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nervx 07-18-2008 10:14 AM

Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
Hi Everyone -- I'm reposting this here, as it was suggested this forum may be able to provide more help. I'm feeling very vulnerable and hoping someone can offer input.

I'm feeling just terrible, like my life has been put on hold, barely able to function. I'm very concerned being as I am currently single and living on my own, plus I am self-employed, so have no avenues for support while I deal with this. I have limited funds available to deal with these health issues (due to recent "divorce" and having started my own business!), and I have Kaiser for insurance, so am limited in that area as well (although my doc is open minded, so that's good, at least). I'm hoping someone might be able to offer input/experience regarding my situation. Wondering what the best way to deal with adrenal fatigue is, in conjunction with Hypo.

I'm suffering from what seems to be a mod to often severe case of adrenal fatigue (I've been under [U]enormous[/U] stress for many years), plus Hypothyroidism. I have difficulty in concentrating and thinking, I forget things easily, and I have very little energy (can no longer exercise or even work regularly). I feel tired all the time, and have gained a little bit of weight around the middle. I feel worst in the morning/first part of day, and best in the eve. The symptoms started about a year ago, and at that time I felt poorly in the morning, but was able to function in the late afternoon/eve. Then in January of this year, things got much worse, and the symptoms seemed to be with me the entire day. And just this week, my hands are starting to feel a bit numb and tingling. I think I may have had some level of this stuff going on for many many years though, undiagnosed.

I have Kaiser, and saw my doc in March 08 for the above symptoms. He did some lab work, including running thyroid tests. I now know that I need to ask for Free T3 test and will have this test run in the future. I'm also going to ask for Ferritn test (sp?). I've been tested for B-12 (was OK), and Vit D (was on low side of normal range). Below are the results from the thyroid tests:

March 08: T3 -- 92 [58 - 159], Free T4 -- .85 [.70 - 1.48], TSH -- 1.06 [0.4 - 4.00], TPO -- <60 [ - U/mL]

He then put me on Levothroid, which I started VERY slowly, as I'm quite sensitive to meds. Starting dose was 1/4 of a 25mcg / .025 mg tablet (which I know is hardly anything), and I worked up to a full tablet over 3-4 weeks. I noticed a difference in energy on the second day actually. I think the following test results were obtained after I'd been on Levo for awhile, but I'm not sure if I had started the Armour yet as well (more on that next).

From May 08: T3 -- lab forgot to run this test [58 - 159], Free T4 -- ..84 [.70 - 1.48], TSH -- .92 [0.4 - 4.00]

I started to feel a bit better on the Levo, but I also started getting really intense heart palpitations (like I said, I'm sensitive), and could not sleep, so I went back to the doctor to discuss options. I was told by a couple of people who have hypothyroidism, that Armour was tolerated much better, and that T3 is often also needed in addition to T4, so I asked if I could try Armour, and my doc agreed and prescribed a very low starting dose of 15mg. I worked up to taking about 25 mg and that's where I've been for some time now. I've been feeling a bit more energy (relative, mind you), compared to how I felt in January, but I think the Levo was helping a little bit more....BUT, I cannot tolerate the Levo, so I don't know what to do (Is there a natural T4 booster available?). It seems my latest test results, shown below (just had lab work done yesterday), suggest that I need to take something for T4 specifically (but then what about T3?). I'm also not understanding the change in TSH value.

From July 08: T3 -- 130 [58 - 159], Free T4 -- ..85 [.70 - 1.48], TSH -- .72 [0.4 - 4.00]

Thanks so much to all who offer input. I'm feeling very depressed and like my life is over. I don't know where to turn for help. I have no family to speak of (recently split from long-term relationship + I'm an only child + all extended family is in Europe). I don't know what is going to happen to me if I don't get better and get back out there to bring in new business/$$$.

Thanks so much for any support/input you can offer.

sparkles916 07-18-2008 04:10 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
Hi: I understand what you are going through. But, first I would like to ask you what your Dr said with regard to your oriiginal TSH being pretty much the popluation average, "good" TSH, and your Ft4 being so low? The classic hypo scenario is elevated TSH and either low or below range Ft4, Ft3.

It could be a secondary hypothyroidism, but I am not sure if the TSH has to be really low or not. It could be that all that is necessary is to have [I]inadequate [/I]TSH, to put out a decent amount of T4, but I am not certain. I would ask my dr.

[QUOTE=nervx;3653015]Below are the results from the thyroid tests:

March 08: T3 -- 92 [58 - 159], Free T4 -- .85 [.70 - 1.48], TSH -- 1.06 [0.4 - 4.00], TPO -- <60 [ - U/mL] [/QUOTE]

On the hard time you were having with the thyroxine - it could be you would tolerate synthroid or another preparation better. You can find this info on the web that some do better on certain preparations. I tried this, but it was not the problem.

The other main reasons are (as you might already know) adrenal insufficiency (or some degree thereof) and iron deficiency anemia (maybe low ferritin if not anemic)

You do need to check your ferritin, and some recomend it be optimum at between 70-100. Mine is 23, and has been for a year, tho I am working on it very hard now, with 2x a day iron.

As far as adrenal sufficiency (or some degree thereof), interfering with your ability to tolerate thyorid meds, you need to get the proper tests done to assess if this is the case.

If you go on Armour (or higher dose) and have this problem, you will only exacerbate things as I ended up doing. :(

I went to an integrative medicine dr, who uses saliva testing for free cortisol levels and to trace the diurnal pattern. Mainstream drs may not accept this as "proof" of anything, but it is a useful tool. If you just want to start safe, and it is all you can manage to get from your dr, I would ask for an AM serum cortisol and ACTH. This might shed some light on your situation.

Any AM cortisol between 5 and 19 mcg/dL (pretty sure on this ), is indeterminate and requires dynamic testing. This rule of thumb is comminly found in the med literature. Dynamic testing commonly means and ACTH stimulation test.

You also need a DHEA-s serum preferred to saliva. It is a useful tool in diagnosing a primary hypoadrenal vs. secondary hypoadrenal situation. It is also the precursor to much of a woman's testosterone. It is also instrumental in mood.

My DHEA-s low and so is my testosterone, while my other sex hormones seem to be ok.


As far as your treatment on levo and armour at such low levels, I made this mistake as well, and had drs talk me into it. Bascially, exogenous hormone will supress your own production. So, most people end up taking a full replacement dose. By taking a small dose, you are merely suppressing your own funtion and adding in the small mcg/mg to it. As you can see, your TSH may have gone down, but your Ft4 is basically the same. I don't know how it is affecting your Ft3, it may be that suppressing your thyroid is actually lowering yout Ft3. Have you felt more depressed since treatment? I have felt more depressed on low dose only.

Of course, you do need to check on your Ft3.

Many seem to think that once you start thyroid treatment, it is less important to look at the TSH and more important to look at the free values. Ultimately it depends how you feel.


If you are feeling depressed, it is not your fault, it is very much a consequence of your thyroid issue, and possible adrenal issue. Any search of Pubmed will provide you with tantalizing titles of articles related to psych issuses and endocrine disease.

I myself had untreated hypo for years (and maybe adrenal)...and ended up seeking mental health services. Unfortunately, I was treated with antidepressants and worse, all of which worked against my endocrine problem (s). Then one day my dr found I was hypo. Then, I ordered my old medical records and saw I had been hypo for years and years!

I was on thyroxine for about a year and then tried armour. It did uncover and exacerbate my adrenal issues, and now I can tolerate no thyroid meds of any description. I felt much better on thyroxine than without it, and [COLOR="Magenta"]fantastic [/COLOR]on Armour. I now have an adrenal situaiton I am dealing with and hopefully I will get back on thyroid meds soon. :(

mistersleepy 07-18-2008 04:15 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
Hi nervx,
you have my exact symptoms. mornings are extreme agony, no energy, no focus, wait gain, insomnia ect. my symptoms also dwindle durring the day and i feel somewhat better at night. my new upenn endo sais it is hypopituitarism. my advice would be to go to a university endo. i wasted my time with alternative docs for 7 years.(i don't mean to put those types of docs down, it just didn't work out for me though) my new doc also says adrenal fatigue does not exist. its called adrenal insufficiency. good luck.

whitbywife 07-18-2008 06:23 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
[QUOTE]'m feeling very depressed and like my life is over. [/QUOTE]

I know hon, I have felt like that many times over the years (started with my health problems at 23 I am 48 now) but don't take me as an example of what will happen, there was no internet then and a lot less information sharing. You just have to find out the root of your problem, its a long road but at least there is always someone to support us now :). Sparkle knows a lot, methinks she has read a lot :) and I can relate to your experiences and yours too Sparkle.

It seems that people and a lot of docs think that thyroid disease is simply a matter of a little pill once a day and thats that you are sorted. Oh if only eh? It may be for some but for others that have been left a long time either without diagnosis or untreated with one for whatever reason it has complicated the issue. Take in the co morbid conditions and you have a puzzle to solve, but I believe you will solve it. I am still going on solving mine.
Wishing you good luck and lots of new friends through this illness (one positive lol)

God bless

nervx 07-20-2008 10:33 AM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
Thanks to all for your input. This is very frustrating! Very hard to figure out, especially being I have Kaiser and cannot affored to go outside the HMO system. symptoms do seem to point to hypopituitarism, so I will look into this, thank you. As for seeing a university doc....would I have to pay for this, being as it's a teaching hospital? I don't know much about that type of thing. Also, do they treat people that have insurance (I have Kaiser)?

Sparkles916.....thanks for your detailed input. You've given me much to consider. One thing....I never took thyroxine though. Don't even know what it is (?). I only tried the Levo, which did improve my energy but gave me heart palps so I couldn't take it anymore. Then I switched to Armour, which as you noted, raised my T3, left my T4 exactly where it had been (sub-clinical low), and lowerd my TSH number. I feel horrible.

As for testing for DHEA and cortisol.....I've been using nasal inhalers (low dose) for rhinitis and allergies for years. It's my understanding that this fact would throw off the test results. I don't feel I can give this med up, as I can't breathe through my nose without it. I also take supplements with DHEA in them. I'm guessing this would skew results as well?

I do feel depressed, but I'm not sure if I feel more depressed since on the Armour. I feel like I've been depressed for a while now so it's hard to know when it started! All I know is that I'm largely debilitated now, barely able to carry out enough work-related functions to keep my head above water. Yikes. What is going to happen to me?

Whitbywife.....thanks so much for the support! Much appreciated. :-)

sparkles916 07-20-2008 11:17 AM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues

Sparkles916.....thanks for your detailed input. You've given me much to consider. One thing....I never took thyroxine though. Don't even know what it is (?). I only tried the Levo, which did improve my energy but gave me heart palps so I couldn't take it anymore. Then I switched to Armour, which as you noted, raised my T3, left my T4 exactly where it had been (sub-clinical low), and lowerd my TSH number. I feel horrible. [/QUOTE]

Sorry for the confusion. I get used to my own shorthand. Thyroxine is the T4 hormone, I meant by it any preparation that is "T4 only" as thyroid medicine. So, that includes, levothyroxine (the generic what you were taking), synthroid, etc.

It is possible that the Armour, even though it is a low dose and may be suppressing your thyroid function (thus your very similar FT4 level), may be giving you enough t3 so that you don't feel any worse for wear.

[QUOTE=nervx;3655279] As for testing for DHEA and cortisol.....I've been using nasal inhalers (low dose) for rhinitis and allergies for years. It's my understanding that this fact would throw off the test results. I don't feel I can give this med up, as I can't breathe through my nose without it. I also take supplements with DHEA in them. I'm guessing this would skew results as well?


If your nasal inhaler contains a steroid, yes, it would affect a cortisol test, and not provide an accurate reading of what your true state is. However, if you are feeling rotten and think it may be having some impact on your adrenal function, which in turn is affecting thyroid function and/or your ability to tolerate thyroid meds, it is worth testing - just to get a snapshot of what is going on.

As you are probably aware, a steroid based med, like asthma inhaler etc, can lead to cushings, where one has too much cortisol,. and it can also suppress adrenal function, giving one secondary AI (usually not permanent). I don't see why you dr would be unwilling to do such testing, to see if your inhaler treatment has had a negative effect.

Finally, mistersleepy is correct in pointing out possible hypopituatiary (I said secondary hypo). Your low normal TSH in combination with a low normal Ft4 is not typical of primary hypo. You really should follow up on this with your dr and see if there is something more going on here.

From a diagnostic standpoint, it is very much a part of the algorithm to test you for secondary hypo, [I]at the least[/I]. Your dr and insurance co should be able to do this for you. With a low-normal Ft4, you should have an elevated TSH. You do not, and in fact, yours is low normal. A good dr would pursue this.

nervx 07-20-2008 12:52 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
Thanks Sparkles916, for the clarifications and extra input. Question: Regarding cortisol testing and my nasal inhaler......would I have to go off of the inhaler to take the test? long?.....or would results be able to be interpreted, keeping my nasal inhaler (flonase) dose in mind? If I go off the inhaler, I imagine I would have to ramp down on the dose, not just stop.....and this would take time I imagine. How would I deal with the inability to breathe through my nose, when I'm not on this med? This is all so very complicated! Thanks so much to all for helping me sort this out. :-)

sparkles916 07-20-2008 01:53 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
It seems that your inhaler is a corticosteroid. I could only find that it has a precaution re developing cushings. I did not get a chance to check the whole insert. But, I have read of asthma inhalers causing secondary AI as well by means of suppressing adrenal function from chronic use.

I would not do anything myself, or at my recommendation. You should talk to your dr. I am not sure about the procedure used to discover if the inhaler has had a negative effect on you - that is, whehter you must be off it for a period, or whehther a dr would have you submit to a test without first going off it. I am sorry, but I don't know much more than [I]how[/I] the inhaler [I]may[/I] affect your adrenal situation. Maybe some others know more.

I do know that for a valid adrenal assessment, you must be off steroids for a period. So, some people who are in the "adrenal fatigue" category and have been started on hydrocortisone without dynamic testing (ACTH stim), sometimes decided to be properly tested later, and have to wean off the HC and wait a period until their HPA axis and adrenal function resumes. I know this is the case from reading around on boards and also some medical literature and abstracts. It is strongly recommended that a person be properly tested before embarking on steroid therapy for addisons or secondary AI.

But, we don't really know what is going on with you. It may be there is nothing wrong adrenal-wise. You should discuss with your dr.

The one thing I can say, is that your thyroid panels do show there is an issue that needs to be further investigated - as per my and mrsleepy's suggestion. I really think your current gp should be able to at least run the basic tests, before you go on to a specialist. That way your insurance might cover it. If your current gp is not willing to, can you get another PCP before trying out of pocket? The more you can get tested for while covered, the better.

I had unhelpful drs and ended up doing alot of pocket :mad:

keep us posted:cool:

ssMarilyn 07-26-2008 01:32 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
I agree that your TSH is good...females want it as close to 1.0 as they can get it and I see your lab is still using OLD lab values for the TSH. New lab values as of 3 years ago don't want your TSH over 3.0 Your FT4 needs to be on the high end of the lab values, so that is way too low. FT3 is real important, as that is the useable hormone, and if you're feeling really crummy, it could very well be that your FT3 is too low and you might need Cytomel. I'm not an expert by any means, and I have learned so much from the gals on this board, other boards and also by doing some research on my own. It's hard to find an MD or an Endoc that is really up to snuff on these things.

I have hypothyroidism, but am keeping my TSH right around 1.0 Docs here don't do the FT3 test, so as far as I'm concerned the FT4 is useless. I also have all the symptoms of adrenal fatigue, so found a doctor on the Top Docs list to see. He's a holistic MD who specializes in FM and thyroid disease and is so good that I can't get in to see him until December 22!! In the meantime I'm reading the book '[I]Adrenal Fatigue - The 21st Century Stress Syndrome[/I]' by James L Wilson, N.D. D.C., Ph.D. The book should have my name on the cover because it spells out my life perfectly. Since I can't get in to see the new doc til December, I'm following the advice of this book, and it's all good things, nothing that can hurt you. I had no idea that adrenal fatigue cannot be treated with meds, but rather with life changes, diet, relaxation, etc.. It's all a matter of making the right choices so that your adrenals are finally allowed to recharge themselves. The doctor can do tests to figure out where your hormone levels are and then help you structure things in your life so that you can heal. I feel pretty crappy most of the time and have to force myself to walk a mile on the treadmill every day. I figure if I give that up, then I'll end up in bed and I don't want that to happen, so I keep on keepin' on.

I was also diagnosed with FM - Fibromyalgia, by a neurologist several years ago, and now I wonder if it's just adrenal fatigue? I've had a very stressful life, am medically retired from law enforcement and while I was working THAT job fulltime, I worked my days off cleaning houses and waitressing at the truck stop because I was raising 3 kids on my own. I always wondered how I was able to keep going and now I see it was probably mostly adrenelin.

Get the's worth its weight in gold! I bought mine at ****** for just a couple of bucks - used.

nervx 07-26-2008 10:40 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
Thanks so much for sharing your experience ssMarilyn. I appreciate it. I bought the adrenal book some time ago, and agree it's a good book. I've actually also been taking Dr. Wilson's supplements for a few weeks, but they haven't helped me at all as of yet.

I would love to see a holistic doc, but unfortunately, I cannot afford to go outside of my Kaiser plan right now. Finances are a big part of my problem at this time. I divorced a few years ago and pretty much ended up having to start my life over financially, at age 43....with health problems. The stress of that, plus moving, plus starting a new business, plus the passing of my mother last year, plus losing all my pets in short order after the divorce, and having to move once again......really took it's toll on me. And that's on top of a lifetime of stress. I'm really at a loss now, and the stress of all this is just adding to everything.

In addition, I don't have any family to fall back on. I'm pretty much on my own, and self-employed to boot. It's a tough time. A vicous circle. My brain is so foggy that it's hard for me to understand the complexities of all this thyroid/adrenal stuff....and I'm a smart person so that should tell you how foggy I am. ;-)

I'm most curious at this time. about why my T3 went up, but my T4 stayed the same, and my TSH went a bit down....all this after having started on low dose Armour. I don't know if I should take more Armour, less Armour, no Armour, Armour plus T3, or go with a completely different protocol. My doc is not much help either, as he knows little about this. I'm hoping I can at least get referred to an Endo within the system....not that I'm confident that the Kaiser Endo would be of any additional help, but I have nothing else.

I'm doing a DHEA and Cortisol saliva test this Monday, as I feel it's imperative to have this info. That may shed some light on things, although I'm quite certain that I have adrenal fatigue.

Anyway, sorry to sound so down, but like the subject line says, I'm feeling kinda hopeless right now.

Thanks again. Your input means a lot.....and everyone elses as well. :-)

oceanl72000 07-30-2008 02:20 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
Hello there,

I am terribly sorry youhave to live your life feeling these ways I have a few things I would like to say and guide you in the direction of.

My mom suffers from addisons disease / adrenal fatigue and a very close friend of mine suffers from hypothyroid. Two things I want to offer advice for. One ask your doctor if you are a canidate for steroid or hormone replacement and if you can get dhea in your daily routine.. adrenal support with DHEA supplementation can make a big difference.

GTSMUM 08-24-2008 01:45 PM

Re: oceanl72000
hi there lm new hear, and lm in the same place as you, i have had anght of felling sick and tyerd, with no awers from doctors, im in and out of hosp,please forgive my spelling. for me l just push myself as hard as l can every day l wark 7 days a week from 6 to 14hh a day the more l push the better l fell about my self thats wote keeps me going. but same times it does fell like Y should l evan get up in the mornings, then l have to remember the good days, and Y l have to live, my kids , grandkids, my job ,my dog, then l get up and start again. good luck chin up.

pulsk 11-25-2008 10:38 PM

Re: Please Help - Feeling Hopeless -Adrenal +Thyroid Issues
Hi, I am new here but suffer from Cushings, secondary Addisons, and Thyroid problems. I saw on another post you said you have a lot of sweating. So do I. I really would like to know if anyone has a solution for that. The sleep thing is normal in Cushings as one of its symptoms is a reversal of the sleep wake cycle. Roserum (sp?) was developed to help people back to the normal cycle. See if you can try it. Usually takes a couple of weeks to work fully. Depression seems to be normal, and it increases the amount of pain you feel. My Dr. put me on wellbutrin(sp?) and folic acid recently, and they have helped a little. I have had fatigue for over 10 years now, and have not found anything that eases it.I haven't found any suppliments that will help with the fatigue because most work with the adrenal glands and I dont have any. The only other thing I can recomend to you is to get a lot of sunshine or use those lights that recreate it. The sun is a natural antidepresant, and I have found if I go too long without it I really get bad.
I wish you the best and hope you will find your solution soon.

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