Can hypothyroidism/adrenal fatigue mimic CFS?

[drob31]

I know that CFS can trigger hypothyroidism, and so can adrenal issues. I'm trying to figure out if post exertorial malaise, and non-restorative sleep can manifest itself for hypothyroidism like it does for CFS.

Let's use a hypothetical scale of 1-10. 1 is slow walking. 10 is intense weight lifting.

Monday: 6-7 (moderate cardio) Fatigue factor: 1-2
Tuesday: 9 (weight lifting heavy) Fatigue factor: 0-1
Wednesday: 7: (weight lifting light) Fatigue factor: 5-6 Something's starting to happen, pushed through it.
Thursday: 2 (nothing) Fatigue Factor: 7-8 (random bouts during the day) backed off, however the fatigue begins
Friday: 2 (nothing) Fatigue Factor: 7-8 (random bouts during the day)
Saturday 2 (nothing) Fatigue 7-8 (random bouts during the day)

The other part of hypothyroidism or adrenal fatigue that I have is the non-restorative sleep. I can get 9-10 hours, but it never feels like real sleep, it dosen't feel deep and restorative when I wake up. Sometimes a quick nap in the afternoon or evening can feel more restorative than 10 hours of sleep.

Since I was sub-clinical hypothyroid (TSH 4.5) for a period of time (before the crash), and still had restorative sleep, I'm trying to determine if more severe hypothyroid symptoms / adrenal fatigue can cause these two issues, as they do in CFS.

 

[Leopardtail]

As far as I am aware, ME is the only illness that produces true PEM with all its features. Hypothyroidism can cause severe fatigue but one wouldn't expect it to continue to worsen for days, or worsen after sleep...

 

[drob31]

As far as I am aware, ME is the only illness that produces true PEM with all its features. Hypothyroidism can cause severe fatigue but one wouldn't expect it to continue to worsen for days, or worsen after sleep...

So you don't think non refreshing sleep or restorative sleep could be a symptom of adrenal or hypothyroid disfunction?

 

[Leopardtail]

So you don't think non refreshing sleep or restorative sleep could be a symptom of adrenal or hypothyroid disfunction?

lots of things can cause non-restorative sleep. Feeling worse after sleep (greater exhaustion) and staying that way all day seems to be ME.

 

[drob31]

Sleep doesn't make me feel worse per se. It just doesn't "cure" everything the way sleep used to. I used to be able to sleep it off. Now I can't sleep it off. The fatigue isn't all day, it comes and goes. Sometimes it goes away.

 

[Leopardtail]

well with hypothyroidism, I would generally expect you to feel better after sleep than before, but not 100%.
Most of us with light-moderate ME feel MUCH worse the following day or days than we did straight after stopping.

Your figures above do look like PEM.

 

[drob31]

Thanks for the analysis. That's what I'm trying to figure out. Fatigue / water retention are the main symptoms that get worse when PEM hits.

 

[Gingergrrl]

@drob31 Sorry if I missed this part but are you taking medication for the hypothyroid and do you also have Hashimoto's (or just regular hypo without the Hashi's part?) Also when you said TSH of 4.5 was subclinical hypo, many endocrinologists (at least in the U.S.) would disagree with you and cut it off at a much stricter scale of TSH at 3.5. If you have ever taken thyroid meds which brought you to a TSH of around 1.0, do your PEM type symptoms disappear?

 

[SickOfSickness]

I think they can, and other conditions can. (I don't have any details on why or what others, sorry.)

 

[drob31]

@drob31 Sorry if I missed this part but are you taking medication for the hypothyroid and do you also have Hashimoto's (or just regular hypo without the Hashi's part?) Also when you said TSH of 4.5 was subclinical hypo, many endocrinologists (at least in the U.S.) would disagree with you and cut it off at a much stricter scale of TSH at 3.5. If you have ever taken thyroid meds which brought you to a TSH of around 1.0, do your PEM type symptoms disappear?

Not taking any medication for anything currently. I need to get another adrenal stress profile test done, because the first one is ambigious. It falls within the normal range, but the range is huge. I don't want to take the thyroid hormone before I know if the adrenals are ready, otherwise, since it's armour, they will convert the t4 portion to rt3, or there will not be enough cortisol to let the t3 in.

My TSH about 10 months ago was 4.1 or so. My TSH 2 months ago was 1.6. This was after 2 weeks of iodine, but it eventually crashed me, I'm guessing because the adrenals weren't ready, unless it was a herx effect, but it seemed more like just deeper hypothyroidism, colder, and more hair loss, more water retention.

I have researched using the circadian t3 only method, which I'm considering trying, but I want to get another read on my adrenals. I'm also buying some isocort from ebay, so I have some cortizone on hand in case I want to experiment.

 

[Gingergrrl]

@drob31 I would get tested for the two Hashimoto's antibodies (if you haven't already done so.) In my case even though my TSH was right on the border with the standard criteria, and hypothyroid by the stricter criteria, I had sky high levels of both antibodies and was started on low dose Armour Thyroid and told to avoid iodine. I know all doctors are different so I am only reporting what was helpful for me.

 

[drob31]

My antibodies have come out clean both teams, 10 months ago, and 2 months ago.

However, is it possible to have hashimoto's without antibodies present?

Also, assuming it is, would my autoimmune profile be positive for Anti-DNA (double-stranded) antibodies; antinuclear antibodies; complement C3?

My numbers:

Thyroid Peroxidase (TPO) Ab <6 0-34 IU/mL
Thyroglobulin, Antibody <1.0 0.0-0.9 IU/mL

 

[Gingergrrl]

@drob31 As far as I know, if you do not test positive for the antibodies then you do not have Hashimoto's. My antibodies were both really high although I do not have a positive ANA or any other known autoimmune disease (besides whatever ME/CFS ultimately turns out to be labeled!) I have chronic viral re-activation of EBV but that is another story...

 

[drob31]

You don't think EBV is the root of your problems instead of the elusive CFS antibody?

Also, have you ever tried replacing cortisol?

 

[Gingergrrl]

You don't think EBV is the root of your problems instead of the elusive CFS antibody?

Also, have you ever tried replacing cortisol?

@drob31 Oh, I definitely think that EBV re-activation is at the root of my CFS and that the Hashimoto's is a co-morbid issue from the EBV/CFS. My Hashimoto's is well controlled with Armour Thyroid and not the cause of my CFS. I meet all the criteria of CFS with fatigue, PEM, neurological/autonomic issues, etc. I am unable to do any exertion or get shortness of breath.

My CFS doctor said I have a classic viral reactivation syndrome that thus far my immune system has been too impaired to fight on it's own so I am now taking Famvir. I really do not know if the elusive "CFS antibody" will ever be found?!

I take Atenolol and Florinef as a result of the cardiac and autonomic issues I have from the EBV/CFS but have not been told by any Dr that I have needed Cortisol. I did the 24 hour saliva cortisol test and although my numbers were low, they were not ridiculously low and were not reversed. My ND recommended DHEA but it made me severely nauseous at that time (I tried it 3-4x) and was unable to tolerate it. My endocrinologist did not want me to take Cortisol and felt Florinef was the better med for my situation.

 

[drob31]

Interesting, so he thought it was better to replace aldosterone rather than cortisol.

The thing about the adrenal saliva numbers being optimal or not, is that I'm having trouble finding a lot of data, other than what STTM has, suggesting optimal numbers. Perhaps having a 6.5, when the range is 3-9 is normal for that particular person, but is low according to STTM. What measure should we really go by?

In my case I'm still searching for causality. I know I had issues prior to my crash, my TSH was high, I've probably had pyroluria for a while, my wbc has been low, and I'm compound hetero MTHFR. However, about 1 year ago I was actually feeling very good, minus my excessive need to sleep all the time. My adrenal saliva results were ambigious in my opinion, which is why I'm doing it again, and going with the ASI test instead of zrtlabs.

 

[Gingergrrl]

In my case it was b/c I have having severe tachycardia and IST/POTS symptoms and no longer able to take a shower without a shower chair and basically homebound. My cardiologist and endo felt these were the best meds for me but my situation sounds very different than yours! I had none of these issues prior to mono and EBV.

 

[drob31]

Did your CFS start off with being sick? Did you ever get sick from mono or ebv prior?

 

[Gingergrrl]

I was extremely sick from mono in 2012 with high fever for three weeks straight, liver tests so high I was almost hospitalized, twice to the ER for IV fluids for dehydration and abcess on my tonsil, steroids to shrink tonsils so I could breath, bruises all over my body, extreme sickly fatigue, tachycardia, and I could go on and on. It was the sickest I had ever been in my life! I had never had mono prior to this episode and for whatever reason, the EBV keeps re-activating with high titers on five different EBV tests but my doctor is hoping the Famvir can break this cycle.

 

[drob31]

Wow, ok so there is a pathological connection there. When I think of it, I did have the swine flu back in 2010, but I haven't had any episodes like yours.

Ever hear of influenza variants being linked to CFS?