Senior Veteran (male)
Join Date: Aug 2001
Location: Euless, TX
Re: Thyroid concern
Considering your symptoms, it sounds more to me like you have advanced adrenal fatigue--ESPECIALLY the anxiety and the low blood pressure. Often this is found with LOW thyroid conditions, but the lab results in that case tend to all come out "low-normal" and most doctors will overlook that, not realizing that it is a problem. I fall into that category, but am lucky enough to have a savvy doctor who recogniced the pattern of symptoms and blood tests and treated me.
I copied this from a discussion on a case similar to yours. It is long, but I think much of it will hit home for you.
Q: I am a 38-year-old male, 5 feet 9 inches tall, and I weigh about 142 pounds. I’m slim and relatively fit. I have been overworking and quite stressed for about three years; I worry and sleep badly. About two years ago, I got a pain in my chest just above and to the right of my left nipple, and my left arm felt slightly numb. I went to my doctor. He used his stethoscope and found nothing and took my blood pressure and said it was “a little high.” He thought the pain was just “muscular” and nothing to worry about. The chest pain and left-arm ache have persisted. They aren’t agonizing, but they play on my nerves.
I have periods now of intense fatigue. I get irritable easily, especially when stressed or even if I am late in taking a meal. Particularly when I am in hot climates or when getting to my feet quickly, I can feel dizzy. Do you think that I may have the beginnings of a heart condition? Should I go to the doctor again and demand further tests?
A: I know your primary concern is your heart, and I will give you a few thoughts on that subject, but considering that your doctor has assured you that you do not have a heart problem, I would like to focus this column on your intense fatigue, your other symptoms of irritability, poor sleep and overwork and, finally, your general high levels of anxiety and stress.
First, about your heart: Chest pain and left-arm numbness certainly suggest coronary artery disease. I would insist that, at the least, your doctor arrange for you to have a treadmill electrocardiogram. He may be an excellent clinician, but just taking your history and performing a physical examination may not be sufficient to rule out coronary artery disease.
In addition to electrocardiograms, several kinds of noninvasive scans can help rule out this problem, as can coronary angiography. Either blood-cholesterol, triglycerides and homocysteine levels in high-risk range or a family history of heart disease should prompt your doctor to do a more extensive work-up, regardless of your relatively young age.
Back to your other current primary symptoms: You complain of intense fatigue, dizziness when you get up too quickly from sitting or lying and irritability, if you delay a meal or become stressed. You appear to have some of the classic symptoms of adrenal fatigue.
The adrenal glands are thumb-sized endocrine glands that sit atop each kidney. They each have different sections that produce a variety of hormones. Two very important ones from the cortex of the adrenals are cortisol and dehydroepiandrosterone (DHEA). Each has vital functions.
Under stress, a normal adrenal will produce extra quantities of both hormones. They give you energy, reserve, and resistance to the mental, emotional and physical effects of stress. You cannot live without your adrenals, and you cannot thrive without healthy adrenals.
When stress is severe or, as in your case, becomes chronic, the adrenals are often unable to maintain the extra DHEA level. (The elevated cortisol levels can go on for years.) This divergence is the crux of how stress can deteriorate your health. Excess cortisol without the protective effects of adequate DHEA levels becomes destructive. Protein synthesis is inhibited and protein breakdown occurs. Numerous dysfunctions can occur in:
The nervous system: poor memory, poor concentration, cognitive disturbance, sleep disturbance, irritability and sometimes depression.
The immune system: less defense against infections, allergies and cancer.
The musculoskeletal system: a decrease in bone density, poor muscle metabolism and repair, which can lead to muscle pain, easy injuries and slow healing.
The skin: accelerated aging.
The liver: diminished detoxifications of chemicals, heavy metals and other toxins.
The endocrine system: hypothyroid symptoms, hyperestrogen symptoms, hyperglycemic or hypoglycemic symptoms.
The first stage of adrenal imbalance, when symptoms from stress first become apparent, is usually defined by elevated cortisol and relatively low DHEA levels, or an increased cortisol/DHEA ratio. In this state, individuals have a variety of symptoms — sometimes minor, sometimes severe — but can still usually push themselves to function, at least at a minimal level.
More deteriorated levels of adrenal function occur when the once-elevated cortisol level finally falls to abnormally low levels. In such cases, individuals have great difficulty starting their day, are barely able to make it through a normal day, and are often required to severely limit their activities. They are subject to hypoglycemic episodes— low blood pressure with dizziness and lightheadedness — and are profoundly fatigued.
The trouble with standard adrenal urine tests or the standard adrenal blood tests is that they will almost always be interpreted as normal, unless the adrenals have completely ceased to function. There is usually no in-between, no gray zone. It is only by measuring salivary levels of bioactive cortisol and DHEA that I am able to define where my patients lie on this spectrum of adrenal function. With this information, I am able to intervene effectively.
For treating those with increased cortisol/DHEA ratios as well as those with suboptimal cortisol levels, I often emphasize B-complex vitamins with extra vitamin B-5, vitamin C, zinc, magnesium and Siberian ginseng. Extreme cases of elevated cortisol/DHEA ratios in adults will require a temporary prescription of low-dose DHEA (as long as the patients don't have estrogen-sensitive conditions, including breast cancer and possibly endometriosis, uterine fibroids and cystic breasts, or testosterone-sensitive conditions such as prostate cancer). For low cortisol levels, I will recommend whole licorice root extract according to the times of day the cortisol levels are low, as long as the person doesn't have high blood pressure. In the more extreme cases of low cortisol, I will recommend a temporary prescription of low-dose hydrocortisone according to the times of day the cortisol levels are abnormally low. For those with high cortisol/DHEA ratios I will recommend phosphorylated serine. For all of my adrenal patients, I would recommend a whole-foods diet with minimal sweets, alcohol or caffeine, adequate protein and not too much starch. I also have them avoid skipping meals and, perhaps, having five to six smaller meals throughout the day.
Stress management is also a vital aspect of an adrenal-restoration program. This includes such measures as adequate sleep, adequate but not excessive exercise and finding time for recreation, fun and relaxation. (I often teach my patients a skilled relaxation exercise.) Resolving emotional conflicts, often with a therapist, has been key for many of my patients in order for them to experience the nurturing, affection, love and laughter that human beings require for optimal health.
Doctors don't often assess adrenal health in patients with chronic fatigue, depression, headaches, irritability, muscle and joint pain, fibromyalgia and other conditions and symptoms. When they do, they rarely order the kind of tests that will find a definitive adrenal abnormality and indicate a definitive treatment. It is a sad fact that the majority of those with the kind of "gray-zone" abnormality I have described will often be told that nothing is wrong and that their symptoms are all in their heads. For many of them, their symptoms are likely a result of adrenal dysfunction.
<p>[This message has been edited by Meep (edited 01-01-2002).]