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Low Morning Cortisol. Always foggy

Messages
77
My blood tests showed the following

-low AM cortisol
8.0ug/dL.
Range 5.0 - 25.0

-high calcium
10.3 mg/dL.
Range 8.6 - 10.3

-high magnesium
62.7mcg/g.
Range 30.1 - 56.5

-low sodium
137 mEq/L.
Range 136 - 145

-high homocysteine
16.2umol/L.
Range 3.7 - 13.9

-low WBC
4.18 thousand/uL.
Range 4.23 - 9.07

-high TSH
3.170 uIU/mL.
Range 0.400 - 4.000

-low T4
1.22 ng/dL.
Range 0.89 - 1.76

I've been waking up groggy for as long as I can remember, there's always some word slurring and brain fog but I start getting better as the day progresses. I've been taking 1.5g of magnesium glycinate with some malate, and 300mg of l-theanine before bed for a year but I think that magnesium, glycine and l-theanine contribute to my low cortisol. Oddly enough, my amino acid profile shows a need for glycine which I'm addressing now with Betaine HCL

Here are my questions:

Is it possible that I might have hypothyroidism? my mother has it and I constantly have cold hands and feet, lethargy and anxiety, need lots of coffee to get me going but b12 and folate have been helping recently w/ energy

Do magnesium, glycine and theanine contribute to lower cortisol?

who here has low morning cortisol or hypothyroidism, and how do you deal with it?

Thanks
 
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barbc56

Senior Member
Messages
3,657
Are these your interpretation of the results? A few of the results look like they are in the normal range that you have written , maybe high or low normal for some. but I am not a medical professional.

There could be many explanations for your symptoms and test results. That's why it's against the forum rules to give medical advice and best if you discuss this with your doctor.

Good luck!
 
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Old Bones

Senior Member
Messages
808
I've been waking up groggy for as long as I can remember, there's always some word slurring and brain fog but I start getting better as the day progresses. . . .

Is it possible that I might have hypothyroidism? . . . I constantly have cold hands and feet, . . .

who here has low morning cortisol or hypothyroidism, and how do you deal with it?

I can't recall even one morning in my 28 years with ME that I haven't awoken feeling drugged, hung-over, jet-lagged and more exhausted than when I went to bed. Although I eventually wake up, my cognitive problems (brain fog) last all day. I was diagnosed with hypothyroidism a couple of years ago, and like you, I regularly have cold extremities. I'm taking natural dessicated thyroid medication. My dose was gradually increased in the hope it would increase my low body temperature. This didn't work. In fact, at a dose that resulted in a totally "wired" state, my hands and feet were still icy cold.

Sorry, I can't comment on any of your test results.
 

hamsterman

Senior Member
Messages
183
Location
Los Angeles
I can't comment on the results either, but I've seen polls here, that show that its unusual not to wake up feeling horrible everyday that you have ME. I used to love the mornings... now they are just one long blur. And like others... I finally feel ok at the exact time I don't need to.... 9:00 pm.

As far as the cold extremities, if you've had this much of your life, you may just have reynaulds disease. I've got that as well.
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
USA
If your doctor is willing, you could have an ACTH stimulation test done in a clinic. It's a screening test for Addison's disease to see if your adrenals have enough reserve to pump out enough cortisol when demanded. I had it done and it didn't create any crazy adverse effects, and the results were OK, meaning I didn't have Addison's disease.

My understanding is that the low cortisol in ME/CFS has nothing to do with poorly functioning adrenal glands. It's more of a signalling problem where the adrenals don't get the message from the hypothalamus to make more cortisol. It's known as HPA (Hypothlamic-Pituitary-Adrenal) axis dysfunction and I haven't heard of a way to correct it.

Some alternative/integrative physicians might prescribe low-dose hydrocortisone or pregnenolone, but they may have you do some salivary cortisol tests beforehand just to be sure you're low across all times of day. When I had low cortisol all day long, I couldn't tolerate low-dose hydrocortisone at all.

I mentioned the harm of taking excess iodine in a previous post to you, and how it could cause hypothyroidism or hyperthyroidism. Your TSH is high-ish, and the cut-off of 4.0 could be too high, but your T4 is fine. I hope that's a free T4 level.

My TSH rose to around 4 when I started supplementing with iodine. My endocrinologist wanted to repeat my TSH and T4 three months later. I stopped taking the iodine, had the recheck three months later and my TSH was back to normal. I didn't have to be treated.

Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine.

Subclinical Hypothyroidism: An Update for Primary Care Physicians
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664572/

Subclinical Hypothyroidism: Deciding When to Treat
http://www.aafp.org/afp/1998/0215/p776.html

Have you thought about stopping the iodine supplement and asking your doctor to do a TSH and free T4 in three months? It would tell you if your TSH might go lower as a result of stopping the iodine. If it goes lower, you're fine. It if stays high-ish or goes higher, it could be something to watch or treat, depending on how high it goes.
 

hamsterman

Senior Member
Messages
183
Location
Los Angeles
If your doctor is willing, you could have an ACTH stimulation test done in a clinic. It's a screening test for Addison's disease to see if your adrenals have enough reserve to pump out enough cortisol when demanded. I had it done and it didn't create any crazy adverse effects, and the results were OK, meaning I didn't have Addison's disease.

My understanding is that the low cortisol in ME/CFS has nothing to do with poorly functioning adrenal glands. It's more of a signalling problem where the adrenals don't get the message from the hypothalamus to make more cortisol. It's known as HPA (Hypothlamic-Pituitary-Adrenal) axis dysfunction and I haven't heard of a way to correct it.

Some alternative/integrative physicians might prescribe low-dose hydrocortisone or pregnenolone, but they may have you do some salivary cortisol tests beforehand just to be sure you're low across all times of day. When I had low cortisol all day long, I couldn't tolerate low-dose hydrocortisone at all.

Yes, Addison's is quite rare. I also had the test... I was considered high-risk for it... but my results came back within normal range. I take high doses of prednisone on occasion for another ailment, and it had completely removed the fatigue... for the first few tries... but now... it only just barely helps with energy. I am currently doing the low-dose pregnenolone... I think it helps just a tad in the morning. I've heard its important to keep the dose low.... otherwise... it can start to screw up the axis.
 
Messages
77
I can't comment on the results either, but I've seen polls here, that show that its unusual not to wake up feeling horrible everyday that you have ME. I used to love the mornings... now they are just one long blur. And like others... I finally feel ok at the exact time I don't need to.... 9:00 pm.

When the clock strikes 12AM is when I'm ready to take on the world, I'm a natural night owl. Have you tried licorice root? I hear it helps with cortisol

As far as the cold extremities, if you've had this much of your life, you may just have reynaulds disease. I've got that as well.
I've had cold extremities for a long time now but they come and go, at the moment my hands are warm but my feet are cold which doesn't happen often

If your doctor is willing, you could have an ACTH stimulation test done in a clinic. It's a screening test for Addison's disease to see if your adrenals have enough reserve to pump out enough cortisol when demanded. I had it done and it didn't create any crazy adverse effects, and the results were OK, meaning I didn't have Addison's disease.

My understanding is that the low cortisol in ME/CFS has nothing to do with poorly functioning adrenal glands. It's more of a signalling problem where the adrenals don't get the message from the hypothalamus to make more cortisol. It's known as HPA (Hypothlamic-Pituitary-Adrenal) axis dysfunction and I haven't heard of a way to correct it.

Some alternative/integrative physicians might prescribe low-dose hydrocortisone or pregnenolone, but they may have you do some salivary cortisol tests beforehand just to be sure you're low across all times of day. When I had low cortisol all day long, I couldn't tolerate low-dose hydrocortisone at all.

I mentioned the harm of taking excess iodine in a previous post to you, and how it could cause hypothyroidism or hyperthyroidism. Your TSH is high-ish, and the cut-off of 4.0 could be too high, but your T4 is fine. I hope that's a free T4 level.

My TSH rose to around 4 when I started supplementing with iodine. My endocrinologist wanted to repeat my TSH and T4 three months later. I stopped taking the iodine, had the recheck three months later and my TSH was back to normal. I didn't have to be treated.

Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine.

Subclinical Hypothyroidism: An Update for Primary Care Physicians
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664572/

Subclinical Hypothyroidism: Deciding When to Treat
http://www.aafp.org/afp/1998/0215/p776.html

Have you thought about stopping the iodine supplement and asking your doctor to do a TSH and free T4 in three months? It would tell you if your TSH might go lower as a result of stopping the iodine. If it goes lower, you're fine. It if stays high-ish or goes higher, it could be something to watch or treat, depending on how high it goes.

I'm gonna check the thyroid with a specialist hopefully soon and order the ACTH test, and yes that's my free T4 level I posted :)

This is incredible information thank you so much for the reply! I've been taking iodine in the 400-500mcg region for more than a year now but I'm gonna drop it for a few weeks and see if my symptoms clear up.
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
USA
This is incredible information thank you so much for the reply! I've been taking iodine in the 400-500mcg region for more than a year now but I'm gonna drop it for a few weeks and see if my symptoms clear up.
Dropping the iodine probably won't change your symptoms. Most of us with ME/CFS have many of the problems that you're describing: feeling awful in the morning, brain fog that gets better as the day progresses, etc.

I would recommend staying off the iodine unless a doctor tells you that you need it. It's probably affecting your thyroid tests, and since that's a big concern of yours, I'd want to stay off it just so it wouldn't affect my thyroid tests.
 
Messages
77
Dropping the iodine probably won't change your symptoms. Most of us with ME/CFS have many of the problems that you're describing: feeling awful in the morning, brain fog that gets better as the day progresses, etc.

I would recommend staying off the iodine unless a doctor tells you that you need it. It's probably affecting your thyroid tests, and since that's a big concern of yours, I'd want to stay off it just so it wouldn't affect my thyroid tests.

Ah ok, controlling iodine intake is just another piece of the puzzle then. I lowered my magnesium dose at night from 1.5g to 425mg and I feel much more refreshed in the morning, my blood serum magnesium is pretty high tho so that's just my case

Have you ever tried Licorice root for low cortisol? I'm strongly considering it
 
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CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
USA
Have you ever tried Licorice root for low cortisol? I'm strongly considering it
I haven't personally tried licorice root for low cortisol, but I understand that it's often recommended for low cortisol. It keeps cortisol from being destroyed, so it keeps it in your circulation longer, which could be beneficial.
 
Messages
77
Hi all, so I got a little ballsy after reading up on @Freddd threads and high dose folate, and popped 4mg's of methylfolate along with 1mg b12 from one go. My fatigue instantly lifted, I've had crazy energy, borderline manic, for the past three hours and it's been fantastic.

I was dosing 1mcg mb12 and 800mcg in two split doses prior to this with 1200mg of supplemental potassium throughout the day along with other cofactors, but I wasn't feeling any better. I took a shot in the dark and it's worked so well for me, anyone have any idea why?
 

barbc56

Senior Member
Messages
3,657
-low AM cortisol
8.0ug/dL.
Range 5.0 - 25.0

I'm still confused about the implications of your blood test. Is this really a low reading? It looks like it's within normal range. Are the units the same for your blood level and what's considered normal? Your calcium appears to be higher than the normal.

As I said before, I am not a doctor but I can relate my experience. I was supplementing with calcium without knowing it, was roo high. Higher than normal calcium can be caused by several health conditions which meant I had to get several other bloodtests to find out why it was raised. Depending on why the calcium is raised, the treatments differ. In my case a diuretic and increase dairy in my diet, but I can't take calcium supplements as I get kidney stones. It needs to be in my diet as it's absorbed differently. The extra calcium supplements were contributing to my kidney stones as well as causing my kidneys to leak even more calcium from my bones which led to osteopenia in my spine. This would have happened even if I hadn't been supplementing. This can have serious consequences including damage to the kidneys and kidney failure if not treated

It's a bit complicated when interpreting blood tests and sometimes a doctor needs to look at the pattern of all the bloodtests, add tests if indicated plus consider health factors such as age, weight, lifestyle, etc.

Three hours is not enough time to say something is working as it may be contraindicated in the long run. I'm not discounting three wonderful hours of being symptom free. I'd love that, but like cocaine which can make you feel better, there might be a negative cost.

Sorry, I kind of went into my mother role, but it's important to get as much information as possible before deciding on a health treatment. Even if it ends up being the same decision.

Maybe you have done this, apologies if you have, so take what you want from the above info. Plus this is my experience

Again good luck!
 
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Messages
77
According to my MD my cortisol is on the lower side of the range which explains my fatigue. I'm guessing my calcium is high due to thyroid issues, calcitonin works with the parathyroid hormone to regulate calcium and intracellular magnesium, both of which happen to be high. I don't take any form of dietary or supplementary calcium, last time I did it wreaked havoc in my body

I've dropped my magnesium to 425mg every night before bed in the form of malate and my sleep is more refreshing, and my mb12/folate along with high potassium is really helping my energy levels stay consistent

I understand why you'd react that way, I'm usually a skeptic but it's been a long time since something worked so well for me. P5P gave me energy for months, L-histidine made me fluent and quick on my feet again, but it feels like high dose folate has given me both in one day. I believe there's a reason deplin has been so successful in treating depression and anxiety.

A lot of people such as myself started off on very low doses of folate and b12 only to experience sluggishness, fatigue and some anxiety. @Freddd made it clear that low dose folate can cause donut-hole folate deficiency, a tiny dose can't promote healing like a larger dose can. This morning I tried 2.4mg of folate along side 5mg of mb12, while I feel better than usual, it's not the miraculous effect of 4.8mg of folate and 1mg of b12 I tried yesterday.

I have no MTHFR problems but I have BHMT +/+, MTRR +/- and MTR +/+ so I desperately need mb12. I learned yesterday that when the BHMT pathway is running slow it can produce folate deficiency even if your blood levels show high folate on blood tests, which happens to be my case.

I hope this isn't a fluke, I will continue to post my results in this thread and if there's any energy level fluctuations throughout the day.
 

barbc56

Senior Member
Messages
3,657
Ah, that makes sense as I have hyperparathyroidism along with my kidney leaking calcium.

Thanks and continued good health!