Re: My day today (lots of problems)

[Guest guest]

My God man way would you change your meds without talking to your Dr. Val. is

good but she is not a Dr. I don't feel going up to 40 mgs is doing this to your

it's your high Estraidol. I can take Arimidex and be up all night going to the

bathroom and lose 5 to 8 lbs of water over night. And put it right back on in

days.

I don't feel the way your taking your HC is supporting your body the right way.

I do 10mgs first thing in the morning 5am when I get up to go to the bathroom

and I do my TRT if it's that day then my Thyroid mends I then go back to bed and

get up at 8am feeling much better. From then on I do 5mgs. every 4 hrs and at

bedtime for a total of 30 mgs a day.

You can cut back to the Dose your Dr. had you on now or starting in the morning.

Did you ask your GP if you could try your Arimidex.

If not can you call him and ask him if you can try it for a few days it will

make you feel better.

Co-Moderator

Phil

> From: Gibcast <gibcast@...>

> Subject: My day today (lots of problems)

>

> Date: Friday, January 28, 2011, 2:38 PM

> NOTE: I posted this at the adrenals

> group, but it never appears so I am trying here instead:

>

> FYI: I am taking: 40 mg HC daily (since 10-11 days ago),

> 120 mg Thyroid, 35 mg DHEA and 100 mg Testosterone in 1 gram

> compunded gel, daily.

>

> I feel horrible this morning! Woke up with a heavy head,

> and a sleepiness/tiredness that won't go away! I am also

> extra stuck in my nose and sinuses, and my face is even more

> bloated/round.

>

> I increased HC from 35 to 40 mg on my own (wise or stupid?

> without consulting a doc!) 10 days ago. This resulted in a

> temp drop from 99.0 to 98.0 but after some days, up to

> 98.4.

>

> I now wonder if I should raise Thyroid " on my own " cause

> Hertoghe, my doctor, is away in another country on a seminar

> or something. I can't ask any docs, so I am asking here. My

> FT3 was 4.6 (3.5 - 7.0 pmol/l) two days ago, at 11 am,

> fasting from everything except HC. Does this mean I need

> more Thyroid? I definitely feel Hypo at the moment.

>

> Another question is: How can FT3 drop so low when it was

> above 50% of the range only 1 month ago? 1 month ago it was

> 3.40 pg/mL (2.1 - 4.2 pg/mL). I know it's a different

> measurement method than the lab I used for my latest FT3

> analyze, but still. Looking at the ranges it seems like I

> was ok then, and low now. How can I drop so fast? In just 4

> weeks?

>

> It's 12:30 pm, and I woke up only 2 hours ago. My temp is

> 98.2 which is pssibly a bit low (but again, maybe it's

> normal since I woke up only 2 hrs ago?) and BP is normal at

> 125/50/80.

>

> I feel VERY dizzy all the time, sleepy, like my head is

> heavy and my eyelids are too, and my nose is stuck on the

> right side (swollen inside). When I lead forward I get more

> dizzy. Is this a sign of HIGH or LOW cortisol, or something

> else like a sinus infection? Why wouldn't my sinuses become

> BETTER after I increased from 35 to 40 mg HC 10 days ago

> then if so?

>

> I feel SO helpless, and scared at the moment. My doc,

> Hertoghe, is not available, it's Friday, which means a " dead

> weekend " - No doctors are available on weekeneds except

> those at the ER, and those have no hormone knowledge at all.

> I feel alone and helpless. Seriously, this is NOT how one

> should feel. I feel EXTREMELY bad today.

>

> IS THIS HIGH OR LOW CORTISOL? - HOW CAN I TELL THE

> DIFFERENCE? I have been on 40 mg HC for 10 days now. I feel

> like, looking at my face, it CAN be too much, but, Thyroid

> also seems lower now with an FT3 of  4.6 (3.5 - 7.0 pmol/l)

> measured only 2-3 days ago. Just how can I tell what's

> what?

>

> Going to the GP now... Feeling helpness and scared! What do

> I do? I can't feel like this! It's wrong!!!

>

> Update 3 hours later: Just got back from GP. He said it was

> a mistake to increase HC from 35 to 40 mg only because of a

> slight temp of 99.0. I increased HC because said it

> was a smart thing to do. My face got bloated, temps lower.

> And my latest FT3 is lower, probably because I increased HC.

> So, maybe it WAS a mistake to increase HC? It's just

> IMPOSSIBLE TO KNOW WHAT TO DO with HC! So, GP said it's

> probably too much HC making me feel bad PLUS sinus issues.

> We did a CRP and it was less than 8, which is normal.

>

> Will taking HC, which masks infections, also lower CRP

> making me look healthy when I am not? Always wondered about

> that! I asked the nurses at GP's but they had no answer.

> They are not used to people taking HC every day like I do.

>

> I got " Rinexin " and " Nasonex " . The first one is forbidden

> in the US due to some deaths from it. It's a tablet to

> reduce swelling inside the nose/sinuses. I have used it

> before. The second one is a nasal spray with steroids in it.

> I asked GP about the steroids and if it's too much adding

> that to my system, and he said no, the doses are so small it

> doesn't matter.

>

> So I will try these two tonight when I get them from the

> pharmacy. I have no idea what else to do. Also I will lower

> HC I think - INSTEAD of increasing Thyroid.

>

> How should I lower HC? Which dose? This is my HC dose

> today. What about changing the middle 5 mg dose to 2.5 mg?

> Actually I just did. Is this ok? 37.5 mg HC? And is it ok to

> dose down on HC when I feel like this? Maybe it IS high

> cortisol making me more HYPO?

>

> 10

> 2.5

> 10

> 5

> 7.5

> 5

>

> This is what I take daily now, for the past 10-11 days. Can

> I remove 5 mg so I am back to my normal 35 mg daily? Or do I

> have to remove 2.5 at a time with 2-3-4 days til next

> lowering? I seriously don't know if I feel LOW CORTISOL or

> HIGH CORTISOL now, but my boated face (moon face, or

> whatever) is a sign I am on too much HC. I am not really

> shaking. But I feel dizzy.

>

> Oh what to do! Hertoghe is not available til next Tuesday!

>

> Here are my latest Fasting Electrolytes + Full iron panel:

>

> Potassium 3.7 (3.6 - 4.6 mmol/l)

> Sodium 139 (137 - 145 mmol/l)

> Calcium 2.3 (2.15 - 2.51 mmol/l)

> Chloride 100 (100 - 110 mmol/l)

> Phosphorus 1.22 (0.75 - 1.65 mmol/l)

> Magnesium 0.94 (0.71 - 0.94 mmol/l)

> Ferritin 45 (30 - 250 m g/L)

> Transferrin 2.3 (2.0 - 4.0 mg/L)

> Transferrin Saturation 21 (15 - 57%)

> Transferrin Receptor 2.3 (2.0 - 5.0 mg/L)

> TIBC 0.45 (0.20 - 4.0 umol/l)

>

> I think my iron panel looks crappy... I know Thyroid (T3)

> won't go into the cells properly if Ferritin/Iron is too

> low... :-( And I am scared of low Potassium! What do I do

> with IRON and POTASSIUM, HC and Thyroid? And my high E2?

>

>

>

>

>

>

>      

>

>

[Guest guest]

My GP is not a hormone specialist. He has his opinions, and they are often the

opposite of Hertoghe's. Like GP says " never stress dose HC, take one dose all

the time " and that is just wrong if you really need mroe. So, I stress dosed for

3 days, taking 40 mg instead of 35, but kept doing it for 11 days, and today, I

took 37.5 mg HC and in 3 days I will take 35 mg daily again. I hope I have not

damaged myself too much taking 40 mg HC daily for a period of 11 days.

Phils, you say E2 increased with taking more HC? Well, the only blood draw I did

while on 40 mg HC was the newest one, where E2 is just slightly above top range.

But it's still too high. All the other's were done while taking 35 mg HC.

It's so difficult to KNOW when to take more HC. Hertoghe gives a paper about

taking HC to his patients. It states: " If you feel the beginning of a sick, take

5 to 10 mg extra HC every 30 minutes, til you feel improvement " - MY QUESTION

IS: What the heck, what if one never feels better and increases to what.. 200

mg? 300 mg? 1000 mg? Where does the stress-dosing end? My GP said that to me

today. He thinks Hertoghe is crazy cause he doesn't tell his patients to STOP

increasing doses.

I don't think increasing to 40 mg was extreme, but it's possibly too much for

me. Maybe it was enough doing it 1 or 2 days, but I kept going. So...

Here I am, still alive. But man I feel strange in my head. This started today.

It can very well be HIGH CORTISOL, plus a sinus infection, and high E2, all

combined. High E2 also stops Testosterone from working, which again stops T3

from working. Am I correct?

What I saw on yesterdays Thyroid panel result was that FT3 is now in the low

range. Phil, do you know if taking more HC lowers FT3 in the blood so we can see

it? Cause my FT3 was near top range only 1 month ago. Now it's near the low

range. Scary indeed. And I still have the rT3 (Reverse T3) thing in the back of

my mind... I'm thinking " OMG, what if rT3 blocks the little FT3 I have left from

working! Then I'll die! " and stuff like that in addition to the high E2, useless

Testosterone etc.

If you do 10+5+5+5+5 then you're not following your bodys natural cortisol

secretion. It should start at 10, then go down slowly. Like, 10, 7.5, 5, 5, 2.5.

Or something like that. This I learned at the adrenals groups and from STTM.

Hertoghe, however, tells me to take 20 mg HC in the morning cause I, and I

quote, " have a big body " (I'm not BIG, I'm just tall at 6 foot 3 inches). I

tried that but it wasn't good so I changed to multidosing, as Hertoghe calls it.

The multidosing is 's advice and I am following it. I really have no idea

how my body is processing HC, so I am doing the multidosing with smaller doses

throughot the day as you saw in my email below. I have done multidosing since

the summer of 2009 when I started taking HC. I only tried Hertoghes 20+10 dosing

for a few days in March 2010 when I first came to him, then had to stop cause it

was bad.

" You can cut back to the Dose your Dr. had you on now or starting in the

morning. " - What do you mean? Are you talking about HC? I increased HC on my

own. But I was doing " ok " (I guess) on 35 mg HC daily. But who knows which dose

is perfect huh. Nobody. It's a gamble with manual hormone replacement! I hate

it. Really, I hate it.

Did not ask GP about Arimidex. GP's office is closed til Monday morning. So now

I am stuck thru the weekend. Again, I don't think taking more HC makes my E2

higher cause it was high taking 35 mg as well as 40. Actually higher taking 35

than taking 40 mg HC. So... I don't know.

I could try Arimidex. I guess. But then it would be " self medicating " and it

doesn't feel safe IMHO.

Good to hear from you Phil. I feel less alone now. Thanks a bunch, bro.

in Norway

> From: Gibcast <gibcast@...>

> Subject: My day today (lots of problems)

>

> Date: Friday, January 28, 2011, 2:38 PM

> NOTE: I posted this at the adrenals

> group, but it never appears so I am trying here instead:

>

> FYI: I am taking: 40 mg HC daily (since 10-11 days ago),

> 120 mg Thyroid, 35 mg DHEA and 100 mg Testosterone in 1 gram

> compunded gel, daily.

>

> I feel horrible this morning! Woke up with a heavy head,

> and a sleepiness/tiredness that won't go away! I am also

> extra stuck in my nose and sinuses, and my face is even more

> bloated/round.

>

> I increased HC from 35 to 40 mg on my own (wise or stupid?

> without consulting a doc!) 10 days ago. This resulted in a

> temp drop from 99.0 to 98.0 but after some days, up to

> 98.4.

>

> I now wonder if I should raise Thyroid " on my own " cause

> Hertoghe, my doctor, is away in another country on a seminar

> or something. I can't ask any docs, so I am asking here. My

> FT3 was 4.6 (3.5 - 7.0 pmol/l) two days ago, at 11 am,

> fasting from everything except HC. Does this mean I need

> more Thyroid? I definitely feel Hypo at the moment.

>

> Another question is: How can FT3 drop so low when it was

> above 50% of the range only 1 month ago? 1 month ago it was

> 3.40 pg/mL (2.1 - 4.2 pg/mL). I know it's a different

> measurement method than the lab I used for my latest FT3

> analyze, but still. Looking at the ranges it seems like I

> was ok then, and low now. How can I drop so fast? In just 4

> weeks?

>

> It's 12:30 pm, and I woke up only 2 hours ago. My temp is

> 98.2 which is pssibly a bit low (but again, maybe it's

> normal since I woke up only 2 hrs ago?) and BP is normal at

> 125/50/80.

>

> I feel VERY dizzy all the time, sleepy, like my head is

> heavy and my eyelids are too, and my nose is stuck on the

> right side (swollen inside). When I lead forward I get more

> dizzy. Is this a sign of HIGH or LOW cortisol, or something

> else like a sinus infection? Why wouldn't my sinuses become

> BETTER after I increased from 35 to 40 mg HC 10 days ago

> then if so?

>

> I feel SO helpless, and scared at the moment. My doc,

> Hertoghe, is not available, it's Friday, which means a " dead

> weekend " - No doctors are available on weekeneds except

> those at the ER, and those have no hormone knowledge at all.

> I feel alone and helpless. Seriously, this is NOT how one

> should feel. I feel EXTREMELY bad today.

>

> IS THIS HIGH OR LOW CORTISOL? - HOW CAN I TELL THE

> DIFFERENCE? I have been on 40 mg HC for 10 days now. I feel

> like, looking at my face, it CAN be too much, but, Thyroid

> also seems lower now with an FT3 of  4.6 (3.5 - 7.0 pmol/l)

> measured only 2-3 days ago. Just how can I tell what's

> what?

>

> Going to the GP now... Feeling helpness and scared! What do

> I do? I can't feel like this! It's wrong!!!

>

> Update 3 hours later: Just got back from GP. He said it was

> a mistake to increase HC from 35 to 40 mg only because of a

> slight temp of 99.0. I increased HC because said it

> was a smart thing to do. My face got bloated, temps lower.

> And my latest FT3 is lower, probably because I increased HC.

> So, maybe it WAS a mistake to increase HC? It's just

> IMPOSSIBLE TO KNOW WHAT TO DO with HC! So, GP said it's

> probably too much HC making me feel bad PLUS sinus issues.

> We did a CRP and it was less than 8, which is normal.

>

> Will taking HC, which masks infections, also lower CRP

> making me look healthy when I am not? Always wondered about

> that! I asked the nurses at GP's but they had no answer.

> They are not used to people taking HC every day like I do.

>

> I got " Rinexin " and " Nasonex " . The first one is forbidden

> in the US due to some deaths from it. It's a tablet to

> reduce swelling inside the nose/sinuses. I have used it

> before. The second one is a nasal spray with steroids in it.

> I asked GP about the steroids and if it's too much adding

> that to my system, and he said no, the doses are so small it

> doesn't matter.

>

> So I will try these two tonight when I get them from the

> pharmacy. I have no idea what else to do. Also I will lower

> HC I think - INSTEAD of increasing Thyroid.

>

> How should I lower HC? Which dose? This is my HC dose

> today. What about changing the middle 5 mg dose to 2.5 mg?

> Actually I just did. Is this ok? 37.5 mg HC? And is it ok to

> dose down on HC when I feel like this? Maybe it IS high

> cortisol making me more HYPO?

>

> 10

> 2.5

> 10

> 5

> 7.5

> 5

>

> This is what I take daily now, for the past 10-11 days. Can

> I remove 5 mg so I am back to my normal 35 mg daily? Or do I

> have to remove 2.5 at a time with 2-3-4 days til next

> lowering? I seriously don't know if I feel LOW CORTISOL or

> HIGH CORTISOL now, but my boated face (moon face, or

> whatever) is a sign I am on too much HC. I am not really

> shaking. But I feel dizzy.

>

> Oh what to do! Hertoghe is not available til next Tuesday!

>

> Here are my latest Fasting Electrolytes + Full iron panel:

>

> Potassium 3.7 (3.6 - 4.6 mmol/l)

> Sodium 139 (137 - 145 mmol/l)

> Calcium 2.3 (2.15 - 2.51 mmol/l)

> Chloride 100 (100 - 110 mmol/l)

> Phosphorus 1.22 (0.75 - 1.65 mmol/l)

> Magnesium 0.94 (0.71 - 0.94 mmol/l)

> Ferritin 45 (30 - 250 m g/L)

> Transferrin 2.3 (2.0 - 4.0 mg/L)

> Transferrin Saturation 21 (15 - 57%)

> Transferrin Receptor 2.3 (2.0 - 5.0 mg/L)

> TIBC 0.45 (0.20 - 4.0 umol/l)

>

> I think my iron panel looks crappy... I know Thyroid (T3)

> won't go into the cells properly if Ferritin/Iron is too

> low... :-( And I am scared of low Potassium! What do I do

> with IRON and POTASSIUM, HC and Thyroid? And my high E2?

>

>

>

>

>

>

>      

>

>

[Guest guest]

, your sodium is very low in the range. Have you ever tested

aldosterone?

It's possible that you have low aldosterone causing the low sodium. Florinef

may be needed and Dr H does prescribe it to some of his patients I hear.

Hydrocortisone may lower sodium retention by lowering aldosterone. Cortisol

actually has some sodium retaining ability, so this might explain why.

However, in some people, the body decreases production too much in response

to HC. I'm one of those with that issue and I had salt-wasting occur from

taking HC that got even worse on higher doses as I thought I was low

cortisol. I couldn't figure out if I was high or low cortisol and I was

adding salt, which I just urinated right out. That took water and potassium

out of my body with the sodium I couldn't retain, so I was dehydrated yet

was getting quite puffy and my blood pressure was going higher. I also had

orthostatic hypotension that got worse when I tried to up my HC.

I think you know to be very careful about raising thyroid when you have low

iron. I'll add that low sodium may throw off your temps. I had temps

stabilise only when I had Florinef added to HC. Till then tons of HC never

stabilised my temps and random readings would show weird things like a major

drop after an HC dose, which I now know was from loosing more sodium.

Your potassium is also very low, which requires attention if you want to

avoid SEVERE muscle cramps if you can get your doc to give you Florinef.

What's recommended is you recheck sodium/potassium regularly to see what

needs to be changed. Please review the guidelines here:

http://nthadrenalsweb.org/treatment-for-aldosterone.php

http://nthadrenalsweb.org/testing-for-aldosterone.php

Just a warning. The Nasonex goes systemic. I had a weird response to it when

I wasn't on any hormones yet and it seemed to give me salt-wasting as it's a

corticosteroid.

-Nigel

On 28 January 2011 13:38, Gibcast <gibcast@...> wrote:

>

>

> NOTE: I posted this at the adrenals group, but it never appears so I am

> trying here instead:

>

> FYI: I am taking: 40 mg HC daily (since 10-11 days ago), 120 mg Thyroid, 35

> mg DHEA and 100 mg Testosterone in 1 gram compunded gel, daily.

>

> I feel horrible this morning! Woke up with a heavy head, and a

> sleepiness/tiredness that won't go away! I am also extra stuck in my nose

> and sinuses, and my face is even more bloated/round.

>

> I increased HC from 35 to 40 mg on my own (wise or stupid? without

> consulting a doc!) 10 days ago. This resulted in a temp drop from 99.0 to

> 98.0 but after some days, up to 98.4.

>

> I now wonder if I should raise Thyroid " on my own " cause Hertoghe, my

> doctor, is away in another country on a seminar or something. I can't ask

> any docs, so I am asking here. My FT3 was 4.6 (3.5 - 7.0 pmol/l) two days

> ago, at 11 am, fasting from everything except HC. Does this mean I need more

> Thyroid? I definitely feel Hypo at the moment.

>

> Another question is: How can FT3 drop so low when it was above 50% of the

> range only 1 month ago? 1 month ago it was 3.40 pg/mL (2.1 - 4.2 pg/mL). I

> know it's a different measurement method than the lab I used for my latest

> FT3 analyze, but still. Looking at the ranges it seems like I was ok then,

> and low now. How can I drop so fast? In just 4 weeks?

>

> It's 12:30 pm, and I woke up only 2 hours ago. My temp is 98.2 which is

> pssibly a bit low (but again, maybe it's normal since I woke up only 2 hrs

> ago?) and BP is normal at 125/50/80.

>

> I feel VERY dizzy all the time, sleepy, like my head is heavy and my

> eyelids are too, and my nose is stuck on the right side (swollen inside).

> When I lead forward I get more dizzy. Is this a sign of HIGH or LOW

> cortisol, or something else like a sinus infection? Why wouldn't my sinuses

> become BETTER after I increased from 35 to 40 mg HC 10 days ago then if so?

>

> I feel SO helpless, and scared at the moment. My doc, Hertoghe, is not

> available, it's Friday, which means a " dead weekend " - No doctors are

> available on weekeneds except those at the ER, and those have no hormone

> knowledge at all. I feel alone and helpless. Seriously, this is NOT how one

> should feel. I feel EXTREMELY bad today.

>

> IS THIS HIGH OR LOW CORTISOL? - HOW CAN I TELL THE DIFFERENCE? I have been

> on 40 mg HC for 10 days now. I feel like, looking at my face, it CAN be too

> much, but, Thyroid also seems lower now with an FT3 of 4.6 (3.5 - 7.0

> pmol/l) measured only 2-3 days ago. Just how can I tell what's what?

>

> Going to the GP now... Feeling helpness and scared! What do I do? I can't

> feel like this! It's wrong!!!

>

> Update 3 hours later: Just got back from GP. He said it was a mistake to

> increase HC from 35 to 40 mg only because of a slight temp of 99.0. I

> increased HC because said it was a smart thing to do. My face got

> bloated, temps lower. And my latest FT3 is lower, probably because I

> increased HC. So, maybe it WAS a mistake to increase HC? It's just

> IMPOSSIBLE TO KNOW WHAT TO DO with HC! So, GP said it's probably too much HC

> making me feel bad PLUS sinus issues. We did a CRP and it was less than 8,

> which is normal.

>

> Will taking HC, which masks infections, also lower CRP making me look

> healthy when I am not? Always wondered about that! I asked the nurses at

> GP's but they had no answer. They are not used to people taking HC every day

> like I do.

>

> I got " Rinexin " and " Nasonex " . The first one is forbidden in the US due to

> some deaths from it. It's a tablet to reduce swelling inside the

> nose/sinuses. I have used it before. The second one is a nasal spray with

> steroids in it. I asked GP about the steroids and if it's too much adding

> that to my system, and he said no, the doses are so small it doesn't matter.

>

> So I will try these two tonight when I get them from the pharmacy. I have

> no idea what else to do. Also I will lower HC I think - INSTEAD of

> increasing Thyroid.

>

> How should I lower HC? Which dose? This is my HC dose today. What about

> changing the middle 5 mg dose to 2.5 mg? Actually I just did. Is this ok?

> 37.5 mg HC? And is it ok to dose down on HC when I feel like this? Maybe it

> IS high cortisol making me more HYPO?

>

> 10

> 2.5

> 10

> 5

> 7.5

> 5

>

> This is what I take daily now, for the past 10-11 days. Can I remove 5 mg

> so I am back to my normal 35 mg daily? Or do I have to remove 2.5 at a time

> with 2-3-4 days til next lowering? I seriously don't know if I feel LOW

> CORTISOL or HIGH CORTISOL now, but my boated face (moon face, or whatever)

> is a sign I am on too much HC. I am not really shaking. But I feel dizzy.

>

> Oh what to do! Hertoghe is not available til next Tuesday!

>

> Here are my latest Fasting Electrolytes + Full iron panel:

>

> Potassium 3.7 (3.6 - 4.6 mmol/l)

> Sodium 139 (137 - 145 mmol/l)

> Calcium 2.3 (2.15 - 2.51 mmol/l)

> Chloride 100 (100 - 110 mmol/l)

> Phosphorus 1.22 (0.75 - 1.65 mmol/l)

> Magnesium 0.94 (0.71 - 0.94 mmol/l)

> Ferritin 45 (30 - 250 m g/L)

> Transferrin 2.3 (2.0 - 4.0 mg/L)

> Transferrin Saturation 21 (15 - 57%)

> Transferrin Receptor 2.3 (2.0 - 5.0 mg/L)

> TIBC 0.45 (0.20 - 4.0 umol/l)

>

> I think my iron panel looks crappy... I know Thyroid (T3) won't go into the

> cells properly if Ferritin/Iron is too low... :-( And I am scared of low

> Potassium! What do I do with IRON and POTASSIUM, HC and Thyroid? And my high

> E2?

>

>

>

[Guest guest]

,

Val and I worked together at STTM helping people with there Adrenals and Thyroid

problems. She is great and helped me a lot.

But the idea of following your body's rhythm on HC meds dose not work for

everyone. With me I feel bad in the morning so I take 10 mgs with I wake up to

go to the bathroom at about 5am. I then go back to bed and get up feeling

better at 8am then I eat and take 5 mgs then 5mgs at lunch then 5mgs with dinner

then 5 mgs at bedtime for a Total of 30 mgs this is what works best for me. I

go to low when I am sleeping my sugar falls very low and my Testosterone

converts into Estraidol very fast with lower levels of Cortiols when sleeping.

So I take 5 mgs at bedtime.

Did you know if you found out someone you love died your Cortisol levels would

shoot up into the upper 200's to help you with the stress of this bad news.

People don't get sick from taking up to 40 mgs of HC / day.

Here is a FAQ's I know I gave you this link before in this it tells you

everything you need to know about low Cortisol when to stress dose how to come

off HC meds and how to tell if you need more.

Please read this and when you don't know what to do read it again.

http://www.stopthethyroidmadness.com/adrenal-info/faq/

If you have an infection it can lower your Thyroid levels not to worry.

Co-Moderator

Phil

>

>

>

> > From: Gibcast <gibcast@...>

>

> > Subject: My day today (lots of

> problems)

>

> >

>

> > Date: Friday, January 28, 2011, 2:38 PM

>

> > NOTE: I posted this at the adrenals

>

> > group, but it never appears so I am trying here

> instead:

>

> >

>

> > FYI: I am taking: 40 mg HC daily (since 10-11 days

> ago),

>

> > 120 mg Thyroid, 35 mg DHEA and 100 mg Testosterone in

> 1 gram

>

> > compunded gel, daily.

>

> >

>

> > I feel horrible this morning! Woke up with a heavy

> head,

>

> > and a sleepiness/tiredness that won't go away! I am

> also

>

> > extra stuck in my nose and sinuses, and my face is

> even more

>

> > bloated/round.

>

> >

>

> > I increased HC from 35 to 40 mg on my own (wise or

> stupid?

>

> > without consulting a doc!) 10 days ago. This resulted

> in a

>

> > temp drop from 99.0 to 98.0 but after some days, up

> to

>

> > 98.4.

>

> >

>

> > I now wonder if I should raise Thyroid " on my own "

> cause

>

> > Hertoghe, my doctor, is away in another country on a

> seminar

>

> > or something. I can't ask any docs, so I am asking

> here. My

>

> > FT3 was 4.6 (3.5 - 7.0 pmol/l) two days ago, at 11

> am,

>

> > fasting from everything except HC. Does this mean I

> need

>

> > more Thyroid? I definitely feel Hypo at the moment.

>

> >

>

> > Another question is: How can FT3 drop so low when it

> was

>

> > above 50% of the range only 1 month ago? 1 month ago

> it was

>

> > 3.40 pg/mL (2.1 - 4.2 pg/mL). I know it's a different

>

> > measurement method than the lab I used for my latest

> FT3

>

> > analyze, but still. Looking at the ranges it seems

> like I

>

> > was ok then, and low now. How can I drop so fast? In

> just 4

>

> > weeks?

>

> >

>

> > It's 12:30 pm, and I woke up only 2 hours ago. My temp

> is

>

> > 98.2 which is pssibly a bit low (but again, maybe

> it's

>

> > normal since I woke up only 2 hrs ago?) and BP is

> normal at

>

> > 125/50/80.

>

> >

>

> > I feel VERY dizzy all the time, sleepy, like my head

> is

>

> > heavy and my eyelids are too, and my nose is stuck on

> the

>

> > right side (swollen inside). When I lead forward I get

> more

>

> > dizzy. Is this a sign of HIGH or LOW cortisol, or

> something

>

> > else like a sinus infection? Why wouldn't my sinuses

> become

>

> > BETTER after I increased from 35 to 40 mg HC 10 days

> ago

>

> > then if so?

>

> >

>

> > I feel SO helpless, and scared at the moment. My doc,

>

> > Hertoghe, is not available, it's Friday, which means a

> " dead

>

> > weekend " - No doctors are available on weekeneds

> except

>

> > those at the ER, and those have no hormone knowledge

> at all.

>

> > I feel alone and helpless. Seriously, this is NOT how

> one

>

> > should feel. I feel EXTREMELY bad today.

>

> >

>

> > IS THIS HIGH OR LOW CORTISOL? - HOW CAN I TELL THE

>

> > DIFFERENCE? I have been on 40 mg HC for 10 days now. I

> feel

>

> > like, looking at my face, it CAN be too much, but,

> Thyroid

>

> > also seems lower now with an FT3 of  4.6 (3.5 - 7.0

> pmol/l)

>

> > measured only 2-3 days ago. Just how can I tell

> what's

>

> > what?

>

> >

>

> > Going to the GP now... Feeling helpness and scared!

> What do

>

> > I do? I can't feel like this! It's wrong!!!

>

> >

>

> > Update 3 hours later: Just got back from GP. He said

> it was

>

> > a mistake to increase HC from 35 to 40 mg only because

> of a

>

> > slight temp of 99.0. I increased HC because

> said it

>

> > was a smart thing to do. My face got bloated, temps

> lower.

>

> > And my latest FT3 is lower, probably because I

> increased HC.

>

> > So, maybe it WAS a mistake to increase HC? It's just

>

> > IMPOSSIBLE TO KNOW WHAT TO DO with HC! So, GP said

> it's

>

> > probably too much HC making me feel bad PLUS sinus

> issues.

>

> > We did a CRP and it was less than 8, which is normal.

>

> >

>

> > Will taking HC, which masks infections, also lower

> CRP

>

> > making me look healthy when I am not? Always wondered

> about

>

> > that! I asked the nurses at GP's but they had no

> answer.

>

> > They are not used to people taking HC every day like I

> do.

>

> >

>

> > I got " Rinexin " and " Nasonex " . The first one is

> forbidden

>

> > in the US due to some deaths from it. It's a tablet

> to

>

> > reduce swelling inside the nose/sinuses. I have used

> it

>

> > before. The second one is a nasal spray with steroids

> in it.

>

> > I asked GP about the steroids and if it's too much

> adding

>

> > that to my system, and he said no, the doses are so

> small it

>

> > doesn't matter.

>

> >

>

> > So I will try these two tonight when I get them from

> the

>

> > pharmacy. I have no idea what else to do. Also I will

> lower

>

> > HC I think - INSTEAD of increasing Thyroid.

>

> >

>

> > How should I lower HC? Which dose? This is my HC dose

>

> > today. What about changing the middle 5 mg dose to 2.5

> mg?

>

> > Actually I just did. Is this ok? 37.5 mg HC? And is it

> ok to

>

> > dose down on HC when I feel like this? Maybe it IS

> high

>

> > cortisol making me more HYPO?

>

> >

>

> > 10

>

> > 2.5

>

> > 10

>

> > 5

>

> > 7.5

>

> > 5

>

> >

>

> > This is what I take daily now, for the past 10-11

> days. Can

>

> > I remove 5 mg so I am back to my normal 35 mg daily?

> Or do I

>

> > have to remove 2.5 at a time with 2-3-4 days til next

>

> > lowering? I seriously don't know if I feel LOW

> CORTISOL or

>

> > HIGH CORTISOL now, but my boated face (moon face, or

>

> > whatever) is a sign I am on too much HC. I am not

> really

>

> > shaking. But I feel dizzy.

>

> >

>

> > Oh what to do! Hertoghe is not available til next

> Tuesday!

>

> >

>

> > Here are my latest Fasting Electrolytes + Full iron

> panel:

>

> >

>

> > Potassium 3.7 (3.6 - 4.6 mmol/l)

>

> > Sodium 139 (137 - 145 mmol/l)

>

> > Calcium 2.3 (2.15 - 2.51 mmol/l)

>

> > Chloride 100 (100 - 110 mmol/l)

>

> > Phosphorus 1.22 (0.75 - 1.65 mmol/l)

>

> > Magnesium 0.94 (0.71 - 0.94 mmol/l)

>

> > Ferritin 45 (30 - 250 m g/L)

>

> > Transferrin 2.3 (2.0 - 4.0 mg/L)

>

> > Transferrin Saturation 21 (15 - 57%)

>

> > Transferrin Receptor 2.3 (2.0 - 5.0 mg/L)

>

> > TIBC 0.45 (0.20 - 4.0 umol/l)

>

> >

>

> > I think my iron panel looks crappy... I know Thyroid

> (T3)

>

> > won't go into the cells properly if Ferritin/Iron is

> too

>

> > low... :-( And I am scared of low Potassium! What do I

> do

>

> > with IRON and POTASSIUM, HC and Thyroid? And my high

> E2?

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >

>

> >      

>

> >

>

> >

[Guest guest]

I would have to respectfully disagree. Everyone reacts differently, and

if one isn't completely hypopituitary like Phil, or suffering from

's (produces no cortisol whatsoever), then HC can make you worse.

Or cause all kinds of side effects no one every warns you about on STTM

sites. Glaucoma, bone loss, weight gain, high BP are just some. Here's

a good thread from Dr. no's site " Recovering from Terrible HC

Experience... "

http://www.definitivemind.com/forums/showthread.php?t=583 & highlight=hydr\

ocortisone

> People don't get sick from taking up to 40 mgs of HC / day.

[Guest guest]

OK you disagree by one person posting they had probems. Dr. M did not say what

dose of HC did what he was talking about. And in the past Dr. M has said time

and time again the best Dr. at this is the Dr. that did this book SAFE USES OF

CORTISOL by McK. Jeffries 3rd Edition Chapter …

http://www.stopthethyroidmadness.com/safe-uses/

People do need to be tested for a lot of things before going on HC meds it

should be the last thing a Dr. does.

I have lost count to how many times people at STTM posted they felt bad on HC

meds and it was because they were not on enough of it.

Co-Moderator

Phil

> From: Barb <baba@...>

> Subject: Re: My day today (lots of problems)

>

> Date: Saturday, January 29, 2011, 11:51 AM

> I would have to respectfully

> disagree.  Everyone reacts differently, and

> if one isn't completely hypopituitary like Phil, or

> suffering from

> 's (produces no cortisol whatsoever), then HC can

> make you worse.

> Or cause all kinds of side effects no one every warns you

> about on STTM

> sites.  Glaucoma, bone loss, weight gain, high BP are

> just some.  Here's

> a good thread from Dr. no's site " Recovering from

> Terrible HC

> Experience...        "

>

[Guest guest]

DH was on up to 40 mg, got pre-glaucoma (which has gone down now that he's off

HC), and a squamous cell skin cancer (HC can lower your immunity). Nobody is

allowed to post adverse results anymore because the group is 100% moderated. No

one is hearing about the dangers.

His saliva cortisol showed him below range at noon, and low overall for the day.

Thyroid and testosterone also tested low, estrogen high.

I believe Dr Jeffries recommended 15-20 mg/day. STTM recommends WAY more than

that, and WAY too much thyroid (as you know). How many post that they were

taking too much? When one woman did that and started telling about the bad side

effects, Val shut the group down for a week. When it came back, it was on full

moderation. How's that for open discussion?

Barb

>

> > From: Barb <baba@...>

> > Subject: Re: My day today (lots of problems)

> >

> > Date: Saturday, January 29, 2011, 11:51 AM

> > I would have to respectfully

> > disagree.  Everyone reacts differently, and

> > if one isn't completely hypopituitary like Phil, or

> > suffering from

> > 's (produces no cortisol whatsoever), then HC can

> > make you worse.

> > Or cause all kinds of side effects no one every warns you

> > about on STTM

> > sites.  Glaucoma, bone loss, weight gain, high BP are

> > just some.  Here's

> > a good thread from Dr. no's site " Recovering from

> > Terrible HC

> > Experience...        "

> >

>

[Guest guest]

Well I don't feel anyone needs that much HC 20 mgs should work if one needs it

and yes there are people that can't take HC meds. But it was the brand not the

HC with some of them. Yes I have talked to a few that got dam sick on HC meds

but they were self treating and most of the people at STTM do this.

Going by what Dr. M said I would not tell someone not to try HC meds if there

testing shows they need it.

What Chilln is doing at Dr. 's forum Dr. has not given any input on

this. But I seen my cortsiol levels go up as my Preg. levels went up.

So what he is talking about works but it is very hard to follow.

Co-Moderator

Phil

> From: Barb <baba@...>

> Subject: Re: My day today (lots of problems)

>

> Date: Saturday, January 29, 2011, 1:18 PM

> DH was on up to 40 mg, got

> pre-glaucoma (which has gone down now that he's off HC), and

> a squamous cell skin cancer (HC can lower your

> immunity).  Nobody is allowed to post adverse results

> anymore because the group is 100% moderated.  No one is

> hearing about the dangers.

>

> His saliva cortisol showed him below range at noon, and low

> overall for the day.  Thyroid and testosterone also

> tested low, estrogen high.

>

> I believe Dr Jeffries recommended 15-20 mg/day.  STTM

> recommends WAY more than that, and WAY too much thyroid (as

> you know).  How many post that they were taking too

> much?  When one woman did that and started telling

> about the bad side effects, Val shut the group down for a

> week.  When it came back, it was on full

> moderation.  How's that for open discussion?

>

> Barb

>

>

> >

> > > From: Barb <baba@...>

> > > Subject: Re: My day today (lots of

> problems)

> > >

> > > Date: Saturday, January 29, 2011, 11:51 AM

> > > I would have to respectfully

> > > disagree.  Everyone reacts differently, and

> > > if one isn't completely hypopituitary like Phil,

> or

> > > suffering from

> > > 's (produces no cortisol whatsoever), then

> HC can

> > > make you worse.

> > > Or cause all kinds of side effects no one every

> warns you

> > > about on STTM

> > > sites.  Glaucoma, bone loss, weight gain, high

> BP are

> > > just some.  Here's

> > > a good thread from Dr. no's site " Recovering

> from

> > > Terrible HC

> > > Experience...        "

> > >

> >

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Barb, thanks for this..I am off HC (17.5mg/day) 2 months and cannot for the life

of me get well..upper respiratory problems!..El

>

> > People don't get sick from taking up to 40 mgs of HC / day.

>

>

>

>

>

[Guest guest]

Not that I am pushing HC meds but before I went on HC meds I had upper

respiratory problems every winter now I don't.

Co-Moderator

Phil

> From: mbmom123 <lathe30248@...>

> Subject: Re: My day today (lots of problems)

>

> Date: Saturday, January 29, 2011, 5:57 PM

> Barb, thanks for this..I am off HC

> (17.5mg/day) 2 months and cannot for the life of me get

> well..upper respiratory problems!..El

>

>

> >

> > I would have to respectfully disagree.  Everyone

> reacts differently, and

> > if one isn't completely hypopituitary like Phil, or

> suffering from

> > 's (produces no cortisol whatsoever), then HC

> can make you worse.

> > Or cause all kinds of side effects no one every warns

> you about on STTM

> > sites.  Glaucoma, bone loss, weight gain, high BP

> are just some.  Here's

> > a good thread from Dr. no's site " Recovering from

> Terrible HC

> > Experience...        "

> >

[Guest guest]

I don't feel doing a dose of HC to support your body is going to give one bone

loss. I just had this tested and I am fine. I do know you can get bone lose

from low Testosterone we have men here that found out there T levels were low.

One member sneezed and broke a few ribs.

Co-Moderator

Phil

>

> From: mbmom123 <lathe30248@...>

> Subject: Re: My day today (lots of

> problems)

>

> Date: Saturday, January 29, 2011, 11:57 PM

>

>

>

>

>

>

>

>  

>

>

>

>  

>

>

>    

>      

>      

>       Barb, thanks for this..I am off HC

> (17.5mg/day) 2 months and cannot for the life of me get

> well..upper respiratory problems!..El

>

>

>

>

>

> >

>

> > I would have to respectfully disagree.  Everyone

> reacts differently, and

>

> > if one isn't completely hypopituitary like Phil, or

> suffering from

>

> > 's (produces no cortisol whatsoever), then HC

> can make you worse.

>

> > Or cause all kinds of side effects no one every warns

> you about on STTM

>

> > sites.  Glaucoma, bone loss, weight gain, high BP

> are just some.  Here's

>

> > a good thread from Dr. no's site " Recovering from

> Terrible HC

>

> > Experience...        "

>

> >

[Guest guest]

Nigel,

Have you tested aldosterone before Florinef?

What was your level(with ranges)?

Antanas

>

> , your sodium is very low in the range. Have you ever tested

> aldosterone?

>

> It's possible that you have low aldosterone causing the low sodium. Florinef

> may be needed and Dr H does prescribe it to some of his patients I hear.

>

> Hydrocortisone may lower sodium retention by lowering aldosterone. Cortisol

> actually has some sodium retaining ability, so this might explain why.

> However, in some people, the body decreases production too much in response

> to HC. I'm one of those with that issue and I had salt-wasting occur from

> taking HC that got even worse on higher doses as I thought I was low

> cortisol. I couldn't figure out if I was high or low cortisol and I was

> adding salt, which I just urinated right out. That took water and potassium

> out of my body with the sodium I couldn't retain, so I was dehydrated yet

> was getting quite puffy and my blood pressure was going higher. I also had

> orthostatic hypotension that got worse when I tried to up my HC.

>

> I think you know to be very careful about raising thyroid when you have low

> iron. I'll add that low sodium may throw off your temps. I had temps

> stabilise only when I had Florinef added to HC. Till then tons of HC never

> stabilised my temps and random readings would show weird things like a major

> drop after an HC dose, which I now know was from loosing more sodium.

>

> Your potassium is also very low, which requires attention if you want to

> avoid SEVERE muscle cramps if you can get your doc to give you Florinef.

> What's recommended is you recheck sodium/potassium regularly to see what

> needs to be changed. Please review the guidelines here:

>

> http://nthadrenalsweb.org/treatment-for-aldosterone.php

>

> http://nthadrenalsweb.org/testing-for-aldosterone.php

>

> Just a warning. The Nasonex goes systemic. I had a weird response to it when

> I wasn't on any hormones yet and it seemed to give me salt-wasting as it's a

> corticosteroid.

>

> -Nigel

>

[Guest guest]

Antanas,

Pre HC:

Sodium 140 (135-145)

Potassium 3.7 (3.5-5.2)

I didn't have low sodium symptoms there (didn't even crave salt) and hadn't

had excessive urination or thirst for some time. But I did routinely have my

vision blackout/blood pressure drop when I'd get up to stand from sitting

for a few minutes. More on this below.

Then when I was on 25 mg HC and some Isocorts:

Aldosterone 6.2 (4-31)

Sodium 141 (133-146)

Potassium 3.7 (3.5-5.3)

This was morning, after some HC, T3 and two biscuits (oops).

Here my blood pressure had started to creep up (but I wasn't hypertensive).

The problems when standing were worsening. I'd started to experiment with

taking salt water, but other than a very temporary improvement for a few

minutes, I got WORSE orthostatic hypotension when the sodium flushed out of

me. I also didn't crave salt and had a hard time consuming it.

Then I stopped the Isocorts and only took HC at roughly 35 mg a day and got

even worse. The orthostatic hypotension was getting severe and salt water

only made it worse in the end. I tried to introduce some potassium

supplementing, but couldn't tolerate it. Two bananas for about 30 minutes

gave me a heart arrhythmia and I felt like I was in a stupor!

I finally went on fludrocortisone and that ironed out the sodium issue. I

got really bad muscle cramps by day two (resolved with some potassium), but

as I raised it the orthostatic hypotension didn't go away. I figured out the

blood pressure dropping upon standing was low potassium and now that I had

some sodium retention I could tolerate potassium supplements without going

hyponatremic.

For some time I was on at least one Florinef tablet a day and upwards of 4-6

grams of elemental potassium (over the counter gluconate as the RX extended

release type never absorbed) to regulate both electrolyes. Yes, I had

sodium/potassium tested repeatedly to make sure I wasn't too high.

Now my adrenals seem to have restored function enough to allow me to reduce

down to 25 mcg a day. This is amazing as before I'd have terrible salt

wasting at this dose. I didn't need as much potassium when I lowered my

thyroid dose. I think too much thyroid depletes potassium. Of course, less

Florinef tends to preserve potassium better too. Then I stopped needing most

of the potassium supplements when I introduced a very high dose fat-soluble

form of B1 (thiamine) called benfotiamine. It's like potassium finally stuck

inside my cells after I started that B vitamin and some days I hardly need

any potassium. Thiamine has a positive effect on the pump that moves

potassium into cells and sodium out of them. My last blood levels of sodium

and potassium were low in the range, but I didn't feel symptoms of either

one being too low.

-Nigel

On 23 February 2011 05:17, antanas_aradas <antanas_aradas@...> wrote:

>

>

> Nigel,

>

> Have you tested aldosterone before Florinef?

> What was your level(with ranges)?

>

> Antanas

>

[Guest guest]

have you tested when your are on florinef?

> Aldosterone 6.2 (4-31)

its morning, 2 hours not lying?

Btw, are you self treating?

Antanas

>

> >

> >

> > Nigel,

> >

> > Have you tested aldosterone before Florinef?

> > What was your level(with ranges)?

> >

> > Antanas

> >

>

>

>

[Guest guest]

Good job Nigel I am so happy you came here. I still need water pills with my

Florinef due to the low Aldosterone levels and being on TRT my body holds a lot

of water taking water pills lowers my Potassium so my Dr. gives me a script for

Potassium.

And for as long as I can remember my Alkaline Phosphatase levels have been below

normal I think it's due to low iron.

==================================================

Comprehensive Metabloic Panel W/eGFR

Glucose 90 range 65 – 99 mg/dL.

Urea Nitrogen (BUN) 25 range 7 – 25 mg/dL.

Creatinine 1.11 range 0.76 – 1.46 mg.dL.

eGFR NON – AFR. American >60 range > or = 60 mL/min/1.73m2.

BUN / Creatinine Ratio Not Applicable.

Sodum 141 range 135 – 146 mmol/L.

Potassium 4.3 range 3.5 – 5.3 mmol/L.

Chloride 101 range 98 – 110 mmol/L.

Carbon Dioxide 30 range 21 – 33 mmol/L.

Calcium 9.3 range 8.6 – 10 .2 mg/dL.

Protein, Total 6.7 range 6.2 – 8.3 g/dL.

Albumin 4.2 range 3.6 – 5.1 g/dL.

Globulin 2.5 range 2.1 – 3.7 g/dL.

Albumin/Globulin Ratio 1/7 range 1.0 – 2.1 (calc).

Bilirubin, Total 0.9 rage 0.2 – 1.2 mg/dL.

Alkaline Phosphatase 18 low range 40 – 115 U/L.

AST 23 range 10 – 35 U/L.

ALT 20 range 9 – 60 U/L.

Co-Moderator

Phil

>

> >

> >

> > Nigel,

> >

> > Have you tested aldosterone before Florinef?

> > What was your level(with ranges)?

> >

> >  Antanas

> >

>

>

>

[Guest guest]

My Dr. told me testing on florinef tells nothing.

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: My day today (lots of problems)

>

> Date: Friday, February 25, 2011, 1:52 PM

> have you tested when your are on

> florinef?

>

> > Aldosterone 6.2 (4-31)

> its morning, 2 hours not lying?

>

> Btw, are you self treating?

>

> Antanas

>

>

> >

> > >

> > >

> > > Nigel,

> > >

> > > Have you tested aldosterone before Florinef?

> > > What was your level(with ranges)?

> > >

> > >  Antanas

> > >

> >

> >

> >

[Guest guest]

what is optimal aldosterone level?

should be in the middle, top ?

Antanas

> > >

> > > >

> > > >

> > > > Nigel,

> > > >

> > > > Have you tested aldosterone before Florinef?

> > > > What was your level(with ranges)?

> > > >

> > > >  Antanas

> > > >

> > >

> > >

> > >

[Guest guest]

If aldosterone is in the lower half the range, this is highly indicative of

hypoaldosteronism.

=========================================

Edit postDelete postReport this postWarn userInformationReply with quote Chris'

info on preparing for the aldosterone renin test

by Oz » Wed Nov 04, 2009 1:27 am

This is a comprehensive article to help you prepare for and be successful in

getting aldosterone and renin properly tested. I recommend you read these

stickies first.

My explanation of low aldosterone in hypopituitarism

My explanation of the renin-angiotensin-aldosterone system and its effect on

blood pressure and my thoughts on hypothyroidisms effect on this mechanism

In order to get an accurate assessment of your aldosterone and renin production,

you must fast salt and foods with significant sodium content for 24 hours. This

is to make your aldosterone and renin come up as much as possible. In healthy

adrenals, aldosterone and renin come up when when the bodies sodium level is low

and go down when sodium level is adequate. These tests should be done in the

morning when aldosterone levels should be highest in healthy adrenals. All types

of diuretics, lithium,

spironolactone, and verapamil, ACE inhibitors, nonsteroidal anti-inflammatory

drugs, ranitidine, and propranolol will affect these tests, so you'd need to be

off them for at least weeks before testing. Discuss with your doc about any meds

you take that may affect the tests and use their direction to carefully get off

any meds. You should avoid coffee, tea, and cola. Also, strenuous exercise,

acute stress, and pregnancy can affect results

For women: If you still experiance a cycle, you must test aldosterone and renin

the first week of your cycle. This is because in the second and third week

progesterone is higher and aldosterone is gotten from progesterone so usually

goes higher during that time. Most women with low aldosterone will test in the

high part of the range if tested during the second or third week. Progesterone

is lowest in the first week. If on progesterone replacement therapy, you'd need

to taper and be off the progesterone for at least 2 weeks before testing.

Obviously, you should wait to start progesterone if you are planning to test

aldosterone and renin.

You do need to have had sodium and potassium tested (usually found in a CBC

panel so usually not a problem). In interpreting the aldosterone and renin

tests, the first thing that should be looked at is what are the ranges the lab

has given. In most cases ranges are given for upright, normal salt intake

instead of the upright salt fasting or depleted range. Of course if you've

fasted salt, it should be mentioned on the lab sheet so hopefully the lab will

give the sodium depleted range.

The upright, sodium depleted or sodium fasting range for aldosterone will be

similar to 4-22 ng/dl. 1 - 16 or simliar is the supine or laying down sodium

depleted range. You should only lay down if you can't stay upright, but since

it's just a quick blood draw this usually isn't a problem. If laying or supine,

blood draw is done 1/2 hour later. There is a separate range for womens

aldosterone similar to 5- 30 which is not often seen, but this range is gotten

because of the connection of progesterone which can raise aldosterone and even

make it look good for women during anytime other than the first week of their

cycle. If testing is done during the first week, then the range of 4-22 is

adequate. There is a range for normal sodium intake or non fasting salt for

supine and upright, but I don't remember what those ranges are but are lower and

narrower than the fasting ranges.

The upright sodium depleted or sodium fasting range for renin will be similar to

2.9 - 24 ng/dl. It is very common for lab to just give the renin range for

upright, sodium repleted or non fasting salt which is similar to .1 - 4.3. In

many cases I've had to tell what range should have been given.

In interpreting aldosterone and renin, the first thing that must be considered

are symptoms, electrolyte tests and whether the aldosterone and renin tests are

actually valid. Was salt truely fasted for 24 hours? Were the tests done during

the first week of the cycle for women, were drugs like diuretics interferring

with the results. If the tests were done cleanly, then what to look for is

aldosterone to be well into the upper third of the range and renin to be well

above mid point of the range. If aldosterone is in the lower half the range,

this is highly indicative of hypoaldosteronism. Renin can be tricky to interpret

if in the middle of the range in considering if hypo or hyperreninemic is the

cause of low aldosterone. I look at renin being into the lower third of the

range to be likely hyporenin which is what usually happens with secondary

adrenal insufficiency and well into the upper third of the range for hyperrenin

which is what usually happens in

primary adrenal insufficiency.

99% of the time secondaries have low renin, but I have seen some with high

renin. 99% of the time primaries have high renin, but I have seen a few

primaries with low renin. Renin can help determine primary or secondary adrenal

insufficiency if proper testing was not done before starting steroid and steroid

can't be withdrawn to do the tests. Renin is the only thing left that may

determine primary or secondary, but is no substitute for proper tests in the

first place since renin accurately predicts primary and secondary only 99% of

the time.

Sodium is a real good predictor of low aldosterone and salt wasting. Most sodium

ranges are 135-145. I look for 145 as being a good value. If one is in the low

140's or lower, this almost always indicates salt wasting and low aldosterone

and as such aldosterone and renin should be tested.

Potassium may predict what renin could be doing and possible secondary adrenal

insufficiency except when renin falls in the middle of the range. The range is

commonly 3.5 - 5.5. In the area of 4.0 to 4.3 renin could be high or low, but

usually is low 75% of the time in that part of the range. 4.0 and lower almost

always represents low renin. 4.8 to 5.0 could represent healthy or high renin.

Above 5.0 likely points to high renin. I think I've illustrated how fuzzy

potassium can be. I've seen a lot of potassium in combo with acth and acth stims

and this is as good as I've gotten potassium figured out.

Co-Moderator

Phil

> From: antanas_aradas <antanas_aradas@...>

> Subject: Re: My day today (lots of problems)

>

> Date: Friday, February 25, 2011, 2:51 PM

> what is optimal aldosterone level?

> should be in the middle, top ?

>

> Antanas

>

>

> > > >

> > > > >

> > > > >

> > > > > Nigel,

> > > > >

> > > > > Have you tested aldosterone before

> Florinef?

> > > > > What was your level(with ranges)?

> > > > >

> > > > >  Antanas

> > > > >

> > > >

> > > >

> > > > [Non-text portions of this message have been

> removed]

> > > >

> > >

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > >

[Guest guest]

Like I said, I'd had HC, T3 and a couple biscuits. I had been up for at

least three hours and I was upright for the blood draw.

I've tested sodium and potassium on Florinef and potassium to keep up with

things and think this is very important. I don't see the point in testing

aldosterone when on fludrocortisone and have never tested it again.

I have a doctor that prescribes all my meds, so on that I'm not self

treating. I do manage many of my other things like nutritional deficiencies

and diet on my own as they're beyond the scope of my doctor.

Phil posted good info about aldosterone levels. I think symptoms,

sodium/potassium level and aldosterone level ALL need to be taken into

account. Then you can start to see the whole picture.

-Nigel

On 25 February 2011 12:52, antanas_aradas <antanas_aradas@...> wrote:

>

>

> have you tested when your are on florinef?

>

>

> > Aldosterone 6.2 (4-31)

> its morning, 2 hours not lying?

>

> Btw, are you self treating?

>

>

> Antanas

>

>

> >

> > Antanas,

> >

> > Pre HC:

> >

> > Sodium 140 (135-145)

> > Potassium 3.7 (3.5-5.2)

> >

> > I didn't have low sodium symptoms there (didn't even crave salt) and

> hadn't

> > had excessive urination or thirst for some time. But I did routinely have

> my

> > vision blackout/blood pressure drop when I'd get up to stand from sitting

> > for a few minutes. More on this below.

> >

> > Then when I was on 25 mg HC and some Isocorts:

> >

> > Aldosterone 6.2 (4-31)

> > Sodium 141 (133-146)

> > Potassium 3.7 (3.5-5.3)

> >

> > This was morning, after some HC, T3 and two biscuits (oops).

> >

> > Here my blood pressure had started to creep up (but I wasn't

> hypertensive).

> > The problems when standing were worsening. I'd started to experiment with

> > taking salt water, but other than a very temporary improvement for a few

> > minutes, I got WORSE orthostatic hypotension when the sodium flushed out

> of

> > me. I also didn't crave salt and had a hard time consuming it.

> >

> > Then I stopped the Isocorts and only took HC at roughly 35 mg a day and

> got

> > even worse. The orthostatic hypotension was getting severe and salt water

> > only made it worse in the end. I tried to introduce some potassium

> > supplementing, but couldn't tolerate it. Two bananas for about 30 minutes

> > gave me a heart arrhythmia and I felt like I was in a stupor!

> >

> > I finally went on fludrocortisone and that ironed out the sodium issue. I

> > got really bad muscle cramps by day two (resolved with some potassium),

> but

> > as I raised it the orthostatic hypotension didn't go away. I figured out

> the

> > blood pressure dropping upon standing was low potassium and now that I

> had

> > some sodium retention I could tolerate potassium supplements without

> going

> > hyponatremic.

> >

> > For some time I was on at least one Florinef tablet a day and upwards of

> 4-6

> > grams of elemental potassium (over the counter gluconate as the RX

> extended

> > release type never absorbed) to regulate both electrolyes. Yes, I had

> > sodium/potassium tested repeatedly to make sure I wasn't too high.

> >

> > Now my adrenals seem to have restored function enough to allow me to

> reduce

> > down to 25 mcg a day. This is amazing as before I'd have terrible salt

> > wasting at this dose. I didn't need as much potassium when I lowered my

> > thyroid dose. I think too much thyroid depletes potassium. Of course,

> less

> > Florinef tends to preserve potassium better too. Then I stopped needing

> most

> > of the potassium supplements when I introduced a very high dose

> fat-soluble

> > form of B1 (thiamine) called benfotiamine. It's like potassium finally

> stuck

> > inside my cells after I started that B vitamin and some days I hardly

> need

> > any potassium. Thiamine has a positive effect on the pump that moves

> > potassium into cells and sodium out of them. My last blood levels of

> sodium

> > and potassium were low in the range, but I didn't feel symptoms of either

> > one being too low.

> >

> > -Nigel

>

[Guest guest]

How much potassium are you taking, Phil? How many 10 or 20 MEQ pills? It

tends to take a decent dose to benefit some people. Unfortunately some

doctors don't get this and think a pill or two is always enough for

everyone. There's some very easy to stomach potassium gluconate powder out

there that mixes easily with juice. I wonder if that would reduce some of

the fluid retention.

Note causes of low ALP:

http://www.drkaslow.com/html/alkaline_phosphatase.html

" A *decreased* serum alkaline phosphatase may be due to:

- Zinc deficiency.

- Hypothyroidism.

- Vitamin C deficiency/Scurvy.

- Folic acid deficiency.

- Excess Vitamin D intake.

- Low phosphorus levels (hypophosphatasia)

- Celiac disease.

- Malnutrition with low protein assimilation (including low stomach acid

production/hypochlorhydria).

- Insufficient Parathyroid gland function.

- Pernicious anemia

- Vitamin B6 insufficiency "

I don't see the harm in testing zinc... I don't see how they'd not do it as

zinc is a common test to run. Never accept their lame excuses, okay!?

Unless you still need more iron then you shouldn't have signs or symptoms of

iron deficiency if you've been supplementing enough. Does that make sense?

-Nigel

On 25 February 2011 13:43, philip georgian <pmgamer18@...> wrote:

>

>

> Good job Nigel I am so happy you came here. I still need water pills with

> my Florinef due to the low Aldosterone levels and being on TRT my body holds

> a lot of water taking water pills lowers my Potassium so my Dr. gives me a

> script for Potassium.

>

> And for as long as I can remember my Alkaline Phosphatase levels have been

> below normal I think it's due to low iron.

>

> ==================================================

> Comprehensive Metabloic Panel W/eGFR

> Glucose 90 range 65 – 99 mg/dL.

> Urea Nitrogen (BUN) 25 range 7 – 25 mg/dL.

> Creatinine 1.11 range 0.76 – 1.46 mg.dL.

> eGFR NON – AFR. American >60 range > or = 60 mL/min/1.73m2.

> BUN / Creatinine Ratio Not Applicable.

> Sodum 141 range 135 – 146 mmol/L.

> Potassium 4.3 range 3.5 – 5.3 mmol/L.

> Chloride 101 range 98 – 110 mmol/L.

> Carbon Dioxide 30 range 21 – 33 mmol/L.

> Calcium 9.3 range 8.6 – 10 .2 mg/dL.

> Protein, Total 6.7 range 6.2 – 8.3 g/dL.

> Albumin 4.2 range 3.6 – 5.1 g/dL.

> Globulin 2.5 range 2.1 – 3.7 g/dL.

> Albumin/Globulin Ratio 1/7 range 1.0 – 2.1 (calc).

> Bilirubin, Total 0.9 rage 0.2 – 1.2 mg/dL.

> Alkaline Phosphatase 18 low range 40 – 115 U/L.

> AST 23 range 10 – 35 U/L.

> ALT 20 range 9 – 60 U/L.

>

> Co-Moderator

> Phil

>

[Guest guest]

I started on • Potassium Chloride 20 mgs every day.

Until my levels came up. When I could not stand up or walk from statin drugs I

thought it was low Potassium so my Heart Dr. said my labs looked OK but this

does not show what's in the cells. Today I take one Potassium Chloride pill

every other day now. My last look like this.

==================================================

Sodum 141 range 135 – 146 mmol/L.

Potassium 4.3 range 3.5 – 5.3 mmol/L.

Chloride 101 range 98 – 110 mmol/L.

Still not all that great.

Co-Moderator

Phil

>

> >

> >

> > Good job Nigel I am so happy you came here. I still

> need water pills with

> > my Florinef due to the low Aldosterone levels and

> being on TRT my body holds

> > a lot of water taking water pills lowers my Potassium

> so my Dr. gives me a

> > script for Potassium.

> >

> > And for as long as I can remember my Alkaline

> Phosphatase levels have been

> > below normal I think it's due to low iron.

> >

> > ==================================================

> > Comprehensive Metabloic Panel W/eGFR

> > Glucose 90 range 65 – 99 mg/dL.

> > Urea Nitrogen (BUN) 25 range 7 – 25 mg/dL.

> > Creatinine 1.11 range 0.76 – 1.46 mg.dL.

> > eGFR NON – AFR. American >60 range > or = 60

> mL/min/1.73m2.

> > BUN / Creatinine Ratio Not Applicable.

> > Sodum 141 range 135 – 146 mmol/L.

> > Potassium 4.3 range 3.5 – 5.3 mmol/L.

> > Chloride 101 range 98 – 110 mmol/L.

> > Carbon Dioxide 30 range 21 – 33 mmol/L.

> > Calcium 9.3 range 8.6 – 10 .2 mg/dL.

> > Protein, Total 6.7 range 6.2 – 8.3 g/dL.

> > Albumin 4.2 range 3.6 – 5.1 g/dL.

> > Globulin 2.5 range 2.1 – 3.7 g/dL.

> > Albumin/Globulin Ratio 1/7 range 1.0 – 2.1 (calc).

> > Bilirubin, Total 0.9 rage 0.2 – 1.2 mg/dL.

> > Alkaline Phosphatase 18 low range 40 – 115 U/L.

> > AST 23 range 10 – 35 U/L.

> > ALT 20 range 9 – 60 U/L.

> >

> > Co-Moderator

> > Phil

> >

>

>

>