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    Old 07-14-2008, 05:37 PM   #1
    sparkles916
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    Why I am Having Difficulty with HC Replacement?

    I have only been diagnosed with partial AI, and my Dr hoped that a ful replacement would help me and most importantly enable me to go back on thyroid meds, which he agrees I could no longer tolerate due to the stress the thyroid meds put on my adrenals. I likely had weak adrenals or partial AI for some time as I was undiagnosed hypo for many years.

    I wrote an earlier post, likening my trouble tolerating HC replacement 3x per day, as "chasing the tail of the dog". I am still full of ups and downs, and have moved my dose to AM only - which help a little.

    I could not tolerate 20, went down to 17.5, then 15, then 12.5. In the AM with 12.5, there ensued hours of "surges" of anxiety and other overstimulated feelings.

    I had to cut back to 10. I think my HPA axis is depressed now that I have been on HC for alomst a month. Since I have not stabilized, I cannot try thyroid meds again.

    The anxiety and depression fill the day, with periods of relief from it - when I presume my normal (but depressed)cortisol rhythm picks up.

    I don't know what is going on here. Any ideas?

     
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    Old 07-15-2008, 06:38 AM   #2
    rumpled
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    Re: Why I am Having Difficulty with HC Replacement?

    What are your test results? 24 hour urine cortisol? Serum cortisol? Renin? Aldosterone? TSH? Free T3, Free T4?

    Taking HC once a day is... difficult. Your problems could lie elsewhere and the steroids could be masking them.

     
    Old 07-15-2008, 07:27 AM   #3
    sparkles916
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    Re: Why I am Having Difficulty with HC Replacement?

    The main mechanism for my anxiety and depression seems to be the thyroid, but is exacerbated by impaired and depressed cortisol rhythm. I was doing GREAT for the short time I was on Armour. Prior to that, no doing to shabbily on levothyroxine for a year and half. Came to a point where I could no longer tolerate thyroid meds. It has been downhill from there.
    ------------

    Recent thyroid test (no meds 5 weeks+)

    TSH: 5.121 (.350-5.5)
    FT4: 1.04 (.61-1.76)
    FT3 2.8 (2.3-4.2)

    -----------

    I suspect my adrenals were bad all along? since I went untreated for so long.


    My dr has settled on the diagnosis of hypothyroidism and partial secondary AI.


    ADRENAL TESTS

    DHEA-s 40 ug/dL (32-240) 2/8/08
    (day 8 cycle; 8:30 AM)

    ACTH Stim 1/23/08

    Cortisol, A.M. 14.5
    Cortisol 30 minutes 31.7
    Cortisol 60 minutes 33.6


    Prior AM draw

    Cortisol 17.2 mcg/dL (4-22)
    8/1/07
    7AM

    ACTH 11 pg/mL (5-27)
    8/1/07
    7MA


    ________________________________________ _______________________
    Saliva test 11/14/07
    (diagnos tech)

    free cortisol rhythm

    7-8AM 15 nM normal 13-24
    11-noon 3 nM depressed 5-10
    4-5PM 4 nM normal 3-8
    11-midnight 2 nM normal 1-4

    cortisol burden 24 (24-42)

    DHEA pooled value 1 depressed (3-10 ng/ML)
    ________________________________________ _________________________

    Repro hormones
    5/08

    Progesterone: 25.8 ng/mL mid-luteal (4.4 – 28.0)
    (day 21)

    Estradiol 315 pg/ml follicular no range
    (day 10)

    Testosterone 22 ng/dL no range
    (day 10)

    LH 9.0 mIU/mL no range
    (day 10)

    FSH 4.1 mIU/mL no range
    (day 10)

    free Testosterone 1.3 ng/dL (1.1-5.8)
    (day 10)

    ________________________________________ ______________________

    Vit D & Iron

    Ferritin 23 ng/Ml (10-291) 6/8/08


    Vitamin D, 25 hydroxy 21.6 ng/ml L (32-105) 2/14/08

    Last edited by sparkles916; 07-16-2008 at 01:42 PM.

     
    Old 07-16-2008, 07:30 AM   #4
    rumpled
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    Re: Why I am Having Difficulty with HC Replacement?

    Your TSH is too high by today's standards (.3-3) but your FT3 and FT4 seem to be in ok ranges. I feel much better when my TSH is lower. So with a TSH that high, I would feel like garbage.

    I have not had a stim test, but from what I have read, it looks like you have "passed". So while you have had some low readings, not sure.

    You really need vitamin D and iron. Try D3 - 1000iu daily and take iron daily to help. That will make a difference. Read the bottles so you don't take them when they interfere with the other meds.

    There could be more going on, but your doc has not done enough tests - you could be going hypopituitary or more... does your doc treat a lot of adrenal patients - is he/she a neuro-endocrinologist?

     
    Old 07-16-2008, 01:37 PM   #5
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    Re: Why I am Having Difficulty with HC Replacement?

    Quote:
    Your TSH is too high by today's standards (.3-3) but your FT3 and FT4 seem to be in ok ranges. I feel much better when my TSH is lower. So with a TSH that high, I would feel like garbage.
    I do feel horrible. I just wish I could get back on thyroid meds, esp Armour.

    Quote:
    I have not had a stim test, but from what I have read, it looks like you have "passed". So while you have had some low readings, not sure.
    I did plenty of reading up on secondary AI. I know I don't have complete AI, since I would have failed the stim test. But, there is room for accepting a diagnosis of partial AI, or at the least HPA axis failure, or dysfunction.

    It is clearly shown in the low normal ACTH (or alost below range if one uses the older ranges that have 10pg/mL as the low end) and by the low DHEA-s, and resultant low testosterone.

    Quote:
    You really need vitamin D and iron. Try D3 - 1000iu daily and take iron daily to help. That will make a difference. Read the bottles so you don't take them when they interfere with the other meds.
    I restarted my iron therapy. Obviously an increase in three points in a year is not sufficient. (was 20 feritin), so now I am taking iron twice a day.

    The vit D I have just started on. Dr recommened 5000+ IU.

    Quote:
    There could be more going on, but your doc has not done enough tests - you could be going hypopituitary or more... does your doc treat a lot of adrenal patients - is he/she a neuro-endocrinologist?
    What tests are you thinking of?

    My dr is an MD who specializes in hormone treatments. I got his name through one of the adrenal boards. Apparently he does treat a number of cases like mine. He is willing to work with me at least.

    I have spent a fortune! and many hours over the course of a year and a half to get this far. Most endos had no explanaiton why I could no longer tolerate the thyroid. I have been yelled at, humilated, and told to up my psych meds. I decided to find a dr who already practises the protocol I wanted to try - using cortisol to support thyroid therapy.
    ___________________________

    I wondered if you had any explantion why I would feel "overstimulated" on a moderate level of HC, and why I experience the very bad dips in cortisol which precipate extreme anxiety? Do addisons persons have function of the adrenal medulla? I was thinking about some mechanism increasing my epinepherine when the cortisol wears off?

    However, since I switched to AM only, the dips in their intensity have leveled off. I presume that in following the "traditional " treatment advice to take the HC before 8AM so as not to interfere with the HPA axis, seems to work better for me. But it is still a difficult time....not at all like I expected.

    Finally, I do have a another variable in the mix - my psych meds. I was put on them (4yrs ago) when I should have been treated with thyroid meds and/or cortisol. They are Seroquel and Lexapro. I read that the Seroquel, even in small doses as I am taking (after tapering last year) can still significantly lower ACTH and cortisol. The Lexapro lowers T4.

    I don't know if my HPA axis has been permantnely "down-regulated", which is the purpose of the Seroquel, and neither do I know about the long -term effects of SSRIs. I never should have been put on these drugs, esp. Seroquel, since I was already "down-regulated" becasue of my existing endocrine disease.

    My medical records show I was already hypo 4.0 TSH and .9 FT4 in 1995! If only I had known!

    To say I am distressed over my situation is putting it mildly

    Last edited by sparkles916; 07-16-2008 at 01:45 PM.

     
    Old 07-17-2008, 09:23 AM   #6
    rumpled
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    Re: Why I am Having Difficulty with HC Replacement?

    Armour is a great drug, but it has a very high ratio of T3 (higher than usual in a human) which is not right for everyone so you may do better with a T3/T4 combo including cytomel so you can control how much T3 you get or add T4 to the armour.

    DHEA sulfate, IGF-1, prolactin, renin, aldosterone, I would ask for and mind you - renin is just as fussy as ACTH - chilled lavender topped EDTA tube, spun immediately and frozen promptly or you results will come out lower than they really are as they degrade at room temp in minutes so if the lab tech tosses the room temp tube in the bin - you are sunk. Did lab error skew your last results?

    Usually HC only lasts 6-8 hours so weird that you can go the afternoon without. The other meds may be the factor.

     
    Old 07-17-2008, 05:02 PM   #7
    sparkles916
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    Re: Why I am Having Difficulty with HC Replacement?

    I dont' know how accurate the ACTH was, but one can only hope....

    I did have the DHEA-s done, and it was 40 ug/dL (32-240) 2/8/08
    (day 8 cycle; 8:30 AM) - I did some reasearch and saw it is a level typcial of the geriatric population

    I am still thinking Armour is too high T3 for me, as you point out. I was thinking of doing the thyroxine/Armour combo.

    Incidentally, I tried to go back on thyroxine only back in February and it was still a no go. I was soooo upset.

    I do crash in the afternoon, but feel like I have a hangover each morning anyway. There is something out of whack. But, I know the CRAZY train was related to the 3x a day dosing, Can't go back there at the moment.

    I did find somethig of interest re my "sensitivity" to 20+ HC. I found that There is an enhanced effect of corticosteroids on patients with hypothyroidism Apparently, this is due in part to a slower metabolic clearance of steroid.

    Finally, I wondered if you have encountered any stories related to photosensivity and HC. I seem not to be able to go out in the sun. It seems to have coincided with my HC treatment. Very upsetting.

    I really appreciate your replies, Rumpled.

    Last edited by sparkles916; 07-17-2008 at 05:03 PM.

     
    Old 07-17-2008, 08:00 PM   #8
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    Re: Why I am Having Difficulty with HC Replacement?

    Hi there

    I am wanting to go on HC replacement in order to get my Armour up, however I wouldn't be able to do it if my ferritin levels were down there. The ideal is between 70-100.
    If you are not getting the adequate thyroid hormones you would most likely suffer the associated black moods. Your HC is needed to get the T3 into the cells, but the ferritin is needed for you to tolerate the thyroid hormones. I am sure there is a lot more to it than that too, but I am not an expert just another sufferer.

    If I were you I would work on getting the ferritin up. Also have you tried B12 and folate, and B6 all needed to dispell anxiety, you would probably need b12 if it is under 550.

    lotsa luv
    Whittersx

     
    Old 07-18-2008, 05:28 PM   #9
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    Re: Why I am Having Difficulty with HC Replacement?

    Yep. I know about the moods. The only thing that keeps me going is when I reflect on how wonderful I felt on Armour. Not only did I have energy, and had started to see my eyebrows back, my skin regain its oil, but my mood was so fantastic. It was like I was looking through rose-colored glasses, literally. Things seems to have a hue, like in those homey commercials on tv. I was "present" in the world (= no anxiety) and just so calm and happy.

    On my bad days, I remember it and know I can be there again. If it weren;t for this knowlege that there is something better than the state i am in, I would have given up long ago and just slogged on until my body and mind fell to pieces.

    I was taking iron on an irregualr basis (44mg elemental), but obviously, not much changed in a year. I am now doing twice daily at the prompting of my dr.

    I have tried to read around on the issue, and I have found the same thing you say about the 70 -100. Did you have intolerance and did it resolve with optimizing your ferritin?

    I do attend to my b12 which was in the tank and I take the 2000mcg methylcobalamin sublinguals every day. I also take b complex sublingual.

    What is your adrenal situation and current Armour dose? I am always glad to compare notes with a fellow sufferer thanks!

    Last edited by sparkles916; 07-18-2008 at 05:28 PM.

     
    Old 07-18-2008, 05:54 PM   #10
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    Re: Why I am Having Difficulty with HC Replacement?

    Hiya hon
    I am currently just tolerating 1 3/4 grains of Armour, I am having problems with anxiety too when I raise, takes ages for me to level out and I feel wiped out and breathless, however I am still nowhere near as wiped out and breathless as I was when I was on Levothyroixine.
    I had a scary episode on that when I became confused, vomited, dizziness (I had had periods of dizziness for months) and apparently my pupils contracted and then relaxed when the doc shined the light in, I was admitted to hospital and they found nothin on a CT or any other problems. I have high BP and due to the confusion I suppose thats what the CT was for, but they did not put the episode down to anything at all.

    So I have the problem of low saliva results for cortisol and no doc who is willing to prescribe me anything for it because my am cortisol was considered within range. My ferritin was 60 when I had it tested not as bad as yours. My B12 was also within range but when I took some my peritonitis stopped (gums had been bleeding for months and was getting infections) and I could breathe better.

    Your question about the intolerence, yes I do to a certain extent have that as I explained I feel rotton on a raise, I understand when I raise I should be increasing adrenal support for a while each time, however my adrenal support is insufficient anyway as I cannot get hold of hc. The reason I mention the ferritin is that on the sites I have been on really regularly they always point to that as a major issue if you have problems tolerating armour or t3 and I do believe Janie says why in her book Stop the Thyroid Madness.
    I honestly think a lot of this stuff happens because we suffer malabsorbtion due to our slow metabolisms and vital nutrients are missing. I am trying to put all that back with supplements. I use magnesium and calcium and the magnesium helps with muscle spasms. I use B comples sublingual, B12 sublingual, garlic for inflammation, vit c high dose for adrenals, adrenal cortex extracts sublingual, turmeric for inflamation, iron and vit C tabs, multivits, Q10, Vit D3 and unfortunately I am also stuck with old stuff from the seperate diagnoseses of depression and anxiety over the years, diazepam which unfortunately uses the T3 transporters, Seroxat, I am on Bp lowering meds which interfere with my Aldosterone called Olmatec and a water pill.... catches breath lol.
    I am STILL looking for a suitable doc. One thing that did happen since I went on Armour which is worth a million, is that I no longer take my asthma meds as much, and the pains come and go whereas on Levo they were always there and I don't have as many black moods. I am still way under dosed so I do still have a lot of problems. That is why your post struck my eye. Adrenal issues are close to my heart, I read loads of forums and take part in quite a few to try and further my knowledge of this darn disease. I also read with interest papers on AI thyroid problems and adrenal issues. I also have a great interest in nutritional disorders and their relationship to anxiety disorders and mental issues.

    Sorry to ramble lol.

    God bless
    Whitters

    Last edited by whitbywife; 07-18-2008 at 06:06 PM. Reason: typos

     
    Old 08-18-2008, 08:11 PM   #11
    dalmatinka
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    Re: Why I am Having Difficulty with HC Replacement?

    Quote:
    Originally Posted by sparkles916 View Post
    I have only been diagnosed with partial AI, and my Dr hoped that a ful replacement would help me and most importantly enable me to go back on thyroid meds, which he agrees I could no longer tolerate due to the stress the thyroid meds put on my adrenals. I likely had weak adrenals or partial AI for some time as I was undiagnosed hypo for many years.

    I wrote an earlier post, likening my trouble tolerating HC replacement 3x per day, as "chasing the tail of the dog". I am still full of ups and downs, and have moved my dose to AM only - which help a little.

    I could not tolerate 20, went down to 17.5, then 15, then 12.5. In the AM with 12.5, there ensued hours of "surges" of anxiety and other overstimulated feelings.

    I had to cut back to 10. I think my HPA axis is depressed now that I have been on HC for alomst a month. Since I have not stabilized, I cannot try thyroid meds again.

    The anxiety and depression fill the day, with periods of relief from it - when I presume my normal (but depressed)cortisol rhythm picks up.

    I don't know what is going on here. Any ideas?


    This is an old post but I wanted to reply anyway because I have difficulty with HC, and your situation is very much like mine.

    I can't tolerate thyroid meds, I am on very small dose of Armour, my last ferritin was 7 and I can't tolerate Iron supplements either. I have been struggling with this for six long years already and nobody wanted to treat my adrenals until now. I was so optimistic and hopeful when I was prescribed Cortef, , but ever since I started it things are going even more south.

    That was about a month ago when i started taking Cortef, but I feel worse now then I was before I started it. My problem before was that I had no energy and I couldn't tolerate thyroid meds, even vitamins, but ever since I went on Cortef I have many more symptoms. First of all I don't feel good after I take a dose, but couple of hours after I take it I get very sick, crashed, nauseated, faint, my back hurts a lot, I get nervous, just feeling terrible. Then when I take another dose those symptoms go away but I still don't feel right and I feel worse then before I ever started Cortef. It seems to me like I am totally suppressing my own production of cortisol, but dose that I take is not enough to compensate. If I take higher dose I feel lightheaded and still very crashed and just not right. I have not been on steady dose long enough because every dose I tried is not working and I have no idea what to do next.
    Lately I have been taking 5 mg first thing in the morning, 5 mg at around 11 am, and 2.5 mg in the afternoon. I tried 7.5 mg in the morning but I felt worse then after taking 5 mg, and even worse couple of hours later when it wears off.

     
    Old 08-19-2008, 07:40 PM   #12
    sparkles916
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    Re: Why I am Having Difficulty with HC Replacement?

    Yes, I am sure you have suppressed your own function by now. I wondered what your adrenal function test(s) showed, and what your doctor's protocol is.

    I tend to agree with those who say that usually one needs a full replacement dose, e.g. 20 mg HC per day total. The only problem with this is if the patient (like me) has a hard time tolerating the HC itself and dealing with the dips in cortisol throughout the day.

    I have heard that (and my dr mentioned) the possibility of using a long-acting steroid. It is not as good as HC in terms of it not being as close as possible to bio identical, and other problems with long-acting steroids that are said to exist. I did have recommended Medrol to me by my dr and on a few forums, I have read about people who seem to have success with this, when the short-acting HC is not working out.

    I chose not to go this route ....though I may change my mind in future, since I had also such a hard time with the HC itself. I don't know what was the cause, maybe it was the lack of cortisol in my body for so long that caused a sensitivity (as my dr suggested), or it could be from the mineralcorticoid effect of the HC (it seems different steroid have different minerocorticoid effects). I do know that I have some kind of predisposition to anxiety and depression due to low cortisol and this compounded the problem for me. I really don't know the total answer.

    I too thought it would be an easy path to start the HC and then back on the thyroid meds. I am sorely disappointed.

    I stopped my HC exactly two weeks ago after tapering down (2.5 mg/week after shifting to a morning only dose). It was not easy. The past two weeks have been pretty nasty. The old symptoms subsided, like those surges and palpitations I experienced after taking the HC, and the EXTREME anxiety and sometimes crying jags, and crippling fatigue during the in-between dose times...especially in the middle of the night. So bad it would wake me up in a panic. I felt better reading on pubmed about the psychiatric manifestations of untreated addisons (for the sake of discussion low cortisol) can include anxiety and depression.

    All that has stopped. Now I am just normal super fatigued, with a little residual anxiety...though that is likely due to my adrenals still being suppressed - and of course the hypo. It is hard to tell what is what. BUT, I can say that the negative effects I experienced from being on the HC have subsided. No more ups and downs

    I have been profoundly dizzy and nauseous for nearly the whole of the two weeks. Luckily, I just have a little dizziness now, mostly when I drive

    I was starting to despair that I would ever get better from these new symptoms. So, I turned to the internet. I found some info on symptoms of suppressed HPA axis, and I fit the profile with the dizziness and nausea.

    Unfortunately, I found mixed opinions on how quickly the HPA axis resumes function from being suppressed, and also adrenal function itself. I found on a medical school website some excerpts from an internal medicine book in Q& A form, where it was stated that HPA axis is suppression is pretty much certain to occur even a t physiological doses, ESPECIALLY if the steroid is taken throughout the day and at night. Pretty much my profile and likely yours.

    So, where some say two weeks, others say longer. Everything depends on the individual's response, the amount of steroid, the length of time it was taken and whether the patient dosed throughout the day. So, I suspect I am looking at 2-5 months for HPA axis to resume as this one excerpt says. And, it can take longer for the adrenal glands themselves to recover full function (what ever "full" was before presumably) I decided that if at the two week mark all was not greatly improved , I would start assuming that mine will be the longest of possible recovery times, so I can stop fretting.

    I have been getting a tiny bit better on the dizziness, nausea front every day. It is certainly better than what I experienced on the HC.

    If, in the end, I go downhill, because of the length of time my HPA axis and adrenals are suppressed and somehow it exacerbates the hypo part of my illness, and I go completely to pieces, I will consider trying the long-acting steroid.

    Hope this is not too long and that you find it of some help.

     
    Old 08-20-2008, 12:27 PM   #13
    dalmatinka
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    Re: Why I am Having Difficulty with HC Replacement?

    Thanks for the post.

    My cortisol was...

    AM 10 (13-24)
    Noon 4 (5-10)
    PM 3 (3-8)
    Midnight 22 (1-4)


    My doctor thinks that my adrenals are pretty bad, but same as you, I am stopping Cortef. I tried it for a month and I felt worse then before I started it. If the reason I felt worse was because I wasn't taking whole 20 mg, what can I do, more I took worse I felt. He wants me now to try two different things, but first one then another one. One is anti fungal meds. He thinks that there is a possibility of yeast, and there is no way to test for it but to try meds. If I don't feel better in two weeks then I'll try DHEA. He said since Cortef did not worked we need to take back door approach. I can do one or another first, I think I might try DHEA first, not sure yet. I did tried it few years ago and it did not work, but I am willing to give it another try.

    Have you ever consider slow release Cortef? I am sorry if I asked you this before. I have, but only 2.5 mg 2x a day, for two days only, and I felt awful. Maybe dose was low, but I never try different dose.

    I also think that big part in all this is being too low on everything for years. I had anxiety and PA since I was 20 (I am 50 now) and I had hypo symptoms several years before I was diagnosed. I was anemic last 10 years al least if not longer. All that is telling me that my adrenal and thyroid function was low all that time.


    I am glad you are over with HC for now. I didn't take my pm dose yesterday and today I only took 2.5 mg so far. My doctor told me that I can just stop because I was not taking high dose, but I was getting very sick this morning so I took 2.5 and it helped.

    How is your TSH and Free's, and what dose are you on for Thyroid?

    I am taking .31 grain Armour 2x a day, and I am trying third dose, but not every day. I think there is a hope, ha ha, unless stopping Cortef effects me negatively.

    I can't say that I regret trying Cortef because it was reasonable thing to do, but I am way worse now then before, and I am tired of feeling like this.

    Thanks

     
    Old 08-21-2008, 08:49 AM   #14
    rumpled
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    Re: Why I am Having Difficulty with HC Replacement?

    Dalmatinka - your late night high reading is diagnostic for Cushing's disease. Were you taking steroids when you had that reading? Your testing shows a loss of diurnal rhythm and no wonder you feel awful. If your cortisol is high all night, and low all day, it means you are not sleeping and have no energy all day.
    Please get to a special (neuro-endocrinologist) to help you. Get more testing.

     
    Old 08-21-2008, 11:15 AM   #15
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    Re: Why I am Having Difficulty with HC Replacement?

    I agree with Rumpled about your elevated evening cortisol.

    I am on no thyroid meds as I cannot tolerate any at all. I tried recently twice and could tolerate nothing. I wasted about six months on that experiment...thus, why after a full year of thyroid meds intolerance, I was desperate enough to try the HC.

    I may consider the SR Cortef in future as an option.

    I just want to wait to see what level of adrenal function returns before I rethink my treatment plan. If you haven't read my other posts, I was put on Seroquel and Lexapro some years ago as a result panic anxiety and depression I was suffering from . It has been going on since my early twenties, if not from my teens.

    Of course, no one noticed at the time, my hypo condition, and likely I always had concomitant adrenal issues, since my old medical record (recently discovered) showed I had a TSH of 4. something in 1995!

    The Seroquel lowers cortisol. I am on and have been on for over a year on ly 25 mg. The therapuetic dose is 150 or more, usually 300+. I started tapering psych meds after I felt SO god on thyroid meds, and stopped taper after I started having the intolerance to the thyroid meds.

    My recent experience with low cortisol - panic, extreme anxiety, periods of crying, being all over the place mood-wise showed me what physcial mechanisms are at work with regard to my "psych illness", and encouraged me to reduce the remainder of the Seroquel.

    I am halfway there, and at this point, it is a race against time. I am so low in terms of adrenal function now that I have suppressed my function as a result of being on the HC, that I must get off the Seroquel asap. It is really throwing a monkey wrench into things.

    I found some lit on pubmed saying that doses of 25 -50 can significantly reduce cortisol. So, I had thought I was ok at this does, and now, I see that it may have been enough to thrown me into some seconday AI, and cause the intolerance to the thyroid meds.

    I would love to quit the Seroquel althogtether, but I have to go slowly, to avoid withdrawal symptoms. So, must be patient.

    At the moment, I am sooooo weak and fatigued . A new development is breathlessness. I am a bit scared, but must keep going. Anything (almost) is better than what the low cortisol episodes were like during the course of the day while on HC. If I had felt good after taking the HC, instead of surges of adrenaline feelings, I would have considered working with the HC longer.

    Anyway, I have traded one set of problems for another, but it seems that this is better. I am afraid that I have put myself in a precarious position with regard to my adrenal function, but I have to believe that it will get a least a little better. I'll give it a little longer.

     
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