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  • Adrenal Fatigue...Hypothyroid or both?

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    Old 10-26-2012, 10:47 AM   #1
    ALLNISS's Avatar
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    Adrenal Fatigue...Hypothyroid or both?

    Adrenal Fatigue...Hypothyroid or both?

    That is my question. I know it is impossible to diagnose over the internet, but I am looking for some general guidance.

    A little background...

    Male, 32 years old, 212lbs, Active (when I have the energy workout 3-4 days per week)

    Diet: Eat higher protein, higher fat, lower carb diet about 70-80% of the time for the past 6+ years. Used to be 292 lbs, lost 50 lbs of it doing Atkins about 6 years ago. Have my splurges here and there.

    Why the concern?

    Well for probably the last 5 years or so I have noticed increases in unfavorable symptoms... Some of them are... Increased fatigue no matter how much sleep. Wake up tired. Seem to have energy at night though. If I can workout I feel good during, but crash after. Muscle weakness, ALWAYS cold hands and feet, lower sex drive, trouble losing weight, less concentration, muscle cramps, ringing in ears, digestive issues (can go 2-3 days without BM. Have to take colon cleanse pills to actually "go".), and a slew of other things that I never thought was related.

    Long recovery period after any activity
    Chronic Low Grade Depression
    Often feeling cold
    Cold hands and feet
    Hard stools
    No eyebrows or thinning outer eyebrows
    Dry Hair
    Dry cracking skin
    Nodding off easily
    Requires naps in the afternoon
    Inability to concentrate or read long periods of time
    Inability to lose weight
    Always gaining weight
    NO sex drive
    Dry skin or snake skin
    Ringing in ears
    Lactose Intolerance
    Inability to eat in the mornings
    Joint pain
    Excessive fatigue and exhaustion
    Non-refreshing sleep (you get sufficient hours of sleep, but wake fatigued)
    Feeling rundown or overwhelmed
    Consistent lack of energy
    Feeling unrested
    Low stamina
    Muscular weakness
    Slow to recover from exercise, injury, illness or stress
    Poor digestion
    Extreme sensitivity to cold
    Afternoon “low” from 2 to 4 pm, followed by an energy boost at 6pm
    Feeling sleepy at 10pm, but resisting going to sleep
    Suffering from mood swings, mild depression
    Lightheadedness when getting up from a sitting or lying down position
    Decreased sex drive
    Frequent sighing

    About 3-4 years ago, I was fed up and started looking online, taking quizes etc... I came up with Adrenal Fatigue. I started working with a doctor in So Cal (Dr. Lam) and he too diagnosed it as level 3 Adrenal Fatigue. He has me on natural supplement regimen and consults, but unfortunately I was not able to keep up with the expense and had to stop.

    Later I talked to another Dr. and he recommended I do a Saliva test for my hormones.

    Here were the results and his comments.

    Saliva Test 7:00am

    Estradiol: Result - 0.5 pg/ml / Optimal Range = 0.8-1.5
    Progesterone: Result = 0.053 ng/ml / Optimal Range = 0.070-0.150
    Free Testosterone: Result = 102.2 pg/ml / Optimal Range = 75-95
    DHT: Result = 18.8 pg/ml / Optimal Range = 20-40
    DHEA: Result = 585.3 pg/ml / Optimal Range - 250-450
    Cortisol: Result = 4.8 ng/ml / Optimal Range = 8.0 - 15.0

    His first red flag was the Cortisol and asked about stressors in my life. I didn't feel overly stressed at the time, but he pointed to possible Adrenal Fatigue. He had me do the "pupil test" and I "failed" that which was another indication.

    I went to my regular doctor several times since then to get other blood work done... In a nutshell was always told you are in normal range and fine. The only thing that came back out of whack was my Vitamin D levels which were severely low.

    Here are a few of the test results...

    Dr. Blood Test (1:00pm March 3rd)

    Free T4: Result = 1.0 ng/dl / "Normal Range" = 0.8-1.7
    TSH: Result = 4.04 uIU/ml / "Normal Range" = 0.10 - 5.50
    Fasting Glucose: Result = 95 mg/dl / "Normal Range" = 60-99
    Total Testosterone: Result = 391.7 ng/dl / Normal Range = 245-1200 (Dr. said average for my age was 700-900)

    At that time when I talked to the alternative doctor about my saliva results he said "“I suspect since your estradiol is low that you have lower binding proteins and causing more than adequate amounts of free T to be around.IN your case, the low E is helpful. No need to worry about raising, aging and exposure to environmental agents will do that in time. The main issue is your low cortisol”

    This really is the condensed version, but I wanted to paint as good of a picture as I could.

    What are your overall thoughts and any additional questions?

    Thank you in advance for your help

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    Old 10-26-2012, 03:23 PM   #2
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    Re: Adrenal Fatigue...Hypothyroid or both?

    I don't know, but I would definitely try to get your Vitamin D levels up. Have you been tested for anemia, as that can cause fatique?

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    Old 01-10-2013, 08:39 AM   #3
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    Re: Adrenal Fatigue...Hypothyroid or both?

    I am still working through trying to get my own diagnosis and treatment plan (my symptom list is very similar to yours, and I have always been very good about nutrition and exercise due to family cancer history), so I am definately not one of the best people to reply to your post, but I thought I would chime in since you only have the one reply.

    Your hormones that you listed are all out of range, so I don't know why they haven't told you to get to an endocrinologist.

    I would advise you not use the term "adrenal fatigue" at any point when speaking to an endo's office. Most don't believe in it and seem to consider it quackery. Just show them your labs, or ask about adrenal insufficiency.

    Your test ranges are different than the ones my dr's lab uses, but thought I would tell you what the dr. said (some of my results are very similar to yours), just to give you some feedback and idea of what some other docs have said.
    I have not been able to get a dr. to do the hormone testing you have had done, but I have had a lot of cortisol and thyroid tests over the past 3 years, plus auto-immune, virus, echo-cardiogram and plenty of other tests. :)

    tsh 3.13 (.465-4.68 uiu/ml) I have had a steady increase from my first test at 2.1 three years ago. ****I was told by my PCP and endo that most people feel good around 1.0, and they both consider mine to be too high to feel good. Based on this, your TSH would be as well.

    cortisol am 7.6 (4.5 - 22.7 ug/dl) 1st time tested was 3/12 and was 10.9, all tests since then have been in the 7s. ****The range for cortisol is different between your lab and mine, but the pcp said that the optimal cortisol level is 20-22 for this range, so the very top of the range. Mine was low enough to justify a ACTH stimulation test. I could only get this at the endocrinologist's office - finally got in to see one in November. Seems like most patients have to pay for the injection meds out of pocket, then take it to the endo. They take a baseline draw, inject you, take blood at 30 min and 60 min to see what happens.
    This checks to see if the adrenal glands are capable of producing cortisol when you are given an injection. If they don't, then likely issues with your adrenal glands. If they do, then you can look at pituitary or hypothalmus function to see if they are making what they need to in order to tell your adrenal glands to produce cortisol.
    Your cortisol isn't even in range, so I am surprised they haven't recommended a stim test.

    Have you ever had an ACTH serum test? I didn't see ACTH in your list.
    Have you ever had any head injuries (including concussions or whiplash type injuries)? Evidently that can cause issues with the pituitary or hypothalamus.

    Taking a Vit D supplement couldn't hurt - my pcp had me on 10k units/day, the endo moved me down to 2k/day since my levels had gotten so high.
    Also could try a B-100s supplement (I get both at Costco) for energy. Neither one will have a negative impact as long as you follow manufacturer dosing suggestions. I have not noticed a difference, but they could help you.

    Clearly, I am not an expert!! But I really think you should get into an endocrinologist to have them look at your results. They are the ones who are most likely to help you. I am still struggling to speak up and be insistent with the doctors when the tell me things like "you have kids" or "you are 42 now". People keep reminding me that the patient is the customer, you are your best advocate and know your body the best - so I am passing that on to you in hopes that it will remind you to be more insistent than I have been. :)

    When I went to the endo in November I made a spreadsheet tracking my labs history of the key tests (cortisol and thyroid for me) so she could see the path of falling out of range without wading through pages of lab results.
    I also typed up a summary of my "downward spiral" in activity ability, ending with having to quit working and almost all activity. She said these things helped her get a big picture quickly. I don't know how long you have been getting blood work done?
    From my internet research and forum assistance I have learned about secondary adrenal insufficiency (pituitary). It can result in a lot of things being out of whack, including thyroid, cortisol, all of the hormones you listed. There is also a tertiary insufficiency (hypothalamus). If the doctors think the labs back it up, then the next step is often scanning your brain to see if there is anything unusual going on in either of those areas. Do a google for secondary adrenal insufficiency forum - there is a more active forum out there with a lot of knowledgeable people to help you (there aren't many secondary boards that I have found, this one will get you to the site that has a lot of endocrine, adrenal, etc forums).
    Please try to get into an endo - you have too many numbers out of range. I hope that something here is helpful to you, that you find some help and get feeling better soon.

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