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Question about Hypothyroidism and Cortisol

outdamnspot

Senior Member
Messages
924
So after months of dealing with horrible mystery symptoms, I've found a superlative endocrinologist with an 'integrative medicine' flair. The only real marker that has changed over the period in which my symptoms have become debilitating was my TSH migrating from 1.3 to 3.31, and he agrees that the shift might be responsible for my symptoms. He's ordered quite a lot of blood tests -- hormone levels, mineral levels, homocysteine, B12, etc. etc. -- but has also said he's happy to try treatment to see if it ameliorates symptoms, rather than let me suffer endlessly.

I'm only seeing him again in 4 weeks and admittedly I am feeling quite antsy and anxious because I really want to get at least partly back on my feet. I'm pretty much flatlined at the moment and totally bedridden (especially after giving up caffeine).

What I've been wondering is -- if one's body is in a 'weakened' state where Cortisol is presumably low, can correction of hypothyroidism alone go someway towards ameliorating that, or is it possible that the thyroid treatment might not be tolerated? I've read Cortisol and NE are actually increased in hypothyroidism as a compensatory measure, which is how I felt initially, but after months on end like that I'm presumably burned out now ..
 

Invisible Woman

Senior Member
Messages
1,267
Thyroid issues can be a whole can of worms. From personal experience to really understand what is going on you need to get readings for TSH, T3 & T4 for starters. Then there is the issue of the "normal" range - just because it might be right for many people doesn't always mean that these figures would represent what was normal for you - these tests are done after you become symptomatic so you don't have baseline figures. That's before you even start to consider cortisol...

Even doctors struggle to get this stuff right but the following link might provide some useful info:

http://www.thyroiduk.org.uk/tuk/search/search.php?zoom_query=cortisol&Go_button=Go!
 

outdamnspot

Senior Member
Messages
924
I have the three TSH readings. He's testing T3, T4, RT3 and antibodies. I guess I am just completely sick of feeling this way: my life is so stressful and it feels impossible to get on top of a single thing like this. I hate complaining, I know a lot of people here are very unwell, but it's just all so depressing and I have a million worries going through my head (what if I can't tolerate thyroid treatment, what if blah blah etc) that the exhaustion makes it impossible to distract myself from :^/
 

Invisible Woman

Senior Member
Messages
1,267
I think that's a normal reaction and depressingly familiar to many of us. Especially when, for many of us, stress relieving hobbies like sports or just going for a walk are no longer options. It is hard when there are so many issues that are beyond your control.
 

bertiedog

Senior Member
Messages
1,738
Location
South East England, UK
@outdamnspot Just to give you some positive feedback about this subject, I had rising TSH way back in 2002 but I had very long standing severe adrenal issues too which meant they weren't strong enough for me to be able to take thyroid replacement so I needed to treat both.

This was done initially with hydrocortisone around 20 mg daily in divided doses and then titrated up to 2 grains dessicated thyroid. I noticed a huge difference in my sense of well-being and ability to do stuff but for me the h/c ran out too quickly and gave me false highs and lows. I would feel so good for a short while that I would do too much and then pay for it so after 6 months my Endo suggested I might do better with 5mg Prednisolone taken as 2.5 mg first thing and same dose around lunchtime.

This worked great and felt completely natural but I did find it difficult along the way to get the thyroid right as I would get some symptoms from time to time of it being too much and could be a bit manic. It might have been my own body kicking in as I have Hashimotos and the antibodies might have been causing this. Anyway after about 8 years it settled and down and my normal dose is 2 grains plus 25 mcg thyroxine and I don't get overstimulation anymore thankfully.

My understanding is that people with illnesses like ours rarely do well on just thyroxine, this can be due to conversion problems or just the fact we need a small amount of T3 because it is the active hormone. I did try just thyroxine at 50 mcg but it was a disaster, it just made me toxic.

You probably do need to take to your doctor about this big issue of the adrenals needing to be strong enough to handle any extra thyroid treatment even if it is indicated by your symptoms and blood results. I know of several people with ME/CFS who felt worse on thyroid treatment only.

Pam
 

outdamnspot

Senior Member
Messages
924
@outdamnspot Just to give you some positive feedback about this subject, I had rising TSH way back in 2002 but I had very long standing severe adrenal issues too which meant they weren't strong enough for me to be able to take thyroid replacement so I needed to treat both.

This was done initially with hydrocortisone around 20 mg daily in divided doses and then titrated up to 2 grains dessicated thyroid. I noticed a huge difference in my sense of well-being and ability to do stuff but for me the h/c ran out too quickly and gave me false highs and lows. I would feel so good for a short while that I would do too much and then pay for it so after 6 months my Endo suggested I might do better with 5mg Prednisolone taken as 2.5 mg first thing and same dose around lunchtime.

This worked great and felt completely natural but I did find it difficult along the way to get the thyroid right as I would get some symptoms from time to time of it being too much and could be a bit manic. It might have been my own body kicking in as I have Hashimotos and the antibodies might have been causing this. Anyway after about 8 years it settled and down and my normal dose is 2 grains plus 25 mcg thyroxine and I don't get overstimulation anymore thankfully.

My understanding is that people with illnesses like ours rarely do well on just thyroxine, this can be due to conversion problems or just the fact we need a small amount of T3 because it is the active hormone. I did try just thyroxine at 50 mcg but it was a disaster, it just made me toxic.

You probably do need to take to your doctor about this big issue of the adrenals needing to be strong enough to handle any extra thyroid treatment even if it is indicated by your symptoms and blood results. I know of several people with ME/CFS who felt worse on thyroid treatment only.

Pam

Hi Pam,

Just to follow up on this: my TSH was elevated, FT3 and FT4 were pretty good, but RT3 was high. I couldn't keep getting to that endo because he was over an hour away, so have been seeing an integrative GP instead. He's prescribed me Natural Dessicated Thyroid (1/2 grain in the morning), DHEA and a herbal+nutrient Adaptogen cocktail by an Australian company here, Metagenics.

I thought the cocktail was a waste of money (and never did well on most of the ingredients standalone), so began on just the NDT and DHEA. I started the NDT at 1/4 and immediately noticed some palpitations, feeling a little sweatier, hungrier etc. I added in the DHEA but felt it worsened certain symptoms and zombified me a little, so stopped it and have continued on the NDT alone now for 6 days. I bumped the dose up to 1/2 grain this morning.

I will notice acute effects after I take it -- presumably from the T3 -- but overall I am so much more fatigued (like bedridden) and dizzier on it, and feel worse. I did a Saliva Cortisol test, but it came back normal, which the GP is really confused about because I was having terrible hypoglycemia -- eating every hour or so to stave off panic attacks etc.

I called him and he said I have to be on the Adrenal cocktail, so I shelled up $70 I don't really have. I am REALLY skeptical it will do anything for me because my adrenals seem shot, but I don't have much choice but to listen to him.

Most doctors don't believe anything is wrong with me, or offer antidepressants, so I doubt I would get a steroid prescribed (and this integrative doc only deals in bioidentical hormones).

I've ordered some Pregnenolone and Progesterone to try in case the Adrenal cocktail doesn't work, because I've read they can increase Cortisol and may help? Otherwise maybe he will have a few other ideas.

I just am feeling so hopeless .. low on money and options, and like this is the end of the line for me. I am half-tempted to order some Prednisolone as a last-resort.
 

bertiedog

Senior Member
Messages
1,738
Location
South East England, UK
@outdamnspot Sorry to hear you are going through, it does sound to me like an adrenal issue, we all know you have to have adrenals that are strong enough to be able to use the natural thyroid medication.

Have you tried the adaptogen Siberian Ginseng because you might find that is all you need because it works both on the thyroid and adrenals? It would be worth trying a standardised product maybe 200 mg at breakfast and if ok you could add the same sort of dose at lunchtime. Lots of B5 would be helpful for the adrenals too and a good B complex at the very least could be worth trying.

I would check with your doctor if it would be ok for you to try this but you would probably need to be off the thyroid meds for a short while to see if the Ginseng could help. As far as I know Panax ginseng is stronger than Siberian Ginseng so it's always better to start with the Siberian one.

I am sure there are some things you can do to help so don't give up.

Pam
 

CCC

Senior Member
Messages
457
@outdamnspot - we went through a similar thing with integrative doctors prescribing expensive supplements from Metagenics.

It's always worth looking up the ingredients list online, then looking up iherb to see if you can find the same thing at a much lower price. Then search the brand on PR to see if others use it.

We haven't found Metagenics to be higher quality than, say, Thorne, Solgar, Source Naturals, or quite a few of the other brands people on PR have used. But I guess you can hope that Metagenics isn't made in China.

Sometimes, you can save a lot of money.

if you're feeling conservative, you could always buy the doctor's one first so you know what to expect, and you can discuss effects with the doctor in terms of what he prescribed. You can then go for something cheaper once you know.
 

outdamnspot

Senior Member
Messages
924
@CCC thanks for the response. Are you based in Aus as well?

I think my doctor likes to stick to his regime, and since I'm so unwell I have to comply for the time being, so I'd rather just go along with what he prescribes, so at least if it doesn't work, we can try move onto something else. So I did end up paying for the formula.
 
Messages
3
Hello, I am British by birth and living in France at the moment. I'm new to the site and suffer with thyroid problems consequential to throat radiation treatment in 2007. I am pretty certain that I have adrenal problems but find it impossible here to find a doctor or endo who is understanding of this. I travel to the UK to see my elderly mother and have wondered about trying to see an Endo over there in the South of England. Is it permissible to ask if anyone can knows of such an Endo, and if they would PM details to me?
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
USA
Hello, I am British by birth and living in France at the moment. I'm new to the site and suffer with thyroid problems consequential to throat radiation treatment in 2007. I am pretty certain that I have adrenal problems but find it impossible here to find a doctor or endo who is understanding of this. I travel to the UK to see my elderly mother and have wondered about trying to see an Endo over there in the South of England. Is it permissible to ask if anyone can knows of such an Endo, and if they would PM details to me?
@24man, welcome to the forum:)

More people will see your post and you could get more replies by starting your own thread. Try starting a new thread under one of the headings (adrenal dysfunction or thyroid dysfunction) here:
http://forums.phoenixrising.me/index.php?forums/alternative-co-existing-or-missed-diagnoses.121/
 

Little Bluestem

All Good Things Must Come to an End
Messages
4,930
And use a really specific title like "Seeking Endo in the South of England" so the people who can help will read it.
 

outdamnspot

Senior Member
Messages
924
@outdamnspot Sorry to hear you are going through, it does sound to me like an adrenal issue, we all know you have to have adrenals that are strong enough to be able to use the natural thyroid medication.

Have you tried the adaptogen Siberian Ginseng because you might find that is all you need because it works both on the thyroid and adrenals? It would be worth trying a standardised product maybe 200 mg at breakfast and if ok you could add the same sort of dose at lunchtime. Lots of B5 would be helpful for the adrenals too and a good B complex at the very least could be worth trying.

I would check with your doctor if it would be ok for you to try this but you would probably need to be off the thyroid meds for a short while to see if the Ginseng could help. As far as I know Panax ginseng is stronger than Siberian Ginseng so it's always better to start with the Siberian one.

I am sure there are some things you can do to help so don't give up.

Pam

Hi Bertie,

I have tried Siberian Ginseng, but it seemed to worsen my hypoglycemia. I think a lot of the adaptogens might lower blood sugar. I did try the NDT, but could not tolerate it; my doctor tried an adaptogen complex with it, but it was too anxiety-provoking for me.

I'm thinking of giving some HC a shot (I have a bottle from overseas) but am a bit nervous about not being supervised.