Concern over hydrocortisone side effects and blood tests....

LilE1977 · 05-15-2008, 08:31 PM

I have addisons disease and today, due to my recent tests I have started to increase my hydrocortisone from 20 mg in the am since I was about 16. Now 31 and started taking 20 mg in the am and 10 mg in the afternoon for about a week. After talking to her about severe stress I am under she has now instructed me to take 60 mg a day(3 times a day) for 3 days and then to call her on Monday. Although in reference to my thyroid (I had it radioactivly removed and was hyper then hypo after the removal) I have had amazing results with Armour thyroid has given me a 30 day supply until she figures out my addisons disease meds...i.e. Florinef and Cortef after that she says she wants to put me on what I call "the devils drug"synthroid so I won't be seeing her much longer but I wanted someone other than the dumb doctors out there to take a look at my blood work since all I seemed to get was a pat on the head and an up in my hydro.....any thoughts?

COMP METABOLIC PANEL, BL

GLUCOSE 92 60-99 MG/DL
SODIUM 141 133-145 MEQ/L
POTASSIUM 3.8 3.5-5.3 MEQ/L
CHLORIDE 106 98-108 MEQ/L
CO2 23 23-32 MEQ/L
BUN 8 7-23 MG/DL
CREATININE 0.6 0.5-1.2 MG/DL
TOTAL PROTEIN 6.3 6.1-7.9 GM/DL
ALBUMIN 4.0 3.5-5.5 GM/DL
CALCIUM 9.3 8.5-10.3 MG/DL
BILIRUBIN TOTAL 0.6 0.1-1.4 MG/DL
ALK PHOSPHATASE 63 0-115 IU/L
SGOT 22 0-41 IU/L
SGPT 16 0-54 IU/L

Component Your Value Standard Range
CORTISOL SERUM 6.0 - UG/DL
Cortisol Reference Ranges:
AM sample (7-9 AM) 8.7 - 22.4 UG/DL
P.S. this was not an am/pm test!! It was taken at 11 am.....how can they do an am/pm test? I've heard of people being in the hospital all day getting blood tested to get the exact levels?
PM sample (4-6 PM) 2.0 - 9.9 UG/DL

ASSAY THYROID STIM HORMONE
TSH <0.004 0.350-5.500 uU/ML

ASSAY, FREE THYROXINE
FREE T4 1.08 0.71-1.81 NG/DL

TRIIODOTHYRONINE TOTAL ASSAY, TT-3
T3 TOTAL 2.32 0.67-1.99 NG/ML

VITAMIN D-25 HYDROXY., BL
VIT D, 25-HYDROXY 46 32-100 NG/ML

Notes recorded by Romy J Block on 05/14/2008 at 4:02 PM
Vitamin D levels are normal
TSH/total t3 is still slightly high on Armour thyroid - we will make no changes at present and discuss more at the next visit.

cortisol is low with increased ACTH c/w her Addison's.

Her labs are not c/w celiac disease or premature menopause.

Please let the patient know.
Is she feeling better on the increased hydrocortisone

rumpled · 05-16-2008, 04:08 PM

With a TSH like that... looks like you are massively suppressed or that is a pit issue.

Your sodium and potassium are fine... with the cortisol low - my doc usually does a 24 hour urine test to tell where I am at rather than the spot serum. The time it was taken is not accurate anyway... so it is not very valid...

I could see if you wanted to go up a little - but that much... that is for a major illness! Is the stress you are undergoing like that?

Armour has a lot of T3 in it... so if you added a tiny bit of T4 (in another brand, I share your hatred and do not take it either), you can take both and still feel good.

LilE1977 · 05-16-2008, 07:37 PM

Well, I am getting a divorce. Moving 1200 miles with my 9 year old daughter in about a month,starting a new job and having to work full time which I haven't HAD to do in about 7 years, and am having major financial difficulties due to the prior mentionings.....So, I would say I am stressed. I talked to my doc again today (well, her nurse) and she said even though I was feeling *weird* when I took the second dose of hydro (yesterday)and then I didn't proceed to take the 3rd 20mg dose, she told me to try it anyway. She said that people get shakey and have palps if they don't have addisions disease, since I do have it,it should help boost my cortisol levels. *sigh* I am REALLY getting tired of all of this $%*$#. I need to find a good endo in the Tampa Bay area (florida) so if anyone has a reference PLEASE for the love of GOD let me know! P.s. my doc will not even THINK about adding something to the armour...she wants me off of it and when I asked about a combo she said we can take you off armour and switch you to synthroid....just like that. *UGH* I felt like DEATH on synthroid....I've been there, 30 pounds overweight, tired,bitchy,sluggish,major headaches.......ohhh yeah PLEASE put me on that AGAIN! GRRRRRR if I could drink without it making me feel like poop.....I would be tipping a few back right now!

Elizabeth

rumpled · 05-17-2008, 10:07 AM

I don't know of anyone in Tampa - hopefully someone will chime in but if you look at the armour site, I do believe they list the doctors that prescribe them and that would be a start. I take a T4 and a T3 and NEED both or feel like ick so know that T4 alone is not enough. However, the T3 in armour is super high and may not be suitable for you based on your tests... so you *may* be better suited with a T4 like levoxyl or unithroid AND cytomel which will help you control the amount of T3 you are getting. I do that.

Heart palps mean you need FLORINEF as well not cortef... I would start with SALT not cortef or florinef for the fluid retention issues. Addison's is a salt wasting disease and the heart palps means you are not managing your fluids well - probably not eating and drinking well enough. SALT SALT SALT is your friend.

Your doc does not know much... your BP is probably low too? You do need some cortef as you are low - but you need comprehensive testing - and that doc is not giving it so you.