Is it adrenal fatigue?

[Little Bluestem]

My saliva cortisol is flat lined all day but my ACTH STIM test came out fine. On the morning of that test my am blood cortisol was 8 but did double to 16 so they told me my adrenals can work under stress.
I just had mine done again for the 3rd time and in 9 years it is almost always the same results...flat during the day and normal at night.

Your adrenals may work under stress, but do they work under normal day-to-day conditions? Don't your saliva tests and the low am blood cortisol indicate that they do not?

 

[Lotus97]

What are the symptoms of high cortisol? I said that my symptoms were the fight or flight response and was told that was high norepinephrine, but I'm curious what the differences are because cortisol or norepinephrine could rise due to a stress response. And can you have both high cortisol and high norepinephrine (either from a stress response or otherwise)?

 

[heapsreal]

Cortisol is basically a long acting energizer where adrenaline and nor adrenaline are short term energizers. But when in a later stage of adrenal fatigue adrenaline may have to take over a more long term role. Adrenaline I suppose is a stronger response which is why those with af get have adrenaline surges and panic attacks. Some times hydrocortisone etc can reduce these adrenaline surges in people with af. But again its a go low and slow as hc may at first hype one up. Also to higher doses can too.

 

[Lotus97]

I can't afford to see a doctor and get tested right now so I was hoping to self-diagnose (as many people here are forced to do unfortunately). I've been taking pregnenolone, but not doing much else. I'm not sure whether to take adaptogens also for reasons I'll explain in the second paragraph.

I'm also interested because I'm curious about adaptogens and whether they simply lower cortisol or have more complex functions. I've read customer reviews of holy basil and other adaptogens which are supposed to lower cortisol and people said it helps the with "stress". In the studies with adaptogens they trigger a stress response in the subjects to make cortisol rise. I haven't found a study yet on people with low cortisol so I would like to know whether they simply lower cortisol which I assume would make them contraindicated or if they have a more complex mechanism such as normalizing adrenal functions in which case some people with malfunctioning adrenals might benefit from adaptogens. Adaptogens also have other benefits such as improving cognitive function and boosting the immune system. The immune system effects might be a double-edged sword for some of the people here. Astragalus is contraindicated for late-stage Lyme for example. I don't remember if astragalus is suppose to lower cortisol, but it is listed as an adaptogen.

 

[heapsreal]

My understanding is that pregnenolone is best used in a transderamal cream or if orally brands that say they are in a lipid matrix. Im unsure that adaptogens have helped much other then withania which helped with high night time cortisol. U can try high dose vitamin b5 starting at 100mg and work up to 500 to 1000mg. Otherwise try just 5mg hc in morning and see how you feel. You could also try progesterone cream but take at night which can help sleep and then boost day time cortisol. These are just options you can look into. Have you tried dhea? Almost forgot look into cycloset which is a med that boost dopamine and can help stimulate cortisol production. Dr kruse is the guy who is recommending this.

 

[Lotus97]

Let's just assume that the claim is true that adaptogens actually do normalize the HPA axis (rather than simply lowering cortisol). Would that help my stress responses even if they weren't due to cortisol?

Based on what I've been reading though it seems like my anxiety could also be due to glutamate and brain inflammation. Marco has a series of articles about ME/CFS being a neuroinflammatory disorder that I'd recommend.

The pregnenolone I'm taking isn't in a lipid matrix, but it is micronized. It seems to get good reviews:
http://www.iherb.com/product-reviews/MRM-Pregnenolone-50-mg-60-Veggie-Caps/4645/?p=1

I remember you said something about pregnenolone needing to be absorbed slowly so I've been crushing up all my sublinguals (for other reasons) and mixing the pregnenolone powder with the sublinguals. Then I divide the powder into 3 doses and put the powder between my lower lip and gum. It takes an hour or two to dissolve. Each dose has 10 mg of pregnenolone.

 

[heapsreal]

Let's just assume that the claim is true that adaptogens actually do normalize the HPA axis (rather than simply lowering cortisol). Would that help my stress responses even if they weren't due to cortisol?

Based on what I've been reading though it seems like my anxiety could also be due to glutamate and brain inflammation. Marco has a series of articles about ME/CFS being a neuroinflammatory disorder that I'd recommend.

The pregnenolone I'm taking isn't in a lipid matrix, but it is micronized. It seems to get good reviews:
http://www.iherb.com/product-reviews/MRM-Pregnenolone-50-mg-60-Veggie-Caps/4645/?p=1

I remember you said something about pregnenolone needing to be absorbed slowly so I've been crushing up all my sublinguals (for other reasons) and mixing the pregnenolone powder with the sublinguals. Then I divide the powder into 3 doses and put the powder between my lower lip and gum. It takes an hour or two to dissolve. Each dose has 10 mg of pregnenolone.

A pitty u cant get some testing done just to see where the pregnenolone is going. With me it increased cortisol, in some it can increase progesterone, it usually a combination of, but directed more so to one way. I dont know alot about the preg tablets, maybe they need to stay whole?? If u want to try transdermal pregnenolone, they sell it at another site called allthingsmale.com and i think its 100mg per ml, so if using 10mg then its a small volume of cream to use .1ml.

It might be the case we spoke about the other day in that its hard to notice the results until u have other issues sorted. this can be hard to do when doing a treatment and going by feel. atleast with testing u can tell if u have your hormones optimised and if not noticing alot still stay with those treatments but persue other possible issues/infections.

 

[Lotus97]

A pitty u cant get some testing done just to see where the pregnenolone is going. With me it increased cortisol, in some it can increase progesterone, it usually a combination of, but directed more so to one way. I dont know alot about the preg tablets, maybe they need to stay whole?? If u want to try transdermal pregnenolone, they sell it at another site called allthingsmale.com and i think its 100mg per ml, so if using 10mg then its a small volume of cream to use .1ml.

It might be the case we spoke about the other day in that its hard to notice the results until u have other issues sorted. this can be hard to do when doing a treatment and going by feel. atleast with testing u can tell if u have your hormones optimised and if not noticing alot still stay with those treatments but persue other possible issues/infections.

I would get tested if I thought it would make a huge difference in my health, but during the time I was making my recovery my adrenal symptoms went away so I think maybe if I take care of other issues hopefully my adrenals will be less stressed.

The one I'm taking is capsules. I meant that I have other sublingual tablets I also crush up. Since Source Naturals' sells a pregnenolone sublingual I figured putting the capsule contents between my lower lip and gum would have the same effect. People do that with Anabol Naturals' adenosylcobalamin. Even if I don't absorb much sublingually it will eventually make its way to my tummy the digestive tract. They do sell transdermal pregnenolone at iHerb, but I just don't feel like slathering it on my body right now. Plus I'm sensitive to smells.

 

[Sherezade]

On an AM cortisol my adrenals look fine. On 4 point adrenal saliva test, I'm flat-lined on all 4 points (and have been for many years). I don't do that well with stress. I had doctor warn me about how dangerous this was, how it was among the 4 worst profiles they had ever seen, blah blah blah.

I've tried all kinds of adrenal supps and don't tolerate any of them, even in extremely tiny amounts - they're all too overstimulating. I would be scared to death to try Cortef. I was prescribed something like that (can't remember the actual name) but didn't take it either.

So for many years, I supported my adrenals by doing homemade electrolyte drinks. That would be salt, vit. C, and magnesium for me. Others might also need potassium or other substances. The adrenals regulate electrolyte imbalance, so if you have poor adrenals, you'll be losing these electrolytes like crazy. The drink will make you feel a lot better.

Fast forward to a month ago. I've been working on methylation. Within a few months my thyroid (formerly hypothyroid), went hyperthyroid and I had to discontinue my medication. During the same time, my need for the electrolyte drink was reduced in half. So the methylation is really helping my thyroid and adrenals. I should be able to get full recovery of the adrenals, and ditch the electrolyte drink eventually, but I need to continue to go very slow with methylation.

One point about adrenal fatigue - I think for many of us, we have "apparent" adrenal fatigue, not actual adrenal fatigue. Our brand of adrenal fatigue is caused by loss of signaling to the thyroid and adrenals by the hypothalmus and pituitary, not by any actual failure on the parts of these organs. The loss of signaling is caused by glutathione depletion.

So you restore methylation, build up glutathione, and voila, your thyroid and adrenals start working again. Rich Van Konynenburg talked about this.

This would also explain why we don't tolerate adrenal glandulars, as our adrenals are not actually fatigued. It will look the same either way on an adrenal saliva test, so it's misleading.

Hmmm, it just occurred to me that may also explain why your adrenals would look fine on an AM cortisol, while looking terrible on an adrenal saliva test, and maybe that's a way to tell which kind you have...just speculating here.

Hi Caledonia,

Just to know, what does "methylation" means? I would like to try that. Thanks.

 

[Lotus97]

Hi Caledonia,

Just to know, what does "methylation" means? I would like to try that. Thanks.

Methylation might eventually help your adrenals, but I find that it often puts a stress on my body making my symptoms worse. I'm not taking a very high dose, but it only takes a little bit to push me over the edge. I'm not saying that will happen to you, but it would still be good to be cautious and start at low doses.

Caledonia made a set of videos about methylation:
http://forums.phoenixrising.me/index.php?threads/methylation-made-easy-videos.22857/

This is an article by Rich put into simple language about why methylation is necessary for people with ME/CFS
http://phoenixrising.me/research-2/...etion-theory-of-mecfs-by-rich-von-konynenburg

Freddd and Rich both have a methylation protocol. This is Rich's most recent one:
http://forums.phoenixrising.me/inde...ation-protocol-august-25-2012-revision.19050/

And this is Freddd's:
http://forums.phoenixrising.me/index.php?threads/active-b12-protocol-basics.10138/
If you do Freddd's you might also want to check out his micro titration thread. And also don't buy Jarrow's methylcobalamin. For some reason the quality of that brand changed and it's no good.

 

[Beyond]

On an AM cortisol my adrenals look fine. On 4 point adrenal saliva test, I'm flat-lined on all 4 points (and have been for many years). I don't do that well with stress. I had doctor warn me about how dangerous this was, how it was among the 4 worst profiles they had ever seen, blah blah blah.

Hmmm, it just occurred to me that may also explain why your adrenals would look fine on an AM cortisol, while looking terrible on an adrenal saliva test, and maybe that's a way to tell which kind you have...just speculating here.

Hey caledonia I also have fine serum AM cortisol and very low saliva cortisol in all the 4 samples of 24h. My blood thyroid its practically normal as well, but on urine 24h I show hypothyroidism, which came with a diagnosis of Hashimoto´s Thyroiditis. My glutathione was low in tests. I think your hypothesis could have some merit. My research in scientific evidence for the validity of testing urine for thyroid and saliva for cortisol shows those are far more sensitive than serum and therefore catch the disturbances in "sub-clinical" cases.

 

[caledonia]

I didn't know you could test the thyroid by urine - very interesting. My thyroid antibodies were extremely high, so that's how I got diagnosed with autoimmune thyroiditis.

I assume that this urine test is a naturopathic thing and not mainstream?

 

[Beyond]

Yeah exactly,however... http://www.eje.org/content/87/3/525.short

http://hypotyreos.info/attachments/027_Thyroid hormones in 24h urine - European Laboratory of Nutrients, The Netherlands.pdf

http://li123-4.members.linode.com/files/Thyroid Insufficiency. Is TSH Measurement the Only Diagnostic Tool_0.pdf

It is a real boost of hope the fact that you have been able to ditch your thyroid meds and taper down the adrenal support with methylation. Today I have strong brainfog with a tension headache and have just read that its a symptom of hypothyroidism... doctors here say I am fine and the naturopath that diagnosed my Hashis one year ago failed to treat me... he was an expensive and supposedly famous belgian functional doc... so the situation its a bit suffocating. I managed to make my head doctor prescribe me thyroid antibodies again, if they are high they will have to treat me. Because no one takes seriously the antibodies of the belgian. But she would have never prescribed me those tests, it makes me really mad the fact that I am the one that has to research and tell HER to prescribe me the antibodies test.

 

[triffid113]

I had a very stressful message this morning - I immediately got these overwhelming symptoms, felt really weak and my legs went to jelly. Anyone recognise these symptoms? This morning prior to this I was okay - my usual ME self. (eg.trying to make my own rice milk slowly and badly)

I should say my very caring family protect me from as much stress as they possibly can,so I don't get a lot of real world stressing stuff.


A few years ago I was told my adrenals were flat-lining,I was recommended Cortef, which I declined.

Have you considered DHEA? I take that. W/o that I have stage 3 hypertension and a constant panic attack. idk what else because who could think beyond that? Also I did not suffer such more than a coupla days before finding the fix.

ok, beyond that - my adrenals go out during allergy season (proof is that I have stage 3 hypertension and yet suddenly I have low blood pressure and can pass out if I don;t eat salt). So...my doctor told me usually if you have adrenal problems you have a thyroid problem first. He got me to take 1g tyrosone/day for my thyroid and this also helps my adrenal gland. but I already take a B complex 2x/day and it contains B5 which I believe helps the adrenal gland. Beyond this idk. Wish I could be more help

 

[triffid113]

Yeah exactly,however... http://www.eje.org/content/87/3/525.short

http://hypotyreos.info/attachments/027_Thyroid hormones in 24h urine - European Laboratory of Nutrients, The Netherlands.pdf

http://li123-4.members.linode.com/files/Thyroid Insufficiency. Is TSH Measurement the Only Diagnostic Tool_0.pdf

It is a real boost of hope the fact that you have been able to ditch your thyroid meds and taper down the adrenal support with methylation. Today I have strong brainfog with a tension headache and have just read that its a symptom of hypothyroidism... doctors here say I am fine and the naturopath that diagnosed my Hashis one year ago failed to treat me... he was an expensive and supposedly famous belgian functional doc... so the situation its a bit suffocating. I managed to make my head doctor prescribe me thyroid antibodies again, if they are high they will have to treat me. Because no one takes seriously the antibodies of the belgian. But she would have never prescribed me those tests, it makes me really mad the fact that I am the one that has to research and tell HER to prescribe me the antibodies test.

It may help you to know this: http://www.lef.org/protocols/appendix/blood_testing_02.htm?source=search&key=TSH reference range (Note in reading below that a TSH of 2.0 is RIGHT IN THE MIDDLE OF THE SO-CALLED NORMAL RANGE FOR TSH...a range NOt based on science!)

A review of published findings about TSH levels reveals that readings greater than 2.0 may indicate health problems relating to insufficient thyroid hormone output. One study showed that individuals with TSH values greater than 2.0 have an increased risk of developing clinically significant thyroid deficiency during the next 20 years (Vanderpump 1995). Other studies show that TSH values greater than 1.9 indicate risk of autoimmune disease of the thyroid gland (Hak 2000).

A more startling study showed that TSH values greater than 4.0 increases the likelihood of heart disease in postmenopausal women (Hak 2000). Another study showed that administration of thyroid hormone lowered cholesterol in patients with TSH ranges of 2.0–4.0 but had no cholesterol-lowering effect in patients whose TSH value was in the 0.2–1.9 range (Michalopoulou 1998). It also showed that in people with elevated cholesterol, TSH values of 2.0 or greater could indicate that a thyroid deficiency is the culprit, causing excess production of cholesterol, whereas TSH levels at or below 1.99 would indicate normal thyroid hormone status.

Doctors routinely prescribe cholesterol-lowering drugs to patients without properly evaluating their thyroid status. Based on the evidence presented to date, it might make sense for doctors to investigate a thyroid deficiency (based on a TSH value greater than 1.9) before resorting to cholesterol-lowering drugs.

In a study to evaluate psychological well-being, impairment was found in patients with thyroid abnormalities who were nonetheless within “normal” TSH reference ranges (Pollock 2001).
The authors of the Lancet study stated, “The emerging epidemiological data begin to suggest that TSH concentrations above 2.0 (mU/L – milliunit per liter) may be associated with adverse effects.”

-----
Also you should make sure you are getting everything your thyroid needs. In addition to enough tyrosine (I have to take 1-3g/day to get enough), here are the cofactors your thyroid needs: http://www.iherb.com/Thorne-Research-Thyrocsin-Thyroid-Cofactors-60-Veggie-Caps/21588

 

[maryb]

Have you considered DHEA? I take that. W/o that I have stage 3 hypertension and a constant panic attack. idk what else because who could think beyond that? Also I did not suffer such more than a coupla days before finding the fix.

ok, beyond that - my adrenals go out during allergy season (proof is that I have stage 3 hypertension and yet suddenly I have low blood pressure and can pass out if I don;t eat salt). So...my doctor told me usually if you have adrenal problems you have a thyroid problem first. He got me to take 1g tyrosone/day for my thyroid and this also helps my adrenal gland. but I already take a B complex 2x/day and it contains B5 which I believe helps the adrenal gland. Beyond this idk. Wish I could be more help

triffid113
thanks - I too have low BP and need salt - also many many allergies and intolerances.
I just got the iodine(12,5mg) selenium 200mcg and l-tyrosine 600mg - recommende by my doc....
Both the iodine and the selenium made me feel ill - I think I can tolerate the l-tyrosine so will just go with that for a few days and then split the capsules of the other 2 down into smaller amounts, makes life harder when you can't even just pop a pill.....
I've tried so many Bcomplexes which I can't tolerate - which one do you take?

 

[triffid113]

Oh...I have trouble with iodine too ever since I tried to take Iodoral (huge dose) to ward off breast cancer. I am not sure if I am ok with thyrocin (which has a small amount of iodine) because I have an ear infection right now. If I get too much iodine it causes tinnitus...well much causes an actual buzzing in my head. But right now I have tinnitis anyway...

(So watch out, too much iodine causes hyper and then hypo thyroid (like you go hyper for a very short time, like hours, then run out of something and wind up very hypo)...I don't think this is normal but it is common - not that a regular doctor will ever diagnose it, but Life Extension doctors diagnosed it for me right away. If you join you can talk to their doctors by phone and I have found it very helpful.

I take Thorne Basic B 2x/day. This is not enough to correct my methylation. I need this protocol:
DHEA 50mg 1x/day
Thorne Basic B 2x/day
50mg P5P 2x/day
metafolin 800mcg 1x/day
1g TMG 2x/day
50mg zinc picolinate plus at a DIFFERENT time, 3-6 mg copper picolinate
Vitamin D3 to raise blood levels to 70
high dose antioxidants
500mg potassium gluconate in a Vitamin Water

I also take 400-600mg calcium citrate + 400-600mg magnesium citrate
and other things!
you only need tyrosine if you do not eat enough protein. I generally eat <80g protein / day so I need it.

I have 18 genetic mutations out of the Yasko panel of 30 so I can tolerate all this stuff and have no bad reactions pretty much ever. If I do not take any item on my list, I get bad symptoms however. I am not actually sure I can do with as low as 50mg DHEA either...I have been taking 75mg (causes a night to day difference in me) and when I try to dial down to 50mg I get anxiety so I started taking an extra 50mg P5P in the evening and it took care of the anxiety but today I had a terrible low blood sugar attack - which I get whenever I lower my DHEA (and used to get before I started taking it). It so happens there was a hole in the ziplock bag I put my pills into and idk if my DHEA slipped out which may have caused it, or if it is the cumulative effects of lowering my DHEA dose that eventually caught up with me. It takes a long time to really prove out a new protocol...

idk if any methylation strategy will help you with adrenal problems...I believe B5 is important to the adrenal gland, but that is not a methylation supplement. DHEA or some hormone in its cascade alters gene expression and is the only way I can maintain my blood sugar, stop continual panic attacks, and keep my blood pressure normal. I am quite happy taking 50mg as thousands of studies show health benefits for that. The higher doses have been studied for depression but not nearly so much. if your adrenal gland is not too bad high dose rhodiola is very effective in maintaining blood sugar control because it raises glycogen stores. That worked for me through my 40's, but once I hit 50 nothing but DHEA (hormone replacement) would work. I take a Life Extension cruciferous vegetable product and zinc to help make the good hormones out of it (avoid cancer). Zinc is critical to my thyroid and it is used up at a FEROCIOUS RATE by allergy attacks. There is only a small amount of the other substances needed for the thyroid. The two substances needed in higher amounts are tyrosine and zinc. Most people get enough tyrosine in their diets (men anyway), but zinc is needed in a higher amount and is used up if you get a cold or any rhinitis type illness or if you get burns, cuts, or infections (anything in which you need to heal skin). I read someone on a thyroid board saying that zinc is like a dial to turn up the thyroid. idk know if zinc is needed by the adrenal gland. However I observe that during allergy season when my thyroid gets worse then my adrenal gland goes out and that is when I have low blood pressure (my blood pressure is normally high - stage 3 hypertension). My doctor says there is a link between the thyroid and the adrenal gland, but idk what it is. I only observe they have problems together. So...aside from covering all the trace supplement bases, do you get enough zinc?

 

[physicsstudent13]

my endo was against hydrocortisone even though my cortisol was 2.4 in the afternoon? so the adrenals really do get fatigued and do atrophy if you take too many meds?
I'm still struggling with the endocrine fatigue and sleep apnea. I take klonopin for sleep but maybe there's a better way to increase GABA or melatonin from the pineal gland.
I've lost all the energy and stamina for studying I used to have and occasionally take clomid for energy but don't want high testosterone to damage my liver, it seems to give some energy when you start but it doesn't seem to be sustained.

 

[ltd]

I just got back my adrenal saliva test -- way way low, all through the day, both DHEA & cortisol (altho the ratio is fine). I happen to have a bottle of Thorne's DHEA-5 on hand. Does anyone know if it's ok to start that while I'm slowly ramping up RvK's methylation protocol? Some immediate relief would be much appreciated.

 

[Ema]

I just got back my adrenal saliva test -- way way low, all through the day, both DHEA & cortisol (altho the ratio is fine). I happen to have a bottle of Thorne's DHEA-5 on hand. Does anyone know if it's ok to start that while I'm slowly ramping up RvK's methylation protocol? Some immediate relief would be much appreciated.

If it's way, way low you may need additional cortisol prior to adding in DHEA.

I would get a serum cortisol level and an ACTH stimulation test first to rule adrenal insufficiency out prior to doing any supplementation.

Ema