Hydrocortisone + Thyroid Hormone (The Quest Continues)

[Kierkegaard]

Has anyone had success with taking hydrocortisone as a means to tolerating thyroid hormone, i.e., thyroid hormone at a certain dose threshold starts to make you feel worse, and *not* hyperthyroid?

For whatever reason, I had to increase my levothyroxine (I can't tolerate T3, whether as a monotherapy or part of naturally dessicated thyroid) from 50 mcg to 75 mcg, and felt better. A few days ago I decided to try increasing it to 100 mcg and felt worse: photophobia, brain fog, fatigue (particularly around the eyes, like allergy-related fatigue); but also better: good mood, libido.

I decided to try adding 15 mg hydrocortisone in three divided doses over approximately two hours while taking 100 mcg and felt better, though I was unsure if it was the HC as a causal factor. Interestingly, the next day I felt better than I have felt in weeks if not a month or longer. Today I also feel better than usual. So it seems very likely there was a causal influence. A few years ago I tried up to 25 mg of hyrdocortisone per day for a month or two, but I didn't experience any noticeable effects, positive or negative.

I also have what's looking like "partial" pseudohyperaldosteronism: my aldosterone, renin, *and* potassium are all low, and previously I concluded I have some sort of adrenal enzyme blockage (i.e., partial congenital adrenal hyperplasia), meaning I might need HC to correct the feedback mechanism with cortisol and the hypothalamus. I speak English sometimes too.

It's just frustrating. I can think of no other reason why I can't tolerate thyroid hormone at a certain level than an adrenal issue.

Anyone have experience with thyroid and hydrocortisone?

 

[pattismith]

The fact you feel better with cortisone doesn't necessary means you have an adrenal problem.
You may feel better because of anti-inflammatory properties of cortisone, or from its activity against auto-immune diseases.
Do you suffer with muscle pain? autonomic dysfunction?
You have thyroid meds, did you suffer with auto-immune thyroiditis?
Do you have some other evidence of auto-immune dysregulations?

 

[Wishful]

Prednisone was great the first two times I tried it: temporary full remission. I doubt that it had anything to do with my thyroid levels or adrenals. I assume it was immunomodulatory.

I have elevated Tsh, but no symptoms that really fit hypothyroidism, and I don't feel any better or worse on supplemental T4 or T3. I do have a strong response to T2, and if I don't boost my T2 every 21 days, I feel much worse. That likely doesn't apply to your issues, but it's an example of how tricky thyroid issues can be. The cause of your responses might not be as simple as adrenal issues or any other common theoretical causes.

I'm also sensitive to goitrogens, such as brassicas. I assume they reduce my T2 production, but I'm not sure. You can try some raw or slightly (<3 minutes) cooked brassicas to see if your symptoms get worse, which would indicate thyroid involvement. Look up goitrogens and how cooking time affects them if you're interested.

 

[Kierkegaard]

The fact you feel better with cortisone doesn't necessary means you have an adrenal problem.
You may feel better because of anti-inflammatory properties of cortisone, or from its activity against auto-immune diseases.
Do you suffer with muscle pain? autonomic dysfunction?
You have thyroid meds, did you suffer with auto-immune thyroiditis?
Do you have some other evidence of auto-immune dysregulations?

My inflammatory markers have been very good, namely sedimentation rate and CRP.

I have muscle weakness related to low-grade PEM, but nothing much other than that. I do unambiguously have an issue with my thyroid increasing in size (not nodules or goiters, the entire thyroid is slightly larger and harder -- thyroid inflammation), though that has gotten better lately.

The reason I think I have an adrenal issue is:
- I feel better on adaptogens, namely rhodiola, ashwagandha, and adrenal glandulars
- I have a relatively low ACTH:cortisol ratio
- I have below-range aldosterone, renin, and borderline low potassium (without supplementation) -- apparent partial pseudohyperaldosteronism
- I have some classic symptoms of hypothyroidism (missing outer third of eyebrows, consistent 96.6F basal body temperature) despite reaching my threshold for tolerating thyroid meds
- I can't tolerate T3 and even T4 thyroid meds, which Dr Durrant-Peatfield, Dr Brownstein, and others associates with insufficient cortisol

I've also tried tending to mitochondria with every cofactor/supplement out there, including the expensive MItoq.

 

[Kierkegaard]

Prednisone was great the first two times I tried it: temporary full remission. I doubt that it had anything to do with my thyroid levels or adrenals. I assume it was immunomodulatory.

I have elevated Tsh, but no symptoms that really fit hypothyroidism, and I don't feel any better or worse on supplemental T4 or T3. I do have a strong response to T2, and if I don't boost my T2 every 21 days, I feel much worse. That likely doesn't apply to your issues, but it's an example of how tricky thyroid issues can be. The cause of your responses might not be as simple as adrenal issues or any other common theoretical causes.

I'm also sensitive to goitrogens, such as brassicas. I assume they reduce my T2 production, but I'm not sure. You can try some raw or slightly (<3 minutes) cooked brassicas to see if your symptoms get worse, which would indicate thyroid involvement. Look up goitrogens and how cooking time affects them if you're interested.

Interesting stuff on the T2! I've never had that pulled, so maybe it's time.

I took diindolylmethane (DIM) for a few years, and it was one of the only supplements that significantly helped me: dramatic reduction in brain fog/dissociation, increase in libido, etc. (I had started testosterone cypionate at too high a dose, so my estradiol was too high as well). I've since moved on to iodine -- similar estrogen metabolism without the risk of goitrogens, though I don't think DIM ever caused a thyroid issue.