Re: adrenal results - should I use hc?

[Guest guest]

Any thoughts please?

>

> Hi all

>

> I posted my adrenal results in another thread a few days ago, but that was a

lengthy and very helpful discussion with about t3, so I wanted to post them

again separately for advice on the way forward with my adrenals.

>

> For 3 years now, I've had problems tolerating any type of thyroid meds and

I've tried them all. At anything other than a tiny dose, I get hyper type

symptoms, particularly racing pulse and anxiety. I seem to convert from t4 to t3

ok, but then the t3 pools in my blood causing these symptoms. I've various

issues going on, but I belive low iron (which I am addressing) and low cortisol/

low blood sugar to be the main contributort factors. My worse time for these

symptoms is in the early hours of the morning, when cortisol is at its lowest

naturally, so I reckon mine must be really low then.

>

> I'm now on t3 and I want to stick with that as it brings me more relief than

any other thyroid med of my hypo symptoms, though I can only tolerate 5mc a day.

This isn't enough to make a difference to my low cortisol using the circadian

method, I don't think.

>

> I've been taking 5 NAXs, vit c etc for 9 months, and my results have actually

got marignally worse.

>

> They are as follows:

> Cortisol 1: 18.9 (12-22)

> Cortisol 2: 3.7 (5-9)

> Cortisol 3: 3.0 (3-7)

> Cortisol 4: 0.5 (1.0-3.0)

>

> DHEA 1: 0.30 (0.40-1.47)

> DHEA 2: 0.22 (as above)

>

> They've all gone down slightly, except for the first cortisol reading which

has gone up slightly.

>

> Do you think I should now self-treat with hc (and or dhea) and how do I go

about it? How would I know what levels to start at?

>

> I should add that my endo did the synacthen test which I 'passed' and I don't

have adrenal antibodies. Before doing the test, he tried me on cortisol for a

couple of days. I think it was 10mg. I felt loads more energetic the first day

but really, really depressed the second day, so the trial was stopped. Why would

I have reacted like that?

>

> Many thanks

>

> Susie

>

[Guest guest]

One last try thanks!

> >

> > Hi all

> >

> > I posted my adrenal results in another thread a few days ago, but that was a

lengthy and very helpful discussion with about t3, so I wanted to post them

again separately for advice on the way forward with my adrenals.

> >

> > For 3 years now, I've had problems tolerating any type of thyroid meds and

I've tried them all. At anything other than a tiny dose, I get hyper type

symptoms, particularly racing pulse and anxiety. I seem to convert from t4 to t3

ok, but then the t3 pools in my blood causing these symptoms. I've various

issues going on, but I belive low iron (which I am addressing) and low cortisol/

low blood sugar to be the main contributort factors. My worse time for these

symptoms is in the early hours of the morning, when cortisol is at its lowest

naturally, so I reckon mine must be really low then.

> >

> > I'm now on t3 and I want to stick with that as it brings me more relief than

any other thyroid med of my hypo symptoms, though I can only tolerate 5mc a day.

This isn't enough to make a difference to my low cortisol using the circadian

method, I don't think.

> >

> > I've been taking 5 NAXs, vit c etc for 9 months, and my results have

actually got marignally worse.

> >

> > They are as follows:

> > Cortisol 1: 18.9 (12-22)

> > Cortisol 2: 3.7 (5-9)

> > Cortisol 3: 3.0 (3-7)

> > Cortisol 4: 0.5 (1.0-3.0)

> >

> > DHEA 1: 0.30 (0.40-1.47)

> > DHEA 2: 0.22 (as above)

> >

> > They've all gone down slightly, except for the first cortisol reading which

has gone up slightly.

> >

> > Do you think I should now self-treat with hc (and or dhea) and how do I go

about it? How would I know what levels to start at?

> >

> > I should add that my endo did the synacthen test which I 'passed' and I

don't have adrenal antibodies. Before doing the test, he tried me on cortisol

for a couple of days. I think it was 10mg. I felt loads more energetic the first

day but really, really depressed the second day, so the trial was stopped. Why

would I have reacted like that?

> >

> > Many thanks

> >

> > Susie

> >

>

[Guest guest]

For 3 years now, I've had problems tolerating any type of thyroid meds and I've tried them all. At anything other than a tiny dose, I get hyper type symptoms, particularly racing pulse and anxiety. I seem to convert from t4 to t3 ok, but then the t3 pools in my blood causing these symptoms. I've various issues going on, but I belive low iron (which I am addressing) and low cortisol/ low blood sugar to be the main contributory factors. My worse time for these symptoms is in the early hours of the morning, when cortisol is at its lowest naturally, so I reckon mine must be really low then.I'm now on t3 and I want to stick with that as it brings me more relief than any other thyroid med of my hypo symptoms, though I can only tolerate 5mc a day. This isn't enough to make a difference to my low cortisol using the circadian method, I don't think.I've been taking 5 NAXs, vit c etc for 9 months, and my results have actually got marignally worse.They are as follows:Cortisol 1: 18.9 (12-22)Cortisol 2: 3.7 (5-9)Cortisol 3: 3.0 (3-7)Cortisol 4: 0.5 (1.0-3.0)DHEA 1: 0.30 (0.40-1.47)DHEA 2: 0.22 (as above)They've all gone down slightly, except for the first cortisol reading which has gone up slightly.Do you think I should now self-treat with hc (and or dhea) and how do I go about it? How would I know what levels to start at?I should add that my endo did the synacthen test which I 'passed' and I don't have adrenal antibodies. Before doing the test, he tried me on cortisol for a couple of days. I think it was 10mg. I felt loads more energetic the first day but really, really depressed the second day, so the trial was stopped. Why would I have reacted like that?Hello Susie,

Reading all of the above, I am wondering why you would consider HC... Your adrenal profile is only marginally out and in my opinion does not warrant the supplementation of HC. Your morning cortisol is actually pretty healthy with 18.9. I do not doubt for a minute that you do have symptoms, but it is more likely that those might be caused by other issues like low iron, perhaps Candida and it is just possible that you might react adversely to certain foods, which could be causing your symptoms. You might also have some sex hormone issues – I don't know your age, but if you were going through the menopause by any chance, that could explain it. I don't know much about regulating sex hormones, so couldn't say if taking DHEA would be beneficial.

The reason I mention food allergies and Candida is because your symptoms ring bells with me. I have been fighting Candida for the past 18 years with more or less success, and know firsthand what sugar does to me... it hypes me and gives me palps, not to mention the muscle aches and joint pains. I reckon you should look into that possibility, as Candida will prevent thyroid hormone from getting utilized.

The same goes for low iron... until your iron status is restored and you show a ferritin of above 70 – better 90-100 – your body cannot utilize thyroid hormone. – see....

***Low iron/ferritin: Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone (1-4). Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present (1-4)).

1. Dillman E, Gale C, Green W, et al. Hypothermia in iron deficiency due to altered triiodithyroidine metabolism. Regulatory, Integrative and Comparative Physiology 1980;239(5):377-R381.

2. SM, PE, Lukaski HC. In vitro hepatic thyroid hormone deiodination in iron-deficient rats: effect of dietary fat. Life Sci 1993;53(8):603-9.

3. Zimmermann MB, Köhrle J. The Impact of Iron and Selenium Deficiencies on Iodine and Thyroid Metabolism: Biochemistry and Relevance to Public Health. Thyroid 2002;12(10): 867-78.

4. Beard J, tobin B, Green W. Evidence for Thyroid Hormone Deficiency in Iron-Deficient Anemic Rats. J. Nutr. 1989;119:772-778.

I have not read 's book but what I remember him saying about the use of T3 is that you have to start dosing in the early hours to provide the adrenals with thyroid hormone. The principle is that adrenal glands need thyroid hormone in order to produce cortisol. Their production happens between 4 am and 8 am and if by that time there is not sufficient T3 available in the body, then they won't be able to produce enough cortisol – and since the main cortisol production for the day happens during this time, if there is insufficient T3 available, then the cortisol production will be less and a body will `run on low' for the rest of the day. The adrenals will of course produce a little more during the day on demand to help the body cope with daily chores and stress, but chiefly it is the morning cortisol that will be used up during the day.

Since the whole idea of early T3 dosing is based on coaxing the adrenals into action, supplementing HC would have the opposite effect. It would signal the adrenals that they don't have to make any more, because it's being supplemented. So the adrenals cut back and you won't be any better off.

You say that your worst symptoms are in the early hours of the morning when your cortisol is at its lowest....which confuses me a little....- do you mean early hours like midnight or 1 am ? – or early hours like 4 am or later? ... if the former, then yes, your cortisol would be low and should be low.... else you would not be able to sleep. But if you mean 4 am or later, then low cortisol should not be the culprit, because your am cortisol figure looks ok.... So I think it is unlikely that your symptoms are caused by insufficient cortisol and I would be looking at other possible culprits.

A very good friend of mine has a similar problem to yours. She is severely hypothyroid, but can't tolerate any thyroid hormone so far. Like you – name it, she's tried it. Out of desperation she went to see a private endo in London and he came up with a surprising theory... he reckons that she might suffer from a food allergy and put her onto a very severe exclusion diet. If that is her problem remains to be seen (in her case I actually doubt it, but that's another story), but the interesting thing is that intolerances to certain foods can prevent the uptake of thyroid hormone (something Dr. Peatfield has said all along) – mainly because certain foods can keep the intestines in a permanent state of inflammation... and the patient might not at all be aware of it, because it does not necessarily cause violent diarrhoea like a gluten allergy, for instance; it can cause symptoms like palps, headaches, nausea, weakness, getting hyper, etc. My friend invited me to sit in at one of her consultations with this endo, and I must say, I was mighty impressed – something that does not happen very often when it comes to endos.

....Before doing the test, he tried me on cortisol for a couple of days. I think it was 10mg. I felt loads more energetic the first day but really, really depressed the second day, so the trial was stopped. Why would I have reacted like that?ly – If you are talking about HC and not Prednisolone, then I think that was a red herring.... you might have felt the way you did with or without HC. Whilst 10 mg HC can act as a "pick me up" when needed, I doubt if it would be enough to alter your state of mind. If, however, you were talking about Prednisolone, that would be a different thing – 10 mg of Pred equals 40 mg of HC.... so that could have had an influence, although depression on the second day on preds is not really something you would expect... after 2 weeks, yes, but after 2 days, I doubt it.

So all in all, Susie, if it were me in your shoes, I would not opt for HC at this stage, but would carry on with NAX etc, would address the iron in earnest and look into possibilities like Candida and/or food allergies... perhaps with the help of a good nutritionist.

With best wishes,

[Guest guest]

" The same goes for low iron... until your iron status is restored and you show

a ferritin of above 70 – better 90-100 – your body cannot

utilize thyroid hormone. "

Bearing in mind that my ferritin was less than 30 when I started taking T3 and

60 when I had to stop taking oral iron five months ago, does this mean I'm

wasting my time?

D

[Guest guest]

> " The same goes for low iron... until your iron status is restored and you show a ferritin of above 70 – better 90-100 – your body cannot> utilize thyroid hormone."> > Bearing in mind that my ferritin was less than 30 when I started taking T3 and 60 when I had to stop taking oral iron five months ago, does this mean I'm wasting my time?

Hi D,

You got me... - I should have said .....cannot utilize thyroid hormone optimally.... and this has to be taken in context, because it goes equally for all of the other points Dr. Peatfield makes; it is not just iron that will hamper the utilization of thyroid hormone.

I am not terribly versed on iron (it's not a problem I have got) but I think once iron is up, it stays up for quite a while (?) - think I read that somewhere.... I don't know your history, D., and why you had to stop iron supplementation, but it might be worth looking at your iron level again. However, one can supplement iron and raise the level whilst taking thyroid, so no, it's not a waste of time you taking T3. Anyway - what's the alternative? - without thyroid hormone you'd probably be even worse off. But if at all possible, I would try and bring the iron up to optimal level.

Best wishes,

[Guest guest]

Thanks for clarifying that .

I despair of ever getting my ferritin up. I cannot tolerate oral iron and I

cannot get either injections or infusions. Having it tested again tomorrow for

the first time since July, when it was 60. I had to stop taking ferrous

fumarate in September because of the side effects and have found all the viable

alternatives are either ineffective (Spatone and Floravital) or upset my stomach

too badly.

I see the endo next week and will be asking for a referral somewhere that will

be able to give me iron therapy, but I'm not holding my breath.

D

>

> > " The same goes for low iron... until your iron status is restored and

> you show a ferritin of above 70 – better 90-100 – your body

> cannot

> > utilize thyroid hormone. "

> >

> > Bearing in mind that my ferritin was less than 30 when I started

> taking T3 and 60 when I had to stop taking oral iron five months ago,

> does this mean I'm wasting my time?

>

>

> Hi D,

>

> You got me... [] - I should have said .....cannot utilize thyroid

> hormone optimally.... and this has to be taken in context, because it

> goes equally for all of the other points Dr. Peatfield makes; it is not

> just iron that will hamper the utilization of thyroid hormone.

>

[Guest guest]

> I despair of ever getting my ferritin up. I cannot tolerate oral iron and I cannot get either injections or infusions. Having it tested again tomorrow for the first time since July, when it was 60. I had to stop taking ferrous fumarate in September because of the side effects and have found all the viable alternatives are either ineffective (Spatone and Floravital) or upset my stomach too badly.

Hi D,

have you tried Floradix? this is supposed to be very mild...

http://www.chemistdirect.co.uk/floradix-liquid-iron-formula_1_37646.html

or chelated iron from Bluebonnet? (the chelated stuff is supposed to be gentle on the stomach....

http://www.iherb.com/Bluebonnet-Nutrition-Chelated-Iron-90-Vcaps/11571?at=0

all the best,

[Guest guest]

Hi

Thanks so much for your reply and for the time it must have taken you

> Your adrenal profile is only marginally out and in my opinion does not

> warrant the supplementation of HC.

Thanks for clarifying that. To be honest, I am a bit at sea with knowing what's

what here, so it's very helpful to have your input on that.

> but it is more likely that those might be caused by other

> issues like low iron, perhaps Candida and it is just possible that you

> might react adversely to certain foods, which could be causing your

> symptoms. You might also have some sex hormone issues

Yes, I'm sure low iron is a factor. I do have problems with candida too. What do

you use to treat it? I've used flucanazole so much, I'm not sure it helps

anymore! I know that sugar does give me these symptoms, but even when I'm super

vigilant from a candida point of view with my diet, I still react to thyroid

meds this way. I think probably because I've got so many issues going on.

> The reason I mention food allergies and Candida is because your symptoms

> ring bells with me. I have been fighting Candida for the past 18 years

So can you tolerate your thyroid meds ok?

> You say that your worst symptoms are in the early hours of the morning

Yes, I meant in the 1-3am slot. I just wondered if my cortisol was falling way

too low giving me those symptoms. But then, as you say, my morning cortisol is

ok, so maybe that's unlikely.

>Out of desperation she went

> to see a private endo in London and he came up with a surprising

> theory... he reckons that she might suffer from a food allergy and put

> her onto a very severe exclusion diet.

I'm coeliac and do have other food intolerances. I do have a good nhs dietician,

so I will talk to her about doing an exclusion diet. Would you mind emailing me

your friend's endo's details please (or maybe your friend's details is she's

happy with that) as I'd be intersted in seeing this endo myself.

>

> So all in all, Susie, if it were me in your shoes, I would not opt for

> HC at this stage, but would carry on with NAX etc, would address the

> iron in earnest and look into possibilities like Candida and/or food

> allergies... perhaps with the help of a good nutritionist.

>

> With best wishes,

>

>

>

Thank you very much.

Best wishes

Susie

[Guest guest]

Hi D *waves*

Did you see my thread asking about alternative's to iron tabs? Sopmeone kindly

pointed me in the direction of transdermal iron my Neem Genie. I've got some now

and whilst I can't yet comment on how it's impacting my iron levels, i can tell

you that my skin is absolutely fine with it (you might recall that magnesium

'oil' made me really itchy). Might be worth you looking into. If you're nervous

about shelling out on it when your sking might react to it, we could always meet

up and you could try a bit of mine (now there's an offer you can't refuse lol!).

http://www.neemgenie.co.uk/all-products/transdermal-iron/prod_75.html

All the best

Susie x

[Guest guest]

Hi Susie,

I will email you the endo's details privately - but be warned.... he is

very, very , expensive ... £ 450 for a consultation - although he

does work with private health insurances, so if you were insured, it

might be ok.

and Sheila - I know you will be interested in the name and I'm happy to

let you know, but I am not sure that he is NDT-friendly... he has strong

views about the rightness of TSH and goes by the FT's, but at least he

does recognize a conversion problem when it stares him in the eye and

offers to prescribe a T4/T3 combo in such a case.

Best wishes,

[Guest guest]

A warning to coeliacs or the gluten-intolerant: Floradix contains wheatgerm.

Floravital is a formulation from the same company which is gluten-free. However,

although it is supposed to be mild, I can't even tolerate 1ml (a 20th of the

recommended daily dose) without my stomach being a mess, and that's taking it

diluted in orange juice with a meal. I had trouble with Spatone to begin with

too, but I now seem to have adjusted to it.

I've been using the Transdermal Iron from Neem Genie - it dries quickly and

causes no irritation. Whether it works or not, I'll never really know, as I'm

also taking Spatone and eating lots of red meat and offal, plus using a cast

iron pan.

My ferritin was 18 when tested last month, I really hope I am improving it. I

now have a prescription for thyroxine, but don't want to start until I improve

it somewhat.

> > I despair of ever getting my ferritin up. I cannot tolerate oral iron

> and I cannot get either injections or infusions. Having it tested again

> tomorrow for the first time since July, when it was 60.