2 (50-210)




Hi Knickerbocker,


TSH: .80 (.34- 5.6)

Free T4: .84 (.58-1.64) 60% of the Range would be ~1.21

free T3: 2.7 (2.5 - 3.9) 60% of the Range would be ~3.34

You could do a trial of thyroid medication to get you into the upper 1\3 and see how you feel but I would rule out any Adrenal issue first for safety reasons. Increases in thyroid output increase the clearance of Cortisol. So if you have low cortisol now and increase the clearance, you will be in a world of hurt, ie adrenal crisis. So, to be 99.9% sure, ask for a ITT or a Metyrapone Test (over night). Treat Adrenals first then Thyroid or both at the same time. I am not sure if increasing your thyroid would help or hurt but there is only 1 way to find out. Adding thyroid hormones to a weak Adreanal system is Bad newz. Once you were cleared of any adrenal difficulties, I would start adding a T4/T3 combo, like desiccated thyroid. Check out this site for additional information:
http://tiredthyroid.com/


What is your Blood P and Pulse?
Wouldnt mind seeing a CBC and CMP.


total testosterone: 602 (260-1000) Great!!

Free Testosterone: 74.2 (50-210) Little on the low side, Next would be to check SHBG and Estradiol (E2)


I hope this helps you.

Ben

#23 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 25 August 2012 - 10:07 PM

Hi Ben thanks for your insight.

Went to the endo yesterday and he thinks the adrenals are fine , can't blame him the numbers looked good on my stim test. It definitely looks like I can rule out primary ai. I may look for a second opinion to rule out secondary ai.

My current endo and I are now working on one of my very pesky symptoms of reactIve hypoglycemia. My diet is pretty good, yet havent been able to rid myself of the lows. And when I'm low if I don't have a protein meal then it's almost impossible to get my sugar stable. I have a 5hr glucose tolerance test next week, to see exactly what's going on. He thinks that a low Dose of Metformin (glucophage) could help even my sugars and avoid the highs/lows. There is also a drug called Precose(acarbose) that has helped many with reactive hypo, which I may try if metformin doesn't help.. How bad is your hypoglycemia? Did you ever take the glucose tolerance test?

My CMP and CBC are always perfect , the only problems I've seen are low normal potassium and low normal sodium. Sometimes both are low normal , sometimes one is fine and the other is low normal. My bp used to be consistently 120/80. Now it's rarely higher than 110/70 and can get to 90ish / 60 at which point I feel quite lightheaded.

I definitely need a good doc to investigate my shbg and e2 and other sex hormones , is the one you reccomended to Me knowledgeable in this area?






Edited by Knickerbocker, 25 August 2012 - 10:17 PM.


#24 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 26 August 2012 - 12:15 AM

Hi Knickerbocker,
Yes, I do have my 3hr not 5hr OGTT. I dont have them on me but I do know my Fasting Sugar is normal or maybe high, it changes from 90s to 105. When they had me take the 100g of Glucose, the 1 or 1.5hr mark, the sugar went over 200. At the two hr mark, i think it was in the normal range. Once I have numbers, I will let you know. I know that if I have something to eat, like a sandwich on wheat, my sugar goes high then drops to normal levels. I believe its the rapid decrease in sugar that throws me out. I have just had to eliminate all breads etc. ITs good that you are on your way. Also, get your Hba1C completed. My level was around 5.1 which is good.
Ben

#25 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 26 August 2012 - 01:46 AM

My last two hemoglobin a1c readings were 4.8 and 5.2 , so they are normal. I too think my issues come with the rate my blood sugar drops after a meal like yours does. I read of someone on another forum who had this problem and solved their issue with low dose metformin.

#26 searching4health

  • Guest
  • 17 posts
  • 25
  • Location:United States

Posted 27 August 2012 - 06:50 AM

Ok I found my OTT Results

FASTING 98
1/2 HR 235 MG/DL
1 HR 244 MG/DL
2 HR 118 MG/DL

i was put on metformin but didnt really notice a difference how I felt, so I stopped. This just means I need to watch sugar intake.
check out the drop in 1hr from 244 to 188, whew. I would have loved to see the 3-5 hr test, to see how low it went. Reactive Hypo, Maybe?

Edited by searching4health, 27 August 2012 - 06:56 AM.


#27 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 30 August 2012 - 02:19 AM

That is quite the drop, definitely appears to be reactive hypo. Do you experience severe symptoms after meals? Precose is another option, I believe it has a better efficacy than metformin. There are a bunch of studies on pubmed with precose( acarbose) and reactive hypo.

I'm kind of excited as I have just discovered what I think might be the cause of my fatigue issues. It appears that I most likely do have POTS. I have a pulse oximeter at home, and have been measuring my pulse rate from different positions. When supine my hr is about 50-65, immediately upon standing my hr shoots to 110 -120 or sometimes more and seems to stay up around that level. I had no idea that I was waking around with such a high heart rate. It was never caught at my drs office because as soon as I sit or lay down the tachycardia goes away.

I'll report back my glucose tolerance test results and my journey investigating this dysautonomia that i discovered.



#28 Harry777

  • Guest
  • 14 posts
  • 8
  • Location:Australia

Posted 31 August 2012 - 09:50 PM

I recovered from Adrenal Fatigue, I always thought it was strange that I had it in the first place as I didn't have any risk factors to cause it. I suffered from hypoglyciemia a lot, having to eat every 2 hours at my worst. I was also so fatigued that I only felt comfortable lying down. I got diagnosed as having Adrenal Fatigue by a 24 hour saliva test.

Turns out I suffered from Pyroluria and that was what was putting such a strain on my adrenals.

www.pyrolurialife.com

#29 Knickerbocker

  • Topic Starter
  • Guest
  • 13 posts
  • 12
  • Location:NY

Posted 01 September 2012 - 06:10 PM

Harry,

Thank you for bringing this to my attention. How did you go about diagnosing yourself? Did you see evidence on any blood or urine tests? I'm absolutely going to look into this.

sponsored ad

  • Advert
Click HERE to rent this MEDICINES advertising spot to support LongeCity (this will replace the google ad above).

#30 Harry777

  • Guest
  • 14 posts
  • 8
  • Location:Australia

Posted 01 September 2012 - 09:18 PM

For the adrenal fatigue I got diagnosed by a Naturopath, but then when I couldn't recover from it I kept searching. I discovered Pyroluria during an internet search, what led me to this condition was that I always felt like I was zinc deficient. After I found the condition, I visited a doctor who treated the condition, got tested (a urine test) plus a whole lot of other blood tests because you can have Pyroluria and undermethylate or overmethylate as well (I don't under or over methylate).

It's also pretty telling, that for the first time I knew exactly what supplements to take and I could feel myself getting better and better (although initially it can make you feel worse due to the copper detox). It only takes me 24 hours to go downhill again if I stop taking my supplements (particularly the vitamin b6 component), I then start the supplements again and come right within an hour.

I still have to be careful about eating sugar and gluten. I also set myself off a bit recently by drinking alcohol, but have pretty much come right again now. Just got to accept that I can't switch back to a normal diet.




1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users