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Old 01-01-2005, 11:04 PM   #1
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Question hair loss with dhea, hydrocortisone and armour thyroid?

Hi, I am new to this board and need help with a problem. I would invite the moderator and others to please respond. I have a pst Dx of Hashimoto's thyroiditis (my antibody tests have been normal for the past few years) My current dx: CFS, hypothyroid, adrenal fatigue and Undifferentiated Connective Tissue Disease. I have been on hydrocortisone 18.75 mg total, in 4 daily divided doses consisting of 4.75 mg am, 4.75 mg noon and dinner, and 4.5 mg at 9pm. I was dx as having adrenal fatigue with saliva tests which showed significant below normal levels of cortisol in the am. My doc at the time was supposed to be tx me per Dr. W. McJeffries book: Safe Uses of Cortisol. Initially, I felt great. The doc then dumped me, stating"I don't know how to proceed with this. I don't feel comfortable, find someone else to deal with it!!!" Later, I started to gain weight. Over a period of 3 years I gained 30lbs. It got to the point my short term memor was shot, I couldn't get out of bed or exercise, let alone walk down the street without feeling out of breath. The current doc I was seeing put me on lmg.Levoxyl. I felt initially, then all symptoms returned along with severe fibromyalgia. The initial doc I saw who put me on the hydrocortisone, suggested she treat me with armour thyroid. I was put on dhea 25 mg (my own dhea was signigicantly below normal), and kept on the hydrocortisone, along with 1 grain of Armour. Suddenly, I began to feel more energetic and was finally able to loose weight. I lost 20 lbs. I was on this dose for 3 months. I noticed I was experiencing severe dandruff and hair loss, that I never had before. My lab values were: TSH .8. FT4 .9 and FT3 2.8 She then decided, I needed to be "reved up" and raised my armour to 2 grains. Initially, I felt great but noticed my pulse was averaging 80-100 beats per minute, even though I did not feel nervous, and my hair began to fall out severely. I told my doc. Lab tests revealed a below normal level for TSH and T3.My lab values were: TSH .05, FT4 1.1,FT3 4.8. One month later, lab values revealed TSH .01, FT4 1.4 and FT3 6.2. She told me my thyroid had been "over-corrected" and instructed me to lower armour to 1.5 grains. I continued to feel fine, except my hair was continuing to fall out and pulse rate remained the same. I expressed my concern to my doc, and she told me she could no longer handle my thyroid case, as she had no idea what my hair loss was from or why I now had "cardiac problems." She dumped me again! I was finally able to convince my current pcp to take over. She told me I "did not have cardiac problems."Lab values on 1.5 mg armour for 1 month were: FT3 4.8 (2.3-4.2),FT4 1.0 (0.8-1.8) TSH .40 (0.40-5.50) My cholesterol levels continue to remain high at 240 mg., LDL 156. HDL 57. She then lowered armour to 1 grain. I have been on it for about a month, but am still experienceing severe hair loss and increased heart beat, without palpatations or feeling nervous. I have not taken new lab tests yet. I need to know what is going on, and what is causing the hair loss. My pcp said the increased heart rate was within normal range. Could this be true? Is this rate safe? My EKG was normal. Is it true that my adrenals should be balanced with my thyroid? How do you do this? What adrenal tests should my pcp be testing, if any? My pcp seems to think hydrocortisone side-effects are the same as those on prednisone, and that these 2 hormones are practically one in the same in this regard, and they both also can depress thyroid function.Is this true? Do you think my pcp may need additional education in this regard? If so, what do you suggest? I really need HELP PLEASE. I know this is rather a lot of info, but your responses are very much appreciated. Thanks, binks

 
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Old 01-02-2005, 09:20 AM   #2
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Re: hair loss with dhea, hydrocortisone and armour thyroid?

Your most current labs are a little suspect to me. Did you take you meds that day before you had your blood drawn? I though so.

Hydrocortisone does not suppress thyroid function. In fact thyroid function tends to be depressed if Cortisol drops too low. On the other hand, Cortisol helps your body utilize thyroid hormones so that you actually might need a little bit more.

Back to your labs. I am going to disregard the FT3 test, because I don't think it is accurate because you took your meds within about 6 hours of the blood being drawn, if my guess is correct. (I bet the actual reading would have been closer to 3.8-3.9 otherwise, again, just a guess). If docto only knew to tell you to take your meds AFTER your blood is drawn when you are getting Free T3 and Free T4, the thyroid world would have more sanity.

Your Free T4 is probably the reason your hair is falling out and your skin (especially your scalp) is dry. Even though it is also artificially high because you took your meds too close to haveing your blood drawn, it is still registering very low in the normal range in an area whare MANY people report symptoms.

Ideally, Free T3 and Free T4 should be in similar places in their respective ranges. and both should be above the middle of the lab range, preferably just above the upper third, for most people to feel their best. TSH tends to be variable and inaccurate as a guage for measuring thyroid levels and can be dispensed with, if you are measuring Free T3 and Free T4 properly (don't take your meds before labs) and they are within range.
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Old 01-02-2005, 09:24 AM   #3
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Re: hair loss with dhea, hydrocortisone and armour thyroid?

One more thing, get an iron panel done. Measure Iron, Red Blood Cell Count, Hemoglobin, and Ferritin. If Iron is low, then these labs will be low or low-normal.

Normal for Ferritin is 20-150, I believe, but MANY people experience hair oss if it drops below 50.
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Old 01-02-2005, 04:39 PM   #4
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Question Re: hair loss with dhea, hydrocortisone and armour thyroid?

I really do not understand the gist of your message. What is it? What about the hydrocortisone and DHEA? I reduced my armour down to 1 grain a month ago, and am still experiencing hair loss and increased pulse. I was thinking that my hair loss and increased heart rate maybe related to the DHEA. What do you think? I have read these could be some of the side-effects of taking this hormone in high doses, even if your own serum blood level for the hormone is within range (when taking the hormone). DHEA produces testosterone and estrogen. I read that in some susceptable individuals, testosterone is converted to DHT in the hair follicles, and this causes hair loss. I don't know if that is happening with me. I forgot to mention when my armour was at it's highest 2 grains, my hair started falling out like crazy, and my finger nails stopped growing. The nails were very brittle and thin. Since reducing the armour, the nails are better...but my hair is not. I really don't understand what is going on, and it seems my pcp does not as well. I am very concerned. I need HELP! Please respond with any info you might be able to offer. Thanks, binks

Last edited by binks; 01-02-2005 at 04:44 PM. Reason: forgot to mention

 
Old 01-02-2005, 06:57 PM   #5
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Re: hair loss with dhea, hydrocortisone and armour thyroid?

Quote:
Originally Posted by binks
I really do not understand the gist of your message. What is it?What about the hydrocortisone and DHEA? I reduced my armour down to 1 grain a month ago, and am still experiencing hair loss and increased pulse. I was thinking that my hair loss and increased heart rate maybe related to the DHEA.
I am sorry if I offended you, or confused you, that as not my intention. I just jumped straight in with what I felt was pertinent information. I know some of what I say or said will be contrary to what yoru doctor may have told you or what you have read somewhere else, but I can assure you that what I am saying is from reputabel sources.

The gist of the message is that I don't think Hydrocortisone is your problem, nor is DHEA. Generally if you have too much DHEA, you will have excessive hair growth, not hair loss. (you failed to mention your sex, so if you are male, the results MAY be different).

Quote:
What do you think? I have read these could be some of the side-effects of taking this hormone in high doses, even if your own serum blood level for the hormone is within range (when taking the hormone). DHEA produces testosterone and estrogen. I read that in some susceptable individuals, testosterone is converted to DHT in the hair follicles, and this causes hair loss.
Yes, this could cause male pattern baldness and hairloss, but it would more likely cause hirsutism, in a woman. I think the root (pardon the expression ) is somewhere else. I could be wrong, but it bears looking into.

Quote:
I don't know if that is happening with me. I forgot to mention when my armour was at it's highest 2 grains, my hair started falling out like crazy, and my finger nails stopped growing. The nails were very brittle and thin. Since reducing the armour, the nails are better...but my hair is not. I really don't understand what is going on, and it seems my pcp does not as well. I am very concerned. I need HELP! Please respond with any info you might be able to offer. Thanks, binks
Now, back to where I think your problem lies. Thyroid hormone levels are where I think the problem lies in your case. I think your Free T3 is PROBABLY OK, but I can't tell for sure. IF you took your meds within 6-8 hours of when the blood was drawn, then neither your Free T3 nor your Free T4 result will be truly accurate.

When your armour was at its highest, your Free T4 was likely at its lowest, and probably still hasn't recovered.

To be sure I am drawing the right conclusions, it is important for me to know wehn you took your Armour on the day that your blood was drawn for those lab results, as I am only guessing at this point. Within two hours after taking your Armour, your Free T3 (and Free T4 to a lesser degree) is elevated artificially until the proteins in your blood attach themselves to the T3 (and T4) from the Armour. The peak of this phenomenon occurs 2 hours after you take the pill and continues to be high for up to six hours after the peak. Thus it is important that if you are taking thyroid meds and having Free T3 and Free T4 tested that you wait at least 8 hours after you take your meds in order to get an accurate reading, or wait and take your meds after the blood is drawn.

My Guess is that you need to add some Synthetic T4 (Unithroid, Synthroid, Levoxyl, etc) to your Armour to bring up your T4. T3 and T4 should be in similar portions of their respective lab ranges, but you have one high, and one low--a pattern that I have sen in many people to cause symptoms.

Later, I mentioned a very common cause of hair loss: Anemia. A good doctor would have already had those tests that I suggested to see if that was a source of your hairloss.

I hope this helps clarify what I said and why. If you have any questions or any more information that might help, feel free to ask. That's what we are here for.
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Old 01-02-2005, 08:43 PM   #6
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Re: hair loss with dhea, hydrocortisone and armour thyroid?

MEEP-

Thank you for your responses. They continue to be appreciated. I would like to know if the increase in heart rate is something to be concerned about? In regards to the DHEA, the source of the info I gave you regarding hair loss, never mentions hirsutism as a side effect in women. I do not have any signs of hirsutism. One thyroid source (mary shalmon?)suggests the problem lies with testosterone and it's conversion to DHT in the hair follicles...causing hair loss. This person suggests evening primrose to help with this problem. I have tried Borage oil for 1 month but notice no help. I am aware that primrose oil apparently differs in that it is a phytoestrogen. Is this why it works? Does it matter what type of GLA one uses? I was concerned about using additional estrogen, since I already take some. I am VERY concerned about regaining the weight I lost since on the armour and dhea. Is this a valid concern? What can I do to maintain the weight I am at now? Why must the FT3 and FT4 be at similar levels? What does this do to the body's metabolism? I was on 1mg of levoxyl previously, and could not loose weight. I was also severely fatigued etc. The doc then put me initially on l grain armour. During the conversion process, I started to loose weight and felt alot better. Why is this? Now, she is thinking I need to be off the armour and back on the levoxyl. I can't go back to that state! She doesn't want to bother with armour. I get the impression she has other patients on it having a lot of problems. They have a lot of symptoms, and I am not sure she knows how to adjust the armour. What do you suggest I tell her, so she will continue to work on this with me? Why does armour feel so much better than levoxyl, yet it seems to have alot more problems in fine tuning the T4 and T3?
I am also concerned about the dhea. I don't want to go off of it, it seems to help me so much. What about 7-keto dhea? Do you have any experience with this? My other doc put me on dhea because my own values were so low, and as a preventive measure for osteoporosis. When I started having hair loss (very concerned about it) and increased heart rate, she took off on me. I can't afford to loose another doctor. PLEASE HELP. If you could answer the questions I have posed, and try to explain, and deal with the concerns I have voiced, I would greatly appreciate it. Thanks! binks I hope to hear from you soon.

 
Old 01-03-2005, 07:42 AM   #7
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Re: hair loss with dhea, hydrocortisone and armour thyroid?

Quote:
Originally Posted by binks
They continue to be appreciated. I would like to know if the increase in heart rate is something to be concerned about?
Maybe, and maybe not. You still never answered about when you took your meds that day. If you took them before the blood was drawn, then I woudl want to see them re-done. If you took them after the blood was drawn or at least 8 hours from when the blood was drawn, then I would bet that your T3 really is too high and this is why your heart rate is higher. Here's something to try. Split your Armour dose and take half in the morning and half in the afternoon. T3 has a fairly shourt half life and many of us find that we do better symptom-wise when we split our dose. I take mine at about 8:00 and 3:00.

Quote:
In regards to the DHEA, the source of the info I gave you regarding hair loss, never mentions hirsutism as a side effect in women. I do not have any signs of hirsutism. One thyroid source (mary shalmon?)suggests the problem lies with testosterone and it's conversion to DHT in the hair follicles...causing hair loss.
Interesting, I had never heard of hair LOSS being associated with DHEA, so that was a new one for me. I am familiar with Mary's work and have exchanged emails with her on a few occasions a few years ago. She is really on top of things, and I would trust her sources as valid, BUT, I still maintain that it is an unlikely scenario.

Quote:
This person suggests evening primrose to help with this problem. I have tried Borage oil for 1 month but notice no help. I am aware that primrose oil apparently differs in that it is a phytoestrogen. Is this why it works? Does it matter what type of GLA one uses? I was concerned about using additional estrogen, since I already take some.
This is an area where I need to do more homework before I feel comfortable giving an answer. I am suspect of phytoestrogens as a rule, though. If you need estrogen, the real thing is always better. Phytoestrogens compete with estrogen in attaching to the cell receptor sites and may decrease the efficiency of your estrogen.

If you are supplemeting with estrogen, estradiol is the best. Premarin and Prempro are not natural to your body and are known to cause a host of problems in humans. Besides, I disagree with the manufacturer on how the animals they derive the hormones are treated. (Premarin means PREgnant MARe urINe--honestly! look it up!)

Quote:
I am VERY concerned about regaining the weight I lost since on the armour and dhea. Is this a valid concern? What can I do to maintain the weight I am at now?
If it is important to you, then it is a valid concern. I can tell you that once you stabilize your hormone levels that gaining or losing weight will be the same as it is for any other healthy adult. If you were low on DHEA before supplementing, then keep taking it--it is helping. On the Armour, I know you have changed from dose to dose. Again, tell me when you took your meds that day and when you had your blood drawn so I can make a valid interpretation of the results.

Quote:
Why must the FT3 and FT4 be at similar levels? What does this do to the body's metabolism?
Because in a healthy person that is what you would find--balance. This is what is required to keep your metabolism up where it should be. Another reaosn is that some tissues can't use T3 from your bloodstream very well and require T4 which is converted within these individual tissues. The brain is one such organ that doesn't use T3 from the blood, but requires T4 to function properly. If your brain isn't getting adequate T4, then the function in your body that it supports may very well suffer, especially in the long run.

Quote:
I was on 1mg of levoxyl previously, and could not loose weight. I was also severely fatigued etc. The doc then put me initially on l grain armour. During the conversion process, I started to loose weight and felt alot better. Why is this?
On the Levoxyl, your T4 level would have been pretty good, but your T3 probably dropped low enough to cause symptoms. (there are ways to help this, by the way, if your doc switches you back to a T4-only med).

T4 has a long half life. When you switched over to the Armour, your T4 was still in a good range, and the T3 in the Armour also brought your T3 up quickly. Within a few weeks, your T4 was dropping to a point where you started experiencing symptoms and 6 weeks into the Armour regimin, T4 had stabilized where it is now--low enough to be a source of symptoms.


Quote:
Now, she is thinking I need to be off the armour and back on the levoxyl. I can't go back to that state! She doesn't want to bother with armour. I get the impression she has other patients on it having a lot of problems. They have a lot of symptoms, and I am not sure she knows how to adjust the armour.
I don't blame you for not wanting to go back to that state. I am glad that Armour has worked somewhat for you, and that you are asking questions to learn what else can be done. It IS possible to feel better, and I believe that you will. The problem with thyroid meds in general, regardless of the type of med you are on, is that there is NO one-size-fits-all solution. Armour is not the answer, but it helps many people feel better. On the other hand some people do terribly on Armour but feel fine on Levoxyl (or Unithroid or Synthroid...). Some people do thier best on a combination of Armour and a synthetic T4 (I fall into this category, and most likely do, too), some do better on a synthetic T4 and Cytomel (a synthetic T3), and rarely, some people do their best on Armour and a synthetic T3 (this definitely wouldn't be you).

Quote:
What do you suggest I tell her, so she will continue to work on this with me? Why does armour feel so much better than levoxyl, yet it seems to have alot more problems in fine tuning the T4 and T3?
Ask her to humor you and see if she will work with you on this plan:

Throughout your treatment, do NOT take your meds before your blood is drawn. This is imperative for accurate results. I can provide references if your doc needs them or you can just follow my advice and let your doc think you are taking your meds before your blood is drawn, if that is what she prefers. I cannot stress how important this is to getting your thyroid levels balanced properly!

Take Armour alone until your Free T3 is consistently above 3.4. shoot for getting it between 3.4 and 3.6 or so. You can have labs and dose adjustments done as often as weekly when adjusting T3 levels.

Once you get to that point, add in small amounts of the T4 med of your choice (Unithroid, for example, is my choice), having labs done every 6 weeks and adjusting doses until you get your Free T4 right, targeting about 1.5 (somewhere bbetween 1.4 and 1.6). This may have the effect of bringing your T3 up a little, too, so that's why I left a little room at the top of the T3 scale, so there is room it to increase, if needed.

Once you get your T4 where I suggested, hold there for at least 6 months and see if that doesn't make a big difference in your symptoms. Meanwhile, pay attention to make sure you are eating adequately.

For the hair loss, make sure you are not anemic, also. If your red blood cell count, hemoglobin, B12, Iron or Ferritin are low, then you will likely shed hair, and getting your thyroid levels right won't help with that.

Also, keep a symptom journal through all of this. Make entries at least once a week, but don't read over them until at least a month or more has passed. This will serve two purposes. 1. It will show you how you have progressed, since many of the symptoms tend to fade away slowly, and 2. it will be a central location where you can show your doc your progress and have a guage of how well things are working.

You will notice that I didn't mention TSH anywhere in my plan There is a reason for that, and I have a reference for that if you and/or your doc needs them.


Quote:
I am also concerned about the dhea. I don't want to go off of it, it seems to help me so much. What about 7-keto dhea? Do you have any experience with this? My other doc put me on dhea because my own values were so low, and as a preventive measure for osteoporosis.
Your other doc is a wise doc, but apparently a littel flighty. I haven't used the 7-keto DHEA, though I have heard good things about it. it might be a good idea to try it. If you are concerned about being on the DHEA, then have it tested to see where you are. I don't know your age, but you want DHEA to be about in the middle of the range it should be in for a 25-29 year old for optimum results. As long as you keep it there, and no higher, you shouldn't worry about any adverse effects from it


Quote:
When I started having hair loss (very concerned about it) and increased heart rate, she took off on me. I can't afford to loose another doctor. PLEASE HELP. If you could answer the questions I have posed, and try to explain, and deal with the concerns I have voiced, I would greatly appreciate it. Thanks! binks I hope to hear from you soon.
If you are worried about hair loss look at all the possible causes. Listen to me about the Ferritin, especially. It is a MAJOR contributor to hairloss, even if other iron levels are "normal". Ferritin scores below 50 almost always mean you will be losing hair.

I hope this helps!
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Last edited by Meep; 01-03-2005 at 08:05 AM. Reason: I can't type!!!!

 
Old 01-03-2005, 08:17 AM   #8
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Re: hair loss with dhea, hydrocortisone and armour thyroid?

Another quick note. Anemia is a known cause of rapid heart rate in many patients... Hmmm.. rapid heart rate? Hair loss? GET THAT IRON AND FERRITIN CHECKED!
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Old 01-03-2005, 08:51 AM   #9
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Talking Re: hair loss with dhea, hydrocortisone and armour thyroid?

MEEP-

Thanks for your time and responses. In answer to your question about the time I took my meds (thyroid only?), yes, it was within 6 hours before I had my lab tests.

Also, I wanted to ask you about the hydrocortisone again. If you will please look over my original comments, it would help. I need to know what tests, if any, need to be performed. Have you heard of Dr. MCJeffries and his book,"Safe Uses of Cortisol"? What do you think? Are the side-effects of physiological doses of hydrocortisone the same, or similar to prednisone like steroids? Dr. McJeffries thinks they are not, yet my pcp tells me different. I don't know what to believe. It is after I started taking the hydrocortisone, I began to gain weight and developed severe fibromyalgia with severe fatigue.
I read over a site by Dr. Shames. He is supposedly is a family practioner who specializes in treating thyroid. He states it is important to balance the thyroid and adrenals. How does one do this?
Also, I would like to know how estrogen and progesterone effect thyroid levels? (I am taking natural progesterone cream and estradiol (biest)). What is the best way to take DHEA? Is a once a day regime ok? Would it be better to split the dose and take 2 x per day? I would appreciate if you could research the DHEA, and tell me what you come up with. Also, what can I do to help with hair loss, in addition to balancing the thyroid, and possibly the DHEA? (My pcp is very opposed to taking too many lab tests, and is resistant to testing for other hormone level changes when testing again for the thyroid. What do you think about this? How can I get what I need from her?

I look forward to hearing from you again. binks

 
Old 01-03-2005, 10:00 AM   #10
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Re: hair loss with dhea, hydrocortisone and armour thyroid?

Quote:
Originally Posted by binks
MEEP-

Thanks for your time and responses.
Glad to help!

Quote:
In answer to your question about the time I took my meds (thyroid only?), yes, it was within 6 hours before I had my lab tests.
I thougt so. It would be interesting to see results done as I suggest so that the levela ren't skewed like that. In my personal experience, I made a dose adjustment based on a tes twhre I took the meds before the lab and ended up feeling worse for it. I am glad I found scientific literature stating that this was a problem so tha tI could avoid it and tell others.

Quote:
Also, I wanted to ask you about the hydrocortisone again. If you will please look over my original comments, it would help. I need to know what tests, if any, need to be performed. Have you heard of Dr. MCJeffries and his book,"Safe Uses of Cortisol"?
I have heard of Jeffries and read several of his articles. I haven't read the book, but I Am on a similar regimin of 20mg of Cortef a day. I split mine differently than you do to more closely mimic nature. Cortisol should be highest in the morning and drop throughout the day (Cortisol has a short half-life od 8 hours). Cortisol rises while you sleep and is supposed to be highest when you wake in the morning. To mimic this, I take my Cortef first thing in the morning 10mg with breakfast, then I take 5 mg with lunch and 5mg with dinner. I increase this to 30mg a day or even 40mg a day during times of extreme stress or illness, and split the dose similarly. (15-10-5 for 30mg, or 20-10-10 for 40mg)

I used to take 5mg 4 times a day, but have found that I do better the way I am taking it now. You can test for Cortisol levels, but because stress causes a rise in cortisol, just the trip to the doctor's office and anxiety about having the blood drawn (even if you are "not afarid of a needle) causes cortisol to rise, so I don't trust the blood tests. I DO trust (and Jeffries agrees) taking a mornign Cortisol and then immediately doing an ACTH Stim test, thne taking Cortisol at 30 minuts and 1 hour. the mornign cortisol shoudl be above 15 according to Jeffries, and then the subsequent results should rise sharply. The one hour test should be at least double the 8AM test, if not more, according to Jeffries.

Quote:
What do you think? Are the side-effects of physiological doses of hydrocortisone the same, or similar to prednisone like steroids? Dr. McJeffries thinks they are not, yet my pcp tells me different. I don't know what to believe.
I tend to agree with Jeffries. The half life of Prednisone (and others like it) is MUCH longger than the 8 hours of Cortisol. In order to take a dose high enough to match what the highest morning levels should be, you'll still have too much prednisone in your blood in the afternoon and evening. This will cause side effects such as weight gain, roundness of the face and such, over time. In order for the afternoon and evening to be right, your morning woudl have to be low. This will cause side effects of slow, groggy, achy mornings, as if you aren't getting enough Cortisol, but your afternoons and evenings may pick up and be OK.

Quote:
It is after I started taking the hydrocortisone, I began to gain weight and developed severe fibromyalgia with severe fatigue.
I read over a site by Dr. Shames. He is supposedly is a family practioner who specializes in treating thyroid. He states it is important to balance the thyroid and adrenals. How does one do this?
The Drs. Shames (he and his wife work as a team and are WONDERFUL, I have heard) have a book called Thyroid Power that you might want to read. Their patients are almost invariably ecstatic with the protocol the Shames Drs. prescribe.

What else did you start at the same time as taking the hydrocortisone? Was there a change in thyroid meds or seomthing, too?

Quote:
Also, I would like to know how estrogen and progesterone effect thyroid levels? (I am taking natural progesterone cream and estradiol (biest)).
I Am glad you are taking what you are taking and not one ove the Premarin-type hormones. Estrogen causes a bit more thyroid to be bound to proteins in your blood and can affect your Free T3 and Free T4 levels by makign them drop slightly. If you need the estrogen, simply compensate with a small dose increase of your thyroid med. Progesterone is supposed to help with the utilization of thyroid hormones, though, honestly, I haven't done my homework there either.

On the flipside of things, thyroid hormones also affect Progesterone and Estrogen levels (as well as testosterone). These hormones are mode mostly by your ovaries. Well, there aer thyroid hormone receptor cells on your ovaries. If the ovaries detect too littel T3 and or T4, then they assume that this is a time of stress and the levels of progesterone and estrogen are changed, preventing normal cycles and ultimately making it hard to conceive or if conception happens, making it hard to carry a healthy child to term.

Quote:
What is the best way to take DHEA? Is a once a day regime ok? Would it be better to split the dose and take 2 x per day? I would appreciate if you could research the DHEA, and tell me what you come up with.
DHEA should be highest in the morning and drop steadily throughout the day, being lowest at bedtime, so you wouldn't want to throw off the natural rhythm by splitting the dose. I recommend taking it once a day, in the morning.

Quote:
Also, what can I do to help with hair loss, in addition to balancing the thyroid, and possibly the DHEA?
Ferritin. Check your Ferritin. (I have said that repeatedly since my first post to you.). Hypothyorid patients are Very often low on Ferritin, adn I truly believe that this is one of the biggest contributing factors to hypo hairloss. Get it checked!

There may be other causes, but I bet that your Ferritin is low and needs attention. Once ferritin and thyroid levels are right it still might take 6 months for you to notice new hair growth as the follicles become active again.

Quote:
(My pcp is very opposed to taking too many lab tests, and is resistant to testing for other hormone level changes when testing again for the thyroid. What do you think about this?
She is smart to take this approach, but closed minded enough that she is shutting out possibilities to restore your health that might be obvious with the right testing.

Tests I would demand on the next visit are Free T3, Free T4, TSH, Hemoglobin, B12, Iron, Red Blood Cell Count, and Ferritin. These are not too much to ask for.

Quote:
How can I get what I need from her?
there are a few psychological things that you can try to get what you want from a doctor.

Be nice. Ask the doc to just humor you on this, because you are curious and wonder what those levels are. Explain that it is you, the patient, who is paying for the tests, and insist that you get what you are asking for.

If that doesn't work, remain nice and firm and ask what valid medical reason (not an opinion, but a fact) she would have for denying you those tests. IF she has nothing other than opinions to back up her decision, ask what it would hurt to have the tests done.

If that doesn't work, while still being nice, have a form ready for her to sign as to the tests you are asking for. Have room on the form for her to explain the valid medical reason for denying the tests and have her sign and date it. Have copies of the form made so that she can keep one (you keep the original). Explain that you are sending a copy to your insurance company as well.

By this point, one of two things will have happened:

1. The doctor will have proven that she is egotistical and unyielding and not prepared to help you attain the good healthcare that you desire, deserve and are paying for. (in this case, it is time to go doctor shopping).

2. More likely, she will have conceded and you will get the tests you asked for. Most doctors would rather give in and order the tests than have to waste their time filling out a form and having to deal with the questions from the insurance company later.

Hope this helps! Good luck!
__________________
Danny

I am not a doctor, nor have I ever played one on TV...

Last edited by Meep; 01-03-2005 at 10:10 AM. Reason: typing is not one of my stronger skills... :)

 
Old 01-03-2005, 07:01 PM   #11
Senior Member
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Join Date: Jan 2005
Posts: 102
binks HB User
Talking Re: hair loss with dhea, hydrocortisone and armour thyroid?

MEEP-
The doc pretty much left the hydro levels to me. I tested low for cortisol in the am. So...what is the best dosage regime for me to follow? Did you gain weight after taking the hydrocortisone as well? If so, what is a reasonable amount to expect? According to Jeffries, one shouldn't gain weight. He suggested I take 5mg x 4. The original doc who prescribed the hydro had me taking a total of about 15mgs/day in divided doses of four. I didn't seem to gain weight on this dose. It was only after I started raising this dose, I began to have weight gain. Then she split in midtreatment, and I was left floundering around. The pcp I have handling it now, isn't really doing anything to address the dosage. Thinks weight gain is a normal reaction to this steroid. She doesn't know about Jeffries. I told her, and it still didn't change her attitude. No one has ever addressed the issue again with me test wise. I told you I was under the impression the adrenals should be balanced with the thyroid. What do you think? How does one do this? I told you what I am currently taking now. This caused a 30 lb. weight gain. It was only after this,the pcp
told me to take some levoxyl for several years, till I was soo sick with chronic fatigue , could not get out of bed, and
fibro, she finally agreed to try me on armour. She had insisted all along priviously, ,there was no such thing as free T3! She still tells me this. She only has T3uptake
listed. I have to force the T3 issue, to get tested. I need to know what are the best doses to take that will not cause much weight gain and the best time to take them. I used to take my hydro earlier than 9pm, but found I was getting too tired very early. Now, I still remain a night person. I can't seem to get to bed till 1am, and then have a lot of difficulty in the am. I feel like I was run over by a truck. I feel very tired. All I want to do is sleep. What possibly is wrong with this picture, and what can I do about it?I was able to take lab test today for T3,T4,TSH and DHEA. I took the tests 8 hrs. after taking the thyroid. According to the last lab figures I gave you,what does that make me? Hypo or Hyper? Will adding more T4 and having the levels equal, tend to cause me to gain weight? How much T4 and T3 are in 1 grain of armour? How does it compare to 1 mg. of Levoxyl? In answer to your question, I started to take the hydrocortisone at the same time I started the Biest, progesterone cream and testosterone cream. My weight didn't start to shift up till I was told to increase the hydrocortisone from the l5mgs. I felt I couldn't stay at this dose, because I began to feel severe fatigue as the cortisol was wearing off too soon , I think. I could not wait till the next dose. No one ever suggested I take thyroid, inspite of the fact I have a pst hx of Hashimoto's and have developed a lot of problems since stopping the original thyroid. I stopped, because I was told I did not have any more antibodies, and the TSH was in the middle range. I was full of fatigue, vasospasms and severe PMS, as well as IBS, which I continue to have, inspite of taking the hormones I am on now. I have tried a lot of things. Nothing seems to really help for long . I don't know what this is from . I have the C type. No seems able to address this problem, other than to tell me to take laxatives, increase fiber and take ascidopholous. I can't take fiber. Makes things much worse. Perhaps you have some ideas on the that would help as well.Hope to hear back from you soon. binks

Last edited by binks; 01-04-2005 at 01:55 AM. Reason: forgot to mention

 
Old 01-03-2005, 09:07 PM   #12
Senior Veteran
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Join Date: Jul 2002
Location: Belleville, Il, USA
Posts: 664
NodiGoiterGirl HB User
Re: hair loss with dhea, hydrocortisone and armour thyroid?

I had hashimoto's, before I had my thyroid remove and the antibodies never showed up on tests but I had them because that is part of the disease. If I am correct than the only way you don't have them anymore is if you thyroid is dead from the disease or if it is removed.
I had hairloss before I had my thyroid removed, even though my thyroid blood tests were all in "normal" range.
I Feel all the problems I had with high blood pressure, fatigue, headaches, backaches were all related to the antibodies. I say this because now that my gland is gone, all these symptoms are gone.
I too was just diagnosed with IBS but......During the testing to figure out what is going on they found an orange sized mass in my pelvis, now I don't know if this is related to my IBS-D or not but suspect that it might be since they popped up at the same time. I think I had IBS-C my whole life before that, but it could have been thyroid related.
Have you had an ultrasound or any other tests on your pelvis to see exactly what is going on in there? You mentioned bad PMS and this can be a sign of cysts or problems in that area.
For IBS-C I was told that zelnorm is a great medicine. I can't take it since I am mostly D right now and it can cause D to be worse. Wish I could take it because I hate my antispaz meds, they dry me out. If I ever switch to C again I will take it. I remember when I was C and it seemed like fiber didn't work but I either wasn't drinking enough water or I didn't give it long enough to kick in.
I now use fibercon, 2 tablets with a large glass of water before bed and it keeps my stools just right. It can take three to five days for the fiber to work on IBS-C people.
Hang in there,
Nodi

 
Old 01-04-2005, 02:03 AM   #13
Senior Member
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Join Date: Jan 2005
Posts: 102
binks HB User
Talking Re: hair loss with dhea, hydrocortisone and armour thyroid?

Meeps, I still would like to hear from you soon regarding the message I posted after your last one. I received a reply from a senior moderator other than yourself, which I greatly appreciate the info, but I need to hear back from you regarding the other issues I raised. Hope to hear from you soon. It is interesting to note the last reply I received from a senior moderator, mentions she had IBS and it was gone after she had her thyroid removed. Also, I don't understand. Perhaps you can help explain this to me. She mentioned she had Hashimoto's but her antibodies didn't show up on the lab work. How can this be? If this is correct, perhaps that is going on with me as well. However, I have never heard of this before. Perhaps, you and she could elaborate more on this particular topic as well. I USED to have SEVERE pms before I hit menopause. I went through hell each month. It was impossible for me to work on top of this and everything else. I had SEVERE cramps, ,mood problems. The situation was predictable, and often would start 2 weeks before my period, and then into it's first week. I could pretty much count on being incapacitated each month. While I was still on thyroid for the Hashimotos, an endocrinologist put me on massive doses of micronized progesterone. I must say, it really helped. However, this doc gave up his practice to return to research, and I was left without anyone to help carry on his treatment with me. Then, I went off the thyroid and then the progesterone. I think my body went into shock, as nothing seemed to work right in my body after that. I just got sicker.I was also told I was allergic to my own progesterone and estrogen by an Environmental Immunolgist. I also feel my adrenals really went down hill.I was then told I had Lupus. After a round with some Lupus meds, and a form of chemotherapy, I was now told I did not have Lupus, but rather, Undifferentiated Connective Tissue Disease! I am not sure they really know what is going one now.( I am chemically sensitive and very sensitive to most meds) No one seemed interested in what the previous docs had done regarding my hormones and the problems I was having. They basically made light of the whole thing, and for a better part of 10 years I suffered greatly. It wasn't till I was at the brink of menopause, and was put on natural hormones and the hydrocortisone, that I began to feel somewhat better...until the severe fatigue and fibro set in...and I was pretty much bed ridden again. I did not have the medical care I think I needed. It was impossible for me to get!
Thanks so much. I look forward to hearing from you all, and receiving answers to my questions, and input regarding the situations I have described. binks

Last edited by binks; 01-04-2005 at 02:24 AM.

 
Old 01-04-2005, 07:09 AM   #14
Senior Veteran
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Join Date: Jul 2002
Location: Belleville, Il, USA
Posts: 664
NodiGoiterGirl HB User
Re: hair loss with dhea, hydrocortisone and armour thyroid?

I didn't say that my IBS disappeared after my thyroid was removed.
I had other symptoms that did disappear but that was not one of them.
I was just sharing my experience with IBS with you. I thought perhaps that if you hadn't hit menopause yet, that it could be a cyst or something causing your IBS. Unfortuantely sometimes IBS just pops up.
I was diagnosed with hashimotos through a needle biopsy. Normally people are diagnosed through their antibodies test, but mine were negative. I don't know how it's possible, and apparently the doctors don't know all there is to know about this disease.
It is frustrating, I had to fight for a diagnosis because everything was "normal" all the time, even though I felt like absolute crap. I was even put on anti-anxiety drugs because the doctor thought it was all in my head.
Doctors rely too much on the magical numbers on the blood tests. Not everyone is the same. I agree that you should get your Iron checked. If you are feeling that bad than I would think that your doctor would want to find out what's wrong by running more tests. If your doctor won't do them then find another doctor.
Good Luck,
Nodi
Nodi

 
Old 01-04-2005, 11:11 AM   #15
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Join Date: Aug 2001
Location: Euless, TX
Posts: 1,639
Meep HB UserMeep HB UserMeep HB User
Re: hair loss with dhea, hydrocortisone and armour thyroid?

Quote:
The doc pretty much left the hydro levels to me. I tested low for cortisol in the am. So...what is the best dosage regime for me to follow?
In my opinion, I think taking a higher dose early in the day when you need it, (and wehn you tested low) makes more sense than taking the same (or almost the same) dose all day long. You are taking 18.75mg daily, so I would split that up 10-5-3.75 (Breakfast-Lunch-Supper) to mimic what nature would provide you with. If you go to 20 mg a day, 10-5-5 liwk I am doing would be a good plan.

Quote:
Did you gain weight after taking the hydrocortisone as well? If so, what is a reasonable amount to expect? According to Jeffries, one shouldn't gain weight. He suggested I take 5mg x 4. The original doc who prescribed the hydro had me taking a total of about 15mgs/day in divided doses of four. I didn't seem to gain weight on this dose. It was only after I started raising this dose, I began to have weight gain.
I actually LOST weight at first. If you gained weight, then perhaps the dosing schedule is wrong for you. Try the schedule I have described and see if it works. Also, speaking from personal eperience, watch how you eat. Hydrocortisone DOES increase your appetite. You may unwittingly be eating a little more without realizing it. I know my appetite increased alot, but I knew to watch it and learned to compensate by snacking and making sure I don't overeat.

Quote:
Then she split in midtreatment, and I was left floundering around.
That could be grounds for a mal-practice suit if you are inclined to pursue it. The grounds: failure to provide continuation of service. She should have referred you, and continued to treat you until you had another doctor rather than to leave you scrambling.

Quote:
The pcp I have handling it now, isn't really doing anything to address the dosage. Thinks weight gain is a normal reaction to this steroid.
Weight gain IS a common side effect of hyydrocortisone--at supraphysiological doses, that is. In other words, if you take more thna what a healthy adult would produce on their own, then you woudl expect weight gain. Sinc eyou are on a smaller dose than that, the weight gain probably has more to do with timing of the dose or other factors (other health issues like thyroid*, appetite, exercise, blood sugar issues, etc) (*I honestly believe that incorrectly treated hypothyroidism is your problem)

Quote:
She doesn't know about Jeffries. I told her, and it still didn't change her attitude. No one has ever addressed the issue again with me test wise. I told you I was under the impression the adrenals should be balanced with the thyroid. What do you think?
I am not surprised that your PCP hasn't heard of Dr. Jeffries. Sadly, his work is largely ignored by mainstream practitioners, and it isnt' taught in medical schools.

I think it is not so much a matter of "balancing" adrenals and thyroid levels as making sure that the adrenal response is healthy or that you are supplementing with hydrocortisone if the adrenal response isn't healthy. That is what the Shames' are referring to. It is necessary to have healthy adrenal response, or your thyroid treatment will be less than optimally effective.

Quote:
How does one do this?
You are doing it already by taking the hydrocortisone. I don't think you are taking it to the best advantage by spreading the doses equally throughout the day, but that is my opinion, only. I am not a healthcare professional, only a well-educated patient.



Quote:
I told you what I am currently taking now. This caused a 30 lb. weight gain. It was only after this, the pcp told me to take some levoxyl for several years, till I was soo sick with chronic fatigue , could not get out of bed, and fibro...
That is commmon, adn agina, I think that while you were on the Levoxyl, I bet your T3 was too low, and while you are on the Armour, your T4 is too low.



Quote:
...she finally agreed to try me on armour. She had insisted all along priviously, ,there was no such thing as free T3! She still tells me this. She only has T3uptake
listed. I have to force the T3 issue, to get tested.
In her defense, many lab requisition sheets don't have Free T3 listed as such. It may be listed as any of the following or might not be listed at all: Tri-iodothyronine, Free; Free Tri-iodothyronine; Free T3; or T3, Free.

If it isn't listed, there are blanks on the lab requisition that say "Other" and Free T3 can be written in there. Your doctor should know this. IF not, the nurse or medical assistant should know this. If they don't, you can educate them on it.



Quote:
I need to know what are the best doses to take that will not cause much weight gain and the best time to take them. I used to take my hydro earlier than 9pm, but found I was getting too tired very early. Now, I still remain a night person. I can't seem to get to bed till 1am, and then have a lot of difficulty in the am. I feel like I was run over by a truck. I feel very tired. All I want to do is sleep. What possibly is wrong with this picture, and what can I do about it?
Sounds liek adrenal fatigue to me. Since Morning Cortisol was what measured low, you need more in the morning. What is happening is that your adrenals are slowly making cortisol (aka hydrocortisone) all day long and the level is rising throughout the day. You are adding to this the way you are taking your meds.

Try splitting your dose as I described above: three doses 10-5-3.75 (Breakfast-Lunch-Supper) to mimic what nature would provide you with. If you go to 20 mg a day, 10-5-5...

Taking the higher dose in the morning will help to get you going, and leaving out the 9PM or later dose will let you sleep better.

Quote:
I was able to take lab test today for T3,T4,TSH and DHEA. I took the tests 8 hrs. after taking the thyroid. According to the last lab figures I gave you,what does that make me? Hypo or Hyper?
Due to when you took your meds the last time, I can't tell whether you are hypo, hyper or "normal" My educated (and probably accurate) guess if hypo, though. I was able to tell that you had taken the meds before the last blood draw, right? That seems to be more than what your doctor could tell from the tests.



Quote:
Will adding more T4 and having the levels equal, tend to cause me to gain weight?
MOst liekly not. Restoring your metabolism to healthy levels that are optimal rather than just normal has a tendency to help people with weight loss. IT doesn't necessarily make you lose weight if you dont' get rid of other factors, though.

For example, Before my thyroid treatment I was about 25 pounds over my "ideal weight". Getting thyroid and adrenal levels balanced dropped 15 of those pounds.

The extra 10 pounds bothered me for a few years after I had my thyroid and adrenal levels where I want them. When I quit eating a snack before bed, magically, the extra 10 pounds was gone in a month with no extra effort on my part. Simple little things like that can make a big difference.

Quote:
How much T4 and T3 are in 1 grain of armour? How does it compare to 1 mg. of Levoxyl?
1 grain of Armour has 38mcg T4 and 9mcg T3, and is supposely equivalent to 100mcg (.1mg) of Levoxyl (or levothyroxine, or Unithroid, or Synthroid). In practice though, many doctors and patients find that Armour is more comparable, physiologically to 75mcg levothyroxine. I tend to agree.

The reason for this can be found with a little math. T3 is about 4 times as active as T4 in the body, so we multiply the 9mcg of T3 by 4 (9x4=36) and add this result to the 38 mcg of T4 in Armour. Thus wwe get 36+38=74 --That's VERY close to the 75mcg I mentioned above, right?

Final answer: one grain of Armour is likely equal to about 3/4 or 75% of a 100mcg Levoxyl for most people.

Quote:
In answer to your question, I started to take the hydrocortisone at the same time I started the Biest, progesterone cream and testosterone cream. My weight didn't start to shift up till I was told to increase the hydrocortisone from the l5mgs. I felt I couldn't stay at this dose, because I began to feel severe fatigue as the cortisol was wearing off too soon , I think. I could not wait till the next dose.
IF you took a larger dose of hydrocortisone in the morning, it would even out those periods when you feel you need the next dose. Been there, done that, got a closet full of T-shirts from it. Give it a try. If you want more advice on how to take that, post a message to Chris on the Addison's board. Chris posts here, too, but moe on the Addison's board and knows the adrenal stuff better than I do. I still bet you'll get the same advice from Chris that I am giving you.
__________________
Danny

I am not a doctor, nor have I ever played one on TV...

 
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