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Hydrocortisone Mystery

Discussion in 'Hormones' started by AlmostEasy, May 21, 2016.

  1. AlmostEasy

    AlmostEasy

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    So before I even discovered the ideas of ME/CFS (not really certain that's what I have, no post exertion fatigue) I went through the more well known disorders and one of them I came across was the thyroid / adrenal fatigue.

    I scoured StopTheThyroidMadness and it made sense to me so I got a full panel done and a 24 hour salivary cortisol test done. My thyroid panel looked good, other than my RT3 being 17 (which according to STTM >14 is indicative of issues with the adrenals). I also had a full HPG/HPA axis panel done to check Prolactin / FSH / LH and all was good there, though my testosterone was about 399 with the bottom end being 350. My body temps also in the morning could hit as low as 95.0 and my highest natural temps were usually 97.0. I never hit 98.6, ever.

    So I started on testosterone replacement with bi-weekly injections subQ totaling 100mg / week with HCG to preserve the testes. I've been on this probably a year and a half. I can't even tell I take it mood / energy wise. The only thing I notice from this is I actually put on and retain muscle.

    My salivary cortisol was a bit off. In the morning I was higher than range, 2nd measurement I was so low it was barely detectable, and the 3rd and 4th were 2-3 x too high. According to STTM this could be a beginning stage of "adrenal fatigue" which I'm not that big of a believer in. I'm a believer of cortisol level issues but not necessarily the conventional fatiguing of the adrenals. People with Cushings disease pump out massively excessive amounts of cortisol their entire lives without issue. From what I read some believe it to be a hypothalamus signaling issue, with Rich Van K claiming it is a lack of glutathione in this organ.

    So anyway, I went with the method of rubbing some hydrcortisone cream on my skin just to test things out, this was around the same time (it was all a couple years ago). I got an amazing response from that. Connected more with my body, facial expressions normalizing, thoughts normalizing, etc etc. The saliva result skewed my perception of this and I dropped the cream, I only used it sparingly for a couple weeks. I then got disappointed by the whole thing with TRT doing nothing and kind of moved onto the next interesting hypothesis.

    Fast forward a couple of years and after going through all kinds of different theories and experiments I came to discover with my schooling that I indeed was having some fairly extreme burnout. I could at times barely have enough will power to watch television if I studied hard for a couple of days. I tested out some licorice root and almost immediately this crushing, defeating, wall of energy drainage evaporated. I perked up and felt pretty good. I had read about consuming the Cortizone 10 ointment (ingredients petroleum jelly and hydrocortisone) so I gave it a shot and for weeks I was feeling incredible, like this was my treatment. I would say my cure but I'm not certain where this is coming from, but it was that strong. My temps were regularly hitting 98.6 for the first time since I started measuring them. I was feeling about 80% normal, up from about 20-25%.

    I had my DHEA / Ferritin / iron panel done and everything was in order, except perhaps my DHEA. Dr Mercola (I think it was his article?) suggested DHEA be in the 400-600 range for optimal levels, out of the range 85-690 mcg/dL mine was 200 mcg/dL so I felt I had some room to improve.

    Over the few weeks this faded a bit and I added in DHEA 50 mg / day. I was back up and running for about 3 or 4 days until I started to notice some fairly poor side effects. One day I was completely enraged, probably owing to the fact that DHEA can push up estrogen levels, which I read can cause these effects. I drop the DHEA and remain on ~30mg HC / day (~190lb male suggested starting dose -STTM). I also had my Dr order generic HC and that did almost nothing, Cortef seemed to be a bit better but unaffordable at the moment, attempting to get a pre-auth. The ointment honestly works really well.

    I'm having a really hard time wondering what I should do or how I should go about getting those results back, or if those results can be gotten back. I'm wondering if I've drained another nutrient or hormone involved in the process. I'm going to add back in 10mg DHEA for a while and slowly go from there and see how I respond but I can't imagine that is the only thing happening here.

    Does anyone have an understanding or experience of what could be going on here? My mood/state STRONGLY correlates with my temperature. If I'm at 98.6 I usually feel at least 80%. I'll still have some fog but I'm so much more functional as a human being. All I want to do now is sit around and research as nothing else in life I can even pretend to enjoy in my state, so that's what I do. At 98.6 I was going around taking trips without a 2nd thought, starting projects, going out and doing whatever I felt like, I just had that effortless energy.

    I've lightly played with pregnenolone without much result and I do have some Cytomel that I didn't really give a proper run in the beginning before TRT (I tried it and didn't get results in like a week - could have been due to cortisol issues. Moved to TRT and dismissed it).

    After 6 or 7 years of hardcore research and experimentation I still don't know what is wrong with me. My disease overview writeup can be found here. My protocol is outdated, I no longer am doing much methylation. Only 7-8 mg Metafolin over the course of the day.

    Labs:
    05/04/2016
    Ferritin, 57. 20-345 ng/mL - (STTM claims men want over 100. Previously had good response from Ferris bis-glycinate 18mg / day. 3-4 hours after taking = 30-45 minute period of heightened mental function, felt dopaminergic. Didn't measure temps).
    DHEA, 200, 85-690 mcg/dL
    % Iron Saturation, 48, 15-60%
    Iron, Total, 136, 50-195 mcg/dL
    Iron Binding Capcity, 285, 250-425 mcg/dL

    05/01/2015
    Bilirubin, 3.3H, 0.2-1.2 mg/dL
    TSH, 0.88, 0.40-4.50 mIU/L

    09/18/2014
    TS, Reverse, LC/MS/MS, 17 ng/dL
    T3, FREE, 3.6, 2.3-4.2 pg/mL
    TSH, 2.16, 0.40-4.50 mIU/L
    T4, FREE, 1.2, 0.8-1.8ng/dL
    No thyroid antibodies


    Thanks!
     
    Last edited: May 21, 2016
    Dichotohmy, South and Mel9 like this.
  2. AlmostEasy

    AlmostEasy

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    So after more time has passed it seems as though the hydrocortisone isn't boosting me like it was before but it still is helping probably 15%, as opposed to 50%+. I added in some Cytomel my Dr gave me to play with a while back and it boosted me quite a bit. Temps were up to 98.0+ again. Several days pass and this begins to fade as well, even titrating up up 75 mcg. I don't even know how this is possible that I'm developing tolerance to thyroid medication.

    I've read of peripheral T3 resistance and especially with high rT3 levels or mitochondrial dysfunction. I'm definitely experiencing a resistance of sorts it seems to getting T3 into the cells. rT3 acts as an anti-thyroid, so this may be a clue. I'll post some studies on this later but even the details aren't that helpful from it. I don't know what the implications are or what I should do.

    Lowering rT3 would be a start, it's one of the only clues I have but I'm not even sure how to go about doing that. I would think hydrocortisone would have been partially the key and it seemed to have been for a bit there because when I initially trialed T3 I got nothing from it at all, whereas this time it had a temporary large impact.

    I've read of super dosing T3 even above those levels but that is a territory I know nothing much about and it makes me a little uncomfortable.

    I don't have that much faith in endocrinologists from what I regularly read but I'm going to try and find a NDT literate endo here soon and possibly see what he has to say about all of this. My hopes are not high for that but I have to do something. I'm not even sure my thyroid is a problem but my response to T3 was fairly impressive. It could just be super saturation of T3 (as my lab values are fine) which lowers the amount of rT3 getting to the cells. Interesting though.

    Anyway, just giving an update and hoping maybe that might trigger something for someone out there who could share some insight.

    Thanks
     
    Dichotohmy and South like this.
  3. Paralee

    Paralee Senior Member

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    @AlmostEasy, how are your cortisol levels? It can mess with T3/T4. Everything has to balance and I've read that if cortisol is off everything else will be. This sounds right but I don't know for sure.

    Also, high cortisol will often make your temperature go down, I think mine does. When that happens my bp is up. High cortisol can also make your temp a little above normal, I have no idea how.

    When my Hashi's is up my bp is pretty much ok and my pulse is high. Or at least I think that's how it's going.
    Interesting about the mitochondrial dysfunction, I'll have to look into that. Thanks.
     
  4. Paralee

    Paralee Senior Member

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    One way to lower rT3 is to go on T3 only. That sounds kind of scary to me, but I've spoken with many that have done so. That way there's only T3 in the blood.
    High doses of vit. D3 can keep conversion of T4 to T3 also. It's a real fun round about.
     
  5. AlmostEasy

    AlmostEasy

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    @Paralee my cortisol levels were fairly high on the 4 sample salivary test in 2012 I believe.

    I went up to 150 mcg T3 for a little bit there based on some fibro studies that tolerated it well with little to no side effects and it was quite wonderful while it was working but as usual with me it stopped working after a few weeks.
     
  6. Paralee

    Paralee Senior Member

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    @AlmostEasy , I know what you mean about something actually working and how wonderful it is but then it just kind of fades away, and you can't get it back. I used to think I was the only one but I've heard that I'm not, there are actually a small group of us. Maybe you have some kind of thyroid resistance? I read that somewhere, probably here.

    About the hormones, I've read that you really shouldn't take the precursors because they can decide to turn into something undesirable. That can happen with people with genetic variants, I have some so I believe it's true. I read take the actual hormone you're deficient in, like testosterone instead of dhea, other hormones you need instead pregnenalone.So I'm like you, so into research that I wonder if I'll ever get it straightened out

    (When T3 stops working it's usually a sign you need more? But you're up to 150 mcg., so I don't know....is there room to go up more?)

    When you adjust one hormone it'll throw other/others off, so there's a constant necessary adjustment. I wish dr.'s knew how to do that. I really didn't want to hang out my shingle this late in life.

    Have you had your vitamins and minerals checked? And copper and lead, etc.? Pardon if you've already said, I can't remember your posts very well, on my first cup of coffee.

    Just saw where you mentioned Cushing's. They do have issues, extreme weight gain, body pain, it messes with their whole body. They're like people with hyperparathyroidism in the fact that it's so hard to get diagnosed.
     

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