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Old 03-05-2008, 09:22 AM   #1
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I am starting down the Adrenal insufficieny diagnosis road.. please help.

Hello all. You may recognize me from thyroid central. Currently my issue is I am on a pure T4 supplement and have high Ft3 levels in comparison with my Ft4 levels. My husband and I want to have a second child, but this is a no go until i get my Ft4 levels into the 60-80% of normal range.

I am currently on 75 mcgs of Synthroid (4 weeks at this dose) and have yet to have my blood work run to check my new levels.. but other than feeling flushed. I am still very hypoT symptom wise.

I have had low B12 and Ferritin.. but taking daily supplements here.

My 50 mcg blood work showed:
TSH 3rd Gen .31
FT4 1.1 (30% in range 0.8-1.8)
FT3 3.66 (72% in range 2.3-4.2)
T3 Uptake was low normal

So the MFM suspects adrenal insufficiency or Addison's. He sent me to my thyroid IM for testing, confirmation, and treatment. I saw her 30 minutes ago.

She has written me a script for three tests. Two cortisol and a ACTH. Only two are fasting.. one is a saliva rhythm test.. So I go in at 8:30 am tomorrow. I was wondering if there were any other tests I should ask for... I would like to be diagnosed and treated ASAP.. I am very impatient .. so I am calling on experience. I she missing something here? What should I ask to add? Should I get a new B12 and Ferritin run?. it has been 6 months...

Any help would be appreciated.
Respectfully your Hashimoto's secondary hypoT crony,
MG
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Old 03-05-2008, 11:43 AM   #2
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

Hi, I am not sure if I can help or not, but I have also been diagnosed with hypoadrenalism and it is truly a nightmare. I would asked to be retested if it has been six months. I know my doctor told me that I needed to be retested every six months. I only had the basic testing of cortisol and DHEA. What were all of the other tests that you had? What are all of your symptoms that you are having? Do you have heart palpitations or tachycardia? I hope that you can be feeling better soon. It so hard to go day after day feeling so miserable all of the time, I know. Take care.
Thanks.

 
Old 03-05-2008, 03:30 PM   #3
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

Well I have had heart and blood pressure issues, but it is hard to tell if it is adrenals or Hashimoto's antibody attacks. Things did get better when I started my thyroid meds.. but I still have all this fatigue.. and until I know why my T3 is so high.. I can not push more T4 supplementations. Nothing like being hypoT in T4 and hyperT in T3.

My allergist had me add IgG, IgA, and IgM to the mix.. because I am so messed up. My body just can't stop working.. it gets bored and has to make work by attacking itself.

So right know tomorrow I will get the adrenal testing done.. or at least the two cortisol and ACTH test run as well as an antibody profile. *sigh* I just want to be normal and if it means takine cortisol to dial back the T3 so my T4 can balance.. what is another pill.

Thanks for the support. It has been rough. Right now every problem I have is pointing to Hashimoto's and the endocrine system. My vision and migraines and memory issues are one step from being identified as hashimoto's encephalopathy. Then I have Hashimoto's killing off my thyroid and this wierd High T3 low T4 concentration issue hindering medication. The funny thing is my thyroid is all but dead. Gotta love the irony. Oh.. and I do have a sinlge nodule in the thyroid beginning to give me issues swallowing food. But what worries me the most is my son (5) has shown up IgG and IgA deficient. SO now he is having to go through more immune testing and autoimmune issue testing. That makes me feel horrible. I know it is not my fault.. but I am the one with AI issues.. just like my mom and her mom and her grandmother..

I will ask about the DHEA. I haven't had that tested before. Thanks for the information and kind words.

MG
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Old 03-06-2008, 05:29 AM   #4
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

Quote:
Originally Posted by mkgbrook View Post
Well I have had heart and blood pressure issues, but it is hard to tell if it is adrenals or Hashimoto's antibody attacks. Things did get better when I started my thyroid meds.. but I still have all this fatigue.. and until I know why my T3 is so high.. I can not push more T4 supplementations. Nothing like being hypoT in T4 and hyperT in T3.


MG

Hi, From the thyroid board as well!! I suffer from hashis too..
From my own personal experience when it comes to t3 mine stayed jacked up as well .. I think its a part of the disease.. The thyroid is in the process of dying . So while it may be lacking in one area" t4 "its more than likely over compensating in another "t3" and add this to the body coverting the synthetic t4 over to t3 your going to have an overload ..

This should slow down when they thyroid dies some more..
hope you feel better soon and may your test come back okay.. Take Care

 
Old 03-06-2008, 06:39 AM   #5
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

Thanks. They took seven or eight vials of blood and sent me walking with the 24 hour saliva test. We shall see how things pan out. I am definitely curious. It is interesting that other Hashi's patients are going through the inverted T4/T3 concentration levels. I know two others on the thyroid board this way. Well I will do the walk and share the findings. I wish that they would just like evaluate everything all at once so you didn't have to do the piece mail step by step for eahc new aspect of our endocrine dysfunction, but then again that would be a LOT of blood to give all at once.

I am just impatient to get leveled out and optimized. Right now my liver is for some reason doing the convert as much T4 to T3 as it can. I almost wish they would yank the blasted pain in my neck so I could get down to business minus the cog in the works. We have all been there though.

Thanks for the reply!

MG
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Old 03-10-2008, 10:45 AM   #6
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

Hey MG,

Let us know what you find out. As you know, I'm looking into thyroid issues as well. I went to a pretty decent doctor who gave me the siliva test for the adrenals.

Keep in touch.

 
Old 03-14-2008, 12:03 PM   #7
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

Well I know my results are in.. but I have to wait for the MD to review them before I can get my hands on them. My knees are getting worse and worse. I am hobbling and living with ice packs on my knees these days. It stinks. I will have my results monday/tuesday and let you know what they are...

MG
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Old 03-14-2008, 04:01 PM   #8
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

Just thought I would let you know. The nurse gave me the results of my tests. The IgG/A/M were normal. The cortisol was in normal range and she couldn't give me specifics.. the one thing that was off was my ACTH. It was 37 on a range of 5 - 27.

So any thoughts? It looks like something is up with my pituitary gland. I was hoping it was low cortisol. Ugh!

MG
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Old 03-18-2008, 07:03 AM   #9
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

I would obtain your cortisol numbers. Did you get your saliva test results back? They usually take a little longer. You could have adrenal fatigue and with thyroid issues, you are probably more prone than normal.

Much like issues with the Thyroid, you could have high or low cortisol but not out of the "range." I'm reading a book on adrenal fatigue (Adrenal Fatigue: The 21st Century Illness) and it made a great point that I think you have made with the Thyroid as well. How can a person be at say 2.5 on a scale of 2.5 - 7.5 for a disease and considered disease free and then all of the sudden have said disease when she/he hits 2.4? The book goes on to say that doctors are trained to focus on black and white and not on gray and symptoms.

Good luck!

Last edited by chris0007; 03-18-2008 at 07:05 AM.

 
Old 03-18-2008, 06:52 PM   #10
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

I go back to the MD on Thusday.. fasting to 11:30 Man am I going to pig out after that. I will pack a lunch. Yes.. normal is not necessarily optimal. I will get a copy of my results then.

My OB SIL and MD/Ph.D Neurologist family friend gave me a list of things to get tested on Thursday.. plus what ever my IM wants to add. My Mds know I have nurses, Ph.D's and MD in the family and that I research and double check everything. They do not dare treat me as a child. Feel for me I am going to be thoroughly poked and drained.

It has been 3 months so..
General blood chemistry: Chem Spec, vit D, B12, and Ferritin
Thyroid Function: TSH, FT3, FT4, T3 Uptake, TT3, TT4, TBG
Adrenal and pituitary and tumor fact finding:
DHEA Sulfate, PTH, Calcitonin (thyrocalcitonin), Serum, and Sed Rate

Okay that is my list.. plus whatever the IM wants to toss in. I think this will beat the 11 vials from when my Hashi's was diagnosed and Graves refuted. I will pop in and share my findings after talking with my IM.

MG
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Last edited by mkgbrook; 03-18-2008 at 06:53 PM.

 
Old 03-20-2008, 06:12 AM   #11
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

I am new to this board, so forgive me if I don't do things right. I have secondary addison's disease. I have been told that the only real way to test the adrenals is to have a cortrisyn stimulation test (don't know how to spell cortrisyn). There are two ways your adrenals can be affected. One is that the pituitary is not working properly and not sending out enough ACTH to cause the adrenals to make cortisol. The other is that your adrenals don't work or are sluggish. Morning cortisols are not always the best way to get results but can be a starting point. When I went addisonian my 3:00 pm cortisol was .04. I was in addisonian crisis. Since it was caused from taking an inhaled steroid, I weaned slowly off the meds. Unfortunately, I got some better but didn't recover totally. I now have to take pred. My morning cortisols are now 6. Weakness, low body temps, low blood pressure, and sometimes weight loss (but not always). I would suggest you check out the [url]www.nadf.us[/url] website. There is a great amount information there. Addison's is a tricky disease. I wish you luck.

 
Old 03-20-2008, 02:52 PM   #12
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

Thanks Pam.

You did great.

Well I have even more respect for my IM. She said most MDs probably can not handle me. I can be a bit intimidating. WHAT? I am a 5'2" over weight moody auto immune thyroiditis suffering blonde female.. what is intimidating about that. She thinks I know too much and that makes the common MD nervous. I actually douoble check everything they say.

Well, I have another set of confirmed conditions. I am officially adrenal insufficient with adrenal fatigue. My IM gave me the results of my adrenal function testing and went over them in detail. The nurse had told me that the cortisol was normal.. and ACTH high.. well actually... Only my 8 am cortisol was low normal (17% )in the normal range. My 12 pm (.07), 5pm (.05), and 12 (.04) am cortisol levels.. were nada. The only reason my cortisol was normal at 8 am was because that was when I take my DHEA which can be converted quickly into cortisol. Bad thing about DHEA.. you don't want to take more than 20 mg and it burns up quickly in your system.. so by noon my cortisol plummets again and I am BLAH. The average person needs a cortisol level between 40-60% of normal range. Lower and higher will give you issues.

So I get to start the art of balancing and popping hydrocortisone pills 4x a day tomorrow. I will be keeping up with this board now as well.

MG
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Old 03-27-2008, 05:55 AM   #13
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Re: I am starting down the Adrenal insufficieny diagnosis road.. please help.

They haven't done the Pregnenolone or Aldosterone tests. Once again my Im and I are working on this together, with me pulling in advice from an MD/Ph.D Neurologist friend and my OB SIL. I am also cross checking with my cardiologist, neurologist, neuro-opthomalogist, and allergist/immunologist.

I was thinking primary as well, but something is up with my pituitary gland as well. It does not produce TSH as it is supposed to... all seems to be pointing to an autoimmune component. My mom is one of five sisters.. they all have thyroid AIs. Hashimoto's and Graves, or Hashimoto's or Graves. My mom had both.. Graves and Hashimoto's. My mother's paternal side is riddled with Graves Disease, while her maternal side is Hashimoto's central. My mother's mother is suspected to have Hashimoto's Encephalopathy as well. I have a special EEG test that my neuro will do in May to determine if that is my culprite for migraines and vision and memory disturbances. All this started with my pregnancy five years ago. During it I had a rough ride.. as well as after it. Things just wouldn't work right any more and my ability to feel warm or lose weight and exercise plummeted. I am hoping that we can get to the bottom of this and fix it before anything else goes wrong. I see my cardiologist on Monday. He specializes in electrophysoilogy. I am his mystery case. He was certian I had POTS.. then when the tilt test came up negative.. things pointed squarely at my thyroid AI. The day I started thyroid meds.. my BP and HR dropped and beta-blockers were no longer necessary. Now I have started the hydrocortizone.. my BP and HR are climbing a bit. SO.. we shall see if he wants me to go back on the B-blockers.

My blood work drawn last Thursday
Thyroid: TSH, FT3, Ft4, T3, T4, T3 Uptake, TBG
General: Blood chem panel, Ferritin, B12, Vit D
Adrenal: DHEA Sulfate

I will ask my Cardiologist to wrap up the adrenal function testing. Thanks for your help.
MG
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