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    Old 09-23-2008, 03:10 PM   #1
    skyal
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    Adrenals & thyroid meds

    I'm hoping someone here can help. My husband has severe thyroid issues. When he was tested, his TSH was 54. He was on Synthroid for awhile, the next time he got tested, his TSH was down to 23. The doctor doubled the amount of Synthroid he was taking (he started at the lowest dose) and he started getting side effects including severe anxiety, muscle spasms & heart palpitations. The doctor suggested that he drop down to the original dose. That helped for a day or 2, but then he got side effects from that, too. After doing some research, we thought maybe he just reacted to the synthetic thryroid, so he asked the doctor to prescribe Armour. Doctor had never heard of it, but did prescribe a natural thyroid medication. After about a week on that, my husband started getting the same side effects.

    Doing some more reading, I found a suggestion that possibly his adrenals are trying to compensate and that in order for him to stop getting these side effects, the doctor will need to do something to get the adrenals to stop trying to compensate (cortisol was one suggestion, I think) before he can take the thyroid meds without having side effects.

    Does anyone know anything about this? Is there any testing to find out if his adrenals are compensating? And how would he go about getting that fixed? It's pretty clear his thyroid has pretty much packed up and I suspect if his adrenals are trying to compensate, eventually they're going to burn out.

     
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    Old 09-23-2008, 03:41 PM   #2
    Meep
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    Re: Adrenals & thyroid meds

    there is testing for that and it might or might not be revealing. If you look here on Healthboards for the Addison's Disease board, you'll find information SPECIFICALLY about the adrenal problems.

    I have low Cortisol in the mornings, so I take Cortef. Testing? Te problem with adrenal testing is that the "normal" ranges are so wide that only people who are practially on their death bed will be diagnosed, unless you have a savvy doctor.

    A morning Cortisol is the first step. IF it is low, then you have a diagnosis of adrenal fatigue, and that can be enough to get many doctors to prescribe something to help.

    If the morning Cortisol is not low, then an ACTH Stim test might be revealing. This test involves a morning cortisol, followed by an injection of ACTH to tell the adrenals to produce Cortisol. at 30 minutes later, another Cortisol lab is done, and another at 60 minutes after the Stim injection. Sometimes a third one is done at 90 minutes.

    What is looked for in these tests is how the adrenals react to stress. In a healthy person, the second test should be well above 15 and the third test can be even higher. In someone with weak adrenal response, the second tes might or might not be higher, but will surely be less than 12 or so. Subsequent tests might or might not be higher than that as the adrenal glands continue to struggle.

    Again the problem with this is that most doctors--even Endocrinologists do not interpret the tests by anythging other than the "normal" lab ranges.

    Self help: Look at books such as "Adrenal Fatigue: 21st Century Stress Syndrome" and other similar books for ideas on nutritionally supporting this and working on things the doctors never tell you, because they were never taught.
    __________________
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    Old 09-23-2008, 05:06 PM   #3
    tygwyn
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    Re: Adrenals & thyroid meds

    I have thyroid issues aswell as Adrenal issues.

    I had my thyroid removed 2 years ago and have never done particularly well on T4 meds. My main symptom has always been anxiety and the related symptoms that comes hand in hand with that.

    I am lucky enough to have found a GP in Sydney who actually believes in the diagnosis of Adrenal Fatigue ( as she suffers from it herself ) and so tested my cortisol levels. The best test apparently is a 24 hour saliva test where they test at specific times throughout the day. I had a 24 urine test though which was basically a collection of my urine over a 24 hour period.

    My results came in at:

    Urinary Free Cortiol: 186 ( 70 - 430 )

    When I first looked at this I thought it was probably OK (and was disappointed that I hadnt found a reason for feeling the way I do), but then my GP explained to me that my result is extremely low, as the ranges are so extreme, and that someone with a cortisol level of 70 would actually be diagnosed with Addisons disease (that being no Cortisol production at all).

    As Meep says, it is hard to find a doctor who firstly believes in the existence of Adrenal Fatigue and then one who knows, and is happy to treat it.

    I am now taking 28mg Hydrocortisone throughout the day which I believe is helping me...although I'm thinking I may need to ramp it up a bit soon.

    My advice would definitely be to get your hubby tested
    __________________
    Rach xxxx

    Total Thyroidectomy Oct 06 due to Massive Multi Nodular Goiter and Hashi
    Adrenal Fatigue
    180mg NTH
    28mg HC
    2 x Caltrate

    Rach xxxx

     
    Old 09-23-2008, 05:38 PM   #4
    mkgb
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    Re: Adrenals & thyroid meds

    Alright here we go.

    I have Hashimoto's, Graves, and Adrenal Insufficiency.

    The basic adrenal panel your husband will need is
    8 am fasting blood serum
    ACTH, cortisol, DHEA-sulfate, and aldosterone.

    Is your husbond on any steriodal supplementation? DHEA supplementation? If so he will have to be off of them 4 weeks so that the tests are not biased.

    Now a full adrenal profile will also include autoimmune antibody testing, ACA (adrenal cortex antibodies) as well as an adrenal stimulation test, estrogen, progesterone, pregnenolone, testosterone.. and let me think a minute.. Humm.. I think that gets it.

    You also need to get a copy of your husbands labs. Adrenal issues can be seen in most patients by an imbalance in your FT3 and Ft4 levels. Has your husband's MD been testing Ft3 and Ft4 in addition to TSH. If your husband is on a Natural T4/T3 supplement then the TSH is artrificially surpressed and worth Cow flop.

    If you can post your husbands Ft3 and Ft4 levels with associated lab range I can tell you if there is an imbalanced and whether hypo or hyperadrenalism is suspected.

    MG
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    Old 09-23-2008, 06:52 PM   #5
    cutejenny77
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    Re: Adrenals & thyroid meds

    Quote:
    Originally Posted by tygwyn View Post
    I had a 24 urine test though which was basically a collection of my urine over a 24 hour period.

    My results came in at:

    Urinary Free Cortiol: 186 ( 70 - 430 )

    Hi, tygwyn, do you think 24 hour urine test for Cortisol can be taken place of salivaroy test? In my region, there is no saliva test but 24 hour urine test!

    Jenny

     
    Old 09-23-2008, 06:54 PM   #6
    tygwyn
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    Re: Adrenals & thyroid meds

    Quote:
    Originally Posted by cutejenny77 View Post
    Hi, tygwyn, do you think 24 hour urine test for Cortisol can be taken place of salivaroy test? In my region, there is no saliva test but 24 hour urine test!

    Jenny
    Well thats all I've had done Jenny and my GP was happy to prescribe HC based on those results

    Actually she'd prescribed HC before the results came in, based on my symptoms, but after seeing the results she increased my dosage
    __________________
    Rach xxxx

    Total Thyroidectomy Oct 06 due to Massive Multi Nodular Goiter and Hashi
    Adrenal Fatigue
    180mg NTH
    28mg HC
    2 x Caltrate

    Rach xxxx

     
    Old 09-24-2008, 01:37 AM   #7
    cutejenny77
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    Re: Adrenals & thyroid meds

    Quote:
    Originally Posted by tygwyn View Post
    Well thats all I've had done Jenny and my GP was happy to prescribe HC based on those results

    Actually she'd prescribed HC before the results came in, based on my symptoms, but after seeing the results she increased my dosage
    Urinary Free Cortiol: 186 ( 70 - 430 )

    So there is only one result of Urinary Free Cortisol? And you have been diagnosed with Adhernal Fatigue?

     
    Old 09-24-2008, 01:40 AM   #8
    tygwyn
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    Re: Adrenals & thyroid meds

    Quote:
    Originally Posted by cutejenny77 View Post
    Urinary Free Cortiol: 186 ( 70 - 430 )

    So there is only one result of Urinary Free Cortisol? And you have been diagnosed with Adhernal Fatigue?
    I have been prescribed Hydrocorisone based on these results..yes

    For my test there was only one result yes because they just test the entire collection of the 24 hour urine...its not tested at certain times.
    __________________
    Rach xxxx

    Total Thyroidectomy Oct 06 due to Massive Multi Nodular Goiter and Hashi
    Adrenal Fatigue
    180mg NTH
    28mg HC
    2 x Caltrate

    Rach xxxx

     
    Old 09-24-2008, 01:46 AM   #9
    cutejenny77
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    Re: Adrenals & thyroid meds

    So they collected the urine just one time? What is your feeling after taking HC? With thyroid hormone treatment?

    Last edited by cutejenny77; 09-24-2008 at 01:47 AM.

     
    Old 09-24-2008, 02:34 AM   #10
    tygwyn
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    Re: Adrenals & thyroid meds

    Quote:
    Originally Posted by cutejenny77 View Post
    So they collected the urine just one time? What is your feeling after taking HC? With thyroid hormone treatment?
    'I' collected 'ALL' of my urine over a 24 hour period into one big bottle! Then took it all in to be tested 'ONCE'
    __________________
    Rach xxxx

    Total Thyroidectomy Oct 06 due to Massive Multi Nodular Goiter and Hashi
    Adrenal Fatigue
    180mg NTH
    28mg HC
    2 x Caltrate

    Rach xxxx

    Last edited by tygwyn; 09-24-2008 at 02:34 AM.

     
    Old 09-24-2008, 03:17 AM   #11
    cutejenny77
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    Re: Adrenals & thyroid meds

    Quote:
    Originally Posted by tygwyn View Post
    'I' collected 'ALL' of my urine over a 24 hour period into one big bottle! Then took it all in to be tested 'ONCE'
    Thanks very much! Got it now!

     
    Old 09-24-2008, 03:18 AM   #12
    tygwyn
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    Re: Adrenals & thyroid meds

    Quote:
    Originally Posted by cutejenny77 View Post
    Thanks very much! Got it now!
    __________________
    Rach xxxx

    Total Thyroidectomy Oct 06 due to Massive Multi Nodular Goiter and Hashi
    Adrenal Fatigue
    180mg NTH
    28mg HC
    2 x Caltrate

    Rach xxxx

     
    Old 09-24-2008, 04:00 AM   #13
    skyal
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    Re: Adrenals & thyroid meds

    The TSH numbers are from before he was on anything & after he was on Synthroid for a few weeks. He's only been on the natural thyroid meds a few days (well, a few days, then he got symtoms again & stopped taking it). I have no idea what DHEA supplementation is, so I'm guessing he's not on it.

    I don't think the doctor has actually tested anything other than his TSH levels. I'll send him a link to this thread so he can ask the doctor to do the other tests, although I think he may have to find another doctor soon who can treat him better. About the only good thing is our doctor is pretty much willing to do whatever testing/treatment we ask for, at least so far, but he really doesn't know much about this subject, so we're having to do our own research.

     
    Old 09-24-2008, 11:04 AM   #14
    mkgb
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    Re: Adrenals & thyroid meds

    skyal,

    Then your husband needs to request that his MD run at LEAST a total T3 and T4 hormonal level test. There is upto 20% error in these tests, but some MDs are more willign to run them because they are cheaper. Your husband is male as well so there will be less estrogen in his system ot interfere with the test.

    But the best basic hypothyroid profile to work from IN MY OPINION is as follows:
    Free T3 and Free T4 (ACTUAL active thyroid hormonal tests - 2.5-5% error in these tests)
    T3 and T4 (15-20% error in these test, it is an indirect method of acquisition)
    TSH if not on a natural supplement that contains T3
    T3 Uptake and Reverse T3.
    TPOAb and TGAb

    This will tell you the source of the hypothyroidism. It will tell you if you have a hormonal binding issue, conversion issue, and/or to suspect an adrenal issue. You can at the same time run the blood serum ACTH, cortisol and aldosterone basic profile. Depending on these results a saliva cortisol rhythm and ACTH stimulation profile may be needed to narrow down the source of his issue. Once again this is going on the supposition that there is an adrenal issue and not just poor reaction to medication. Trying to medicate hypothyroidism by TSH alone is irresponsible in my opinion. Most MDs do not know better though.

    MG
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    Old 06-09-2010, 09:58 AM   #15
    janinel1
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    Re: Adrenals & thyroid meds

    hi i too am pretty much in same situation . i was ill from taking thyroid med . thyroxine and now thyronine . i think my last reading of tsh was 38. i was told that my thyroid wont work much longer . i had no symptoms of underactive thyroid just a borderline reading . but been illl since given , 8 years now i wondered why. got nowhere with gp who kept treating different complaints separately . this i suffered as had no choice . i agreed that adrenals may be the problem . i guess its not that common but not much fun if you the one that has it . i had worries in my life before this that i couldnt resolve i think that has not helped my adrenals, i could see background stress was there most of time uncontrolled . i am going to have my adrenal levels checked properly now as i have finally seen a endo who is actually doing something . it is a hard battle to get someone listen . doctors know very little about so dismiss it. maddening i know . they dish the thyroid med out but if theres a problem you are on your own, insist on seeing a specialist and get your husband seen , it would be a start, i cant give up either one day i will be able to resolve it and get my life back too . noone wants be dependent on pills i didnt mind if harmless but they never have been to me . good luck . janine

     
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