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    Old 12-13-2004, 12:03 PM   #1
    -Misha-'s Avatar
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    Adrenal Fatigue

    Hi, I'm new here and full of questions.

    I copied this quote by Orion off another thread so I wouldn't have to thread jack:
    You see adrenal insufficiency means that for much of the time you have "adrenal sufficiency". It's only when you get stressed, like getting the flu, or a bad day at work that your body can't produce enough cortisol to satisfy the need and so leads to a spiraling down into fatigue, depression and the arrival of weird symptoms. Otherwise, you are pretty much normal. In fact all my simple blood tests showed I had normal cortisol levels. But a stimulation test finally showed I had zero cortisol reserve.
    I'm fairly convinced that I have adrenal fatigue even though my 4 pt cortisol tests came back normal.

    Morning - 6.2 (3-10)
    Noon - 3.2 (1.5-6.5)
    Evening - 1.4 (1-3.5)
    Night - 1.2 (.5-2)

    I never thought about getting an ACTH test b/c Dr. Wilson seemed more favorable towards the saliva tests. How common is it to have a normal saliva test, but an ACTH stim test that shows up abnormal?

    What caught my eye is that you mention that adrenal insufficiency mostly shows up under stress. I spend so much of my time trying to avoid stress, I wonder if it could be falsely increasing my saliva results to normal. Is that far-fetched? What are the best conditions for accurate testing?

    My doctor and I considered adrenal fatigue briefly, it's still on the table. I've thought about supplementing with Isocort or Cortef but I'm also afraid of gaining more weight. I have a hard time losing weight and I go through periods of horrible sugar cravings which cause me to gain weight. I'm only about 20 lbs above what I want to be, but that's bad enough for me. I've also had some terrible reactions to cortisone before. I ended up with Reflex Sympathetic Dystrophy in my wrist after a cortisone injection and when I was on Prednisone I got shingles after discontinuing a very small dose.

    I'm also hypothyroid, possibly secondary b/c my TSH was normal with borderline low FT3 and FT4. I'm not certain of that, though.

    Any help would be appreciated.


    Last edited by -Misha-; 12-14-2004 at 11:07 AM.

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    Old 12-21-2004, 01:18 PM   #2
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    Re: Adrenal Fatigue

    Hi Chris:

    Thank you so much for replying to me, I really appreciate it.

    I haven't had an ACTH stim test done yet. I'm considering asking my doctor for one. I thought they were done only through an Endo but I noticed that you say Osteopaths do them as well.

    I've read "Adrenal Fatigue" and I did the Scorecard Matrix by Dr. Rind. Looking at symptoms, I weigh heavily towards adrenal fatigue, but by the cortisol tests I'm not. DHEA-S blood tests always come out low, but were normal when I had the saliva test. Do you know why that is?

    Here are my thyroid labs:

    Oct 1 '04
    TSH was 2.08
    Free T4 11 (9-23) - 1/7 range
    Free T3 3.9 (3.5-5.5) - 1/5 range

    Nov 9 '04
    TSH: .32 (.3-4.7)
    FT4: 10.6 (9.1-23.8 ) - 1/10 range (gone down)
    FT3: 4.0 (2.5-5.7) - a smidge below 1/2 range

    Dec 15 '04:
    TSH: <.05 (.3-4.7)
    FT3: 4.5 (2.5-5.7) - 2/3 range
    FT4: 19 (9.1-23.8 ) - 2/3 range

    I'm currently on 1 1/2 grains of Armour split between 2 doses and 62.5 mcg of Synthroid.

    I'm definately warmer and my heart rate's up from 54 bpm to 65 bpm. My cycles seem to be trying to normalize, but I can't say that the brain fog's cleared up or the lack of energy (it's been years, I'm not even sure what it would be like to have lots of energy). Right now I'm having a hard time sleeping. Initially my FT4 levels dropped after starting the Armour, causing the insomnia, but now I'm not sure what it is. I've started taking my 2nd dose earlier in the day (12:30 pm) and it helped, but not completely. I also wake up during the night with terrible bouts of itching, causing hives.

    I keep thinking that if I had adrenal fatigue, I wouldn't be able to tolerate the dosage increase to get my FT3 and FT4 into the 2/3 range. That's when I change my mind. I go back and forth each day. I'm confused. LOL

    What I do know is that I CANNOT tolerate stress. I go through periods of working out, only to crash/burn out and/or end up bingeing on sweets. I have to be very protective of what I can tolerate. Travelling is a thing of the past. Golfing is also a thing of the past. A lot of things I used to enjoy are no longer an option for me. I've become completely passive/aggressive b/c standing up for myself requires too much emotional energy. I've learned to cope with an inability to handle stress, but I can't say that it's improved my quality of life.

    Where do you like to see the ranges for the cortisol test? Maybe I'll talk to my doctor about the Isocort. My only concern is that he'll drop the thyroid to deal with adrenals if that's the way I go. Last visit (after my Nov 9th results), he thought there was something wrong with my pituitary b/c my TSH was so low but my FT4 was still low. That's why he considered the adrenals, but when we went through my previous cortisol tests (which were normal), he decided to increase my Synthroid and see what happens with my labs.

    Anyway, I'm sorry to have rambled. I'm sure your time is precious so any thoughts would be great.


    Last edited by -Misha-; 12-21-2004 at 01:23 PM.

    Old 12-22-2004, 12:19 PM   #3
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    Re: Adrenal Fatigue

    Thanks Chris!

    I will discuss the ACTH stim test with my doctor. I mainly wanted to find out if I'm barking up the wrong tree with normal cortisol levels despite symptoms and didn't want to confuse the issue with him if it wasn't warranted. The thing that always threw me off was that I don't have a tendency to lose weight, but I guess the thyroid problem explains that.

    When I think back to the time that I was on low dose Prednisone, I felt wonderful. It was coming off it that really did me in. I'm curious to try the Isocort just to see how I react.

    I will keep you posted. I'm so thankful for your imput.

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