| | Questions for Dr. Meep or others with experience
I'm new to this board -- would appreciate your help.
First a little background -- I'm 32 years old and since 1991 have been battling chronic fatigue (and associated symptoms such as sinus infections). I initially sought medical help, but eventually gave up, lived with it, and focused on improving my diet and trying various herbal/vitamin regimens (with limited success). I made very slow gains over the years, but was still only about 60% of normal.
Eventually, I took things into my own hands and in 2001 determined that I might be hypothyroid. I visited a well known endo in Houston who diagnosed me with hypothyroidism (even though my TSH was within the "normal" range). He started me on low dose Armour and then added Synthroid. Since I started thyroid replacement, I've made rapid gains in health. My testosterone was also low (especially the free testosterone), and the doc wanted to start me on testosterone replacement. The side effects of this really scared me (infertility, etc.) so I never began testosterone replacement.
In 2003 I switched to an endo in Dallas that currently has me on 60 mg. (1 grain) of Armour per day and also 25mg of Clomid every other day. The Clomid is intented to increase the amount of testosterone my own body produces and it apparently has worked - my total T has increased from about 300 to over 500. This doctor has a very conservative approach, which I appreciate.
Overall, I feel 80% normal and even have periods of a week or more where I feel 100%. I am able to excercise regularly and am in the best physical shape of my life. I haven't had a sinus infection in a long time. However, I still tend to crash. For the past few weeks, I wake up feeling good and this continues throughout most of the day. However, in the late afternoon or early evening I crash. I start feeling very fatigued, dizzy (esp. when I stand up), and my brain is foggy. If feels like I would imagine hypoglycemia feels. This continues until I go to bed at night. After a night of sleep, I feel fine again -- and the cycle repeats.
So, I have a several questions for those that are more experienced than me:
1) Is it possible that my Armour dose is too low? I've read that it sometimes takes 2 grains or more per day to "turn the corner". On my current dose, my morning body temp is still low -- usually under 97.5 degrees and sometimes under 97.0. I've tried splitting my dose into a morning and afternoon dose and that doesn't seem to make a difference.
2) When my current endo switched me to Armour-only from Synthroid plus Armour (at my request), my TSH went up from about 1 to about 3. Would this indicate that the mix of Armour + T4 is better for me?
3) Could this be an adrenal problem? I've read a lot about adrenal fatigue and my symtoms definitely correlate. I recently has a morning cortisol test done and the value was 26.7 which is actually above the normal range of 3.1 to 22.4. But as I stated previously, I feel fine in the morning and crash in the evening. I've read that 24-hour saliva tests are the best way to accurately evaluate the adrenals. Is that something I should do?
4) My DHEA value is around 250 -- on the lower end of the "normal" range. SHould I try a low dose of DHEA to see if that helps?
5) Should I buy a blood glucose test kit and check my blood sugar when I feel bad to see if it is low?