Guest guest Posted June 2, 2005 Report Share Posted June 2, 2005 Yeah I'm trying to get completely off. My doctor is the one taking me off. Her treatment plan was to put me on Cortef for one year to allow my adrenals to rest. After the year was up... she wanted me to wean off slowly and allow my own adrenals to wake up and do the job. It's been contriversal as to wheter adrenal fatigue can be corrected or not. I have not found many folks that were able to get there adrenals to work again...but I have found a few so, it gives me hope LaCretia > >thanks, are going completely off of it? What has your doc. said about you >taking this med? >Bev > >LaCretia Mozingo <lacretiamo@...> wrote: >For me Cortef relieved my vomiting, diahrea, weight lose, and the severe >muscle weakness I was having. Hope this helps!... Brain fog still here > >LaCretia > > > > >lifelong anxiety, brain fog, exhaustion > >Gracia > > > > > Hi Gracia, > > > What kind of symptoms did you have that the cortef helped or did it >just > >make you feel better? > > > thanks > > > Bev > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2005 Report Share Posted June 2, 2005 Bev, Would you mind sending to my private e-Mail address? I would really be interested to see it first hand. I have a friend here at work that had Cushings and was able to reverse it nicely...wish the adrenal fatigue woudl go away like that... I'm told to just have patients and it will get better LaCRetia > >If this site would allow you to send attachments I would send my cushings >syndrome pictures to show you what it looks like, but I can't seem to do >it. My pics are on cushings syndrome support group if anybody is >interested. Cusings is not fun, I almost died from it. >Bev > >LaCretia Mozingo <lacretiamo@...> wrote: >If you read up on Cortef you will find it's used to treat not only adrenal >fatigue but other aliments such as arthritis. It reduces inflamation. >Also, it gives one a sense of overall wellness. You are giving your body >basically in a nut shell adrenalyn...which in turn hypes up the body and >the >metabolism if you don't need it. If you are deficient...it will help >greatly though. Here is a link to the side effects of taking too much >steroid. It also includes what symptoms you would get if you withdrawel >too >quickly... hope this helps. > >Side Effects of ALL Glucocorticosteroids > >Every drug may at times cause side effects, but the majority of patients >have no, or only minor, side effects. >Tell your doctor or pharmacist if any of the following occurs: > >Cushing's Syndrome (with long-term use of HC): >Appearance of " moonface " >Enlargement of some fat pad areas >The appearance of fat in the midsection >Abnormal fat deposits >General obesity >Muscle wasting and weakness >High blood pressure >Diabetes mellitus (sugar diabetes) >Osteoporosis >Thinning of skin >Easy or spontaneous bruising > >Too rapid withdrawal of therapy can cause: >Nausea >Fatigue >Loss of appetite >Difficulty breathing >Lowered blood pressure >Joint and muscle aches >Fever >Dizziness >Fainting >General body discomfort >Digestive tract problems: >Nausea >Vomiting >Increased appetite >Weight gain >Indigestion or heartburn >Bloating >Pancreatitis (inflammation of the pancreas gland) >Peptic ulcer >Stomach pain >Rectal bleeding >Local pain or burning with enemas >CNS (central nervous system) problems: >Convulsions or seizures >Increased pressure in the brain >Dizziness, giddiness, or feeling of whirling motion >Headache >Behavior changes >Sleeplessness >Hiccups >Mood swings >Depression >Psychotic manifestations >Clumsiness >Exaggerated sense of well being >Circulatory system problems: >Heart failure >High blood pressure >Thrombosis (clot formation) >Skin changes: >Impaired wound healing >Thin skin and/or loss of fat under the skin >Changes in pigmentation of skin >Acne >Excessive body hair growth >Rash or hives >Easy or spontaneous bruising >Facial flushing >Loss of or abnormal skin sensations >Increased sweating (very common) >Other changes or problems: >Salt and water retention >Potassium loss >General body discomfort >Abnormally low calcium >Muscle weakness >Loss of muscle mass >Bone density loss >Bone fractures >Menstrual irregularities (women) >Growth suppression (children) >Decreased carbohydrate tolerance >Increased blood sugar levels >Cataracts >Glaucoma or increased intraocular pressure >Bulging eyes >Aggravation or masking of an infection >Rare instances of blindness >Tendon rupture >Suppressed reaction to skin tests >Kaposi's sarcoma >Hip or shoulder bone degradation >Secondary adrenocortical and pituitary unresponsiveness >Muscle twitching >Exaggerated rapid eye movement > > > > > >Hi Gracia, > >What kind of symptoms did you have that the cortef helped or did it just > >make you feel better? > >thanks > >Bev > > > >Gracia <circe@...> wrote: > > > >I had several adrenal tests. All blood tests were normal. Saliva was >high > >normal, high, high normal, high. 24 hr urine test from AAL lab showed > >ALL > >adrenal and sex hormones low. So every test had a different result. >Doc > >was a great doc but still told me to use licorice for adrenals!!! Very > >frustrating, so I ordered cortef from http://www.mastersmarketing.com in > >the UK and tried it on my own. I had to figure out the dosing for >myself, > >finally found what Jefferies recommends. When I next saw the doc I said >I > >am trying cortef, he asked does it work? I said YES it works great, and >he > >was fine with that. I have been on it for 2 years now. I noticed good > >effects right away, certainly within a week. > >Gracia > > > > > Hi Gracia! > > > > > > Thanks for your lightening answer.You have written in your posting >today > > > that test on adrenal will show " normal " .Are taking cortef inspite of >the > > > fact that your adrenal is " normal " as per the report?If so how much is > > > your dose?After how many days of dosage,you became " energetic " ? > > > > > > BR > > > > > > > Cortef (hydrocortisone) is a steroid, same as made by the adrenal > >glands. > > > > Low doses support adrenals, high doses suppress them. See Safe Uses > >of > > > > Cortisol by Jefferies MD. > > > > Gracia > > > > > > > >> Hi ! > > > >> > > > >> Your inputs are very useful.Especially adrenal support and the meds > >for > > > >> it.I had a strong doubt.Answer me if the medicine belongs to >steroid > > > >> group.Normally steroid medicines are strong enough to give extra > > > >> ordinary > > > >> and isntant energy to individual at that time. > > > >> > > > >> Please clarifiy me. > > > >> > > > >> B.R. > > > >> > > > >> > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2005 Report Share Posted June 2, 2005 Thanks ... this is what I have heard too! I'm not very good at explaining it though to others I'm interested in what you said here: >The reason this is done is because when people are receiving high doses of >cortisol/steroids and have normally-functioning adrenal glands, the >adrenals >will stop producing coritsol in the interim, as the body's feedback >mechanism senses there is a lot of cortisone in the system and so tells the >adrenals not to make any more. As the level of cortisone (or prednisone, >etc.) is decreased gradually, the body's mechanism detects the lower levels >and tells the adrenals to start making a little more. Gradually as the >therapeutic dosage is reduced, the adrenals increase their production, so >when the medication is stopped, the adrenals will be at their normal full >production rate. This is where I'm at...weaning off. You said that by the time the medication is stopped, the adrenals will be at their normal full production rate. I've been weaning since February and actually had a relapse once I got off the meds and my doctor put me back on the full 20mg I was taking and had me start all over on the weaning process. That was in March sometime. So from there I have been weaning for almost 8-10 wks. Everytime I get near the end of the weaning, I start having crisis. So do you think this is a sign this is perminent for me? My doctor said that after I get off the meds, the adrenals would still be weak and I would need to keep stress doses on hand for up to a year later....is this what you have heard also? This does get confusing becuase the treatment is not consistent between doctors and also the information I get on various groups varies also. I've only had two draws in between all of this... the first was early in the weaning process and I wasn't producing any Cortisol or ACTH. Why my pituitary decided to go to sleep also is still confusing to me but at any rate...not good. Then, when I had my last crisis in the ER...they only took a Cortisol reading...it was 4.5 which was better than before but still at the low end of the range. I don't know if the fact I took in a large tablespoon of salt before going to the ER had anything to do with my Cortisol being higher or not but I did intake a lot to try to prevent the crisis. Usually or at least I'm told when you start going into crisis to take salt because usually it's low and potassium is high which is bad. I'm told if you bring the salt back up soon enough, balance can be brought back and you may avoid a crisis. Could that have had an effect on the Cortisol test? Sorry to ramble...but I know yourself and Tish out here know this stuff really well. Tish always calms me when I get down about not getting the results I want. She always gives me excellent advise about the adrenals and she is one of the one I have found that has done this treatment before and was able to get her adrenals to work again...gives me hope! LaCretia > >LaCretia, > >>A therapeutic dosage is going to be higher than a replacement dosage. >>The >goal of replacement dosage is to achieve a normal level of hormone in the >body, to replace what the body is not making or utilizing properly. > >A therapeutic dosage is a dose given over and above the body's normal >levels >to effect a treatment response. My mother, for example, has emphysema and >right now is battling bronchitis. The doctor put her on a therapeutic >dosage schedule of 60 mg a day for several days, and then will be >decreasing >it by 10 mg a day for a few weeks, until she is tapered to nothing. > >The reason this is done is because when people are receiving high doses of >cortisol/steroids and have normally-functioning adrenal glands, the >adrenals >will stop producing coritsol in the interim, as the body's feedback >mechanism senses there is a lot of cortisone in the system and so tells the >adrenals not to make any more. As the level of cortisone (or prednisone, >etc.) is decreased gradually, the body's mechanism detects the lower levels >and tells the adrenals to start making a little more. Gradually as the >therapeutic dosage is reduced, the adrenals increase their production, so >when the medication is stopped, the adrenals will be at their normal full >production rate. > >If the medication is stopped abruptly at a high dose, they will end up with >inadequate amounts of cortisol in their system because the adrenals >basically have been on vacation during this time and they don't kick right >back in, it takes them some time to gear up production, and so the person >will end up having symptoms of hypo adrenal function...which can even be a >crisis situation in some. > >Keep in mind that all of this pertains to normally functioning adrenal >glands - if a person has lost adrenal function and are perpetually hypo >adrenal, that is a different situation and they will always need >replacement >hormone. > >I will say that 20 mg four times a day sounds very high to me, even for >therapeutic dosages.... but there is such a tremendous variation among >individuals, from size to metabolism to every other parameter. > > > RE: Re: adrenal support > >> > >> > >> >I thought I would tell you to be careful at your age if you get on > >>Cortef. > >> > It robs the bones of calcium and it is recommended that you have a >bone > >> > density test at least once a year if you take it. Thought I would >pass > >> > this > >> > along to you. Most taking it take calcium suppliments to help slow >it > >> > down > >> > but most end up with osteo when taking it. I have one lady on >another > >> > group > >> > that is age 39 and broke a hip due this and she reported that she > >>already > >> > has osteo and has to walk with a cane. > >> > >> > >> > >> > >> > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2005 Report Share Posted June 2, 2005 Sorry, I meant it as the feeling you get... dang brain fog! LaCretia > >I'm confused....in this post, LaCretia said by taking Cortef, you are >basically >giving yourself " adrenalyn " ....it is my understanding that >adrenaline(Epinephrine) >and Hyrodrocortisone are two entirely different things, produced in >different >areas >of the adrenal gland...Epinephrine, being the hormone responsible for >dilating blood >vessels, as to give us more oxygen during times of stress..and >hyrocortisone, >being the hormone that regulates the use of our food energy, and also helps >us >recover from the initial stimulation of the Epinephrine by basically >bringing >us >back " down " ... >Did I miss something? > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2005 Report Share Posted June 2, 2005 Usually when a crisis comes on you have diarrhea, vomiting, mucle weakness, etc. Are you having any of these? The symptoms you describe sound like too much cortisol to me... I bet Bev can help out here... she had cushings. I have adrenal fatigue...and when I have a crisis...I vomit and have diarrhea really bad. I think whether you get too much or too little...neither feels good. LaCretia > >Hi >I dont think Ive been overdoing it, I started to go downhill around the >beg. April, then I had a wisdom tooth + some bone removed at the end of >April,pain pain pain. Since then I just seemed to have ground to a halt. >You mention having an addisons crisis, Im confused (doesnt take much) could >all my symtoms be caused by lack of cortisol and well as too much >Thanks >Gail > Re: Re: adrenal support > > > If this site would allow you to send attachments I would send my > cushings syndrome pictures to show you what it looks like, but I can't > seem to do it. My pics are on cushings syndrome support group if > anybody is interested. Cusings is not fun, I almost died from it. > Bev > > LaCretia Mozingo <lacretiamo@...> wrote: > If you read up on Cortef you will find it's used to treat not only > adrenal > fatigue but other aliments such as arthritis. It reduces inflamation. > > Also, it gives one a sense of overall wellness. You are giving your > body > basically in a nut shell adrenalyn...which in turn hypes up the body > and the > metabolism if you don't need it. If you are deficient...it will help > greatly though. Here is a link to the side effects of taking too much > > steroid. It also includes what symptoms you would get if you > withdrawel too > quickly... hope this helps. > > Side Effects of ALL Glucocorticosteroids > > Every drug may at times cause side effects, but the majority of > patients > have no, or only minor, side effects. > Tell your doctor or pharmacist if any of the following occurs: > > Cushing's Syndrome (with long-term use of HC): > Appearance of " moonface " > Enlargement of some fat pad areas > The appearance of fat in the midsection > Abnormal fat deposits > General obesity > Muscle wasting and weakness > High blood pressure > Diabetes mellitus (sugar diabetes) > Osteoporosis > Thinning of skin > Easy or spontaneous bruising > > > Too rapid withdrawal of therapy can cause: > Nausea > Fatigue > Loss of appetite > Difficulty breathing > Lowered blood pressure > Joint and muscle aches > Fever > Dizziness > Fainting > General body discomfort > Digestive tract problems: > Nausea > Vomiting > Increased appetite > Weight gain > Indigestion or heartburn > Bloating > Pancreatitis (inflammation of the pancreas gland) > Peptic ulcer > Stomach pain > Rectal bleeding > Local pain or burning with enemas > CNS (central nervous system) problems: > Convulsions or seizures > Increased pressure in the brain > Dizziness, giddiness, or feeling of whirling motion > Headache > Behavior changes > Sleeplessness > Hiccups > Mood swings > Depression > Psychotic manifestations > Clumsiness > Exaggerated sense of well being > Circulatory system problems: > Heart failure > High blood pressure > Thrombosis (clot formation) > Skin changes: > Impaired wound healing > Thin skin and/or loss of fat under the skin > Changes in pigmentation of skin > Acne > Excessive body hair growth > Rash or hives > Easy or spontaneous bruising > Facial flushing > Loss of or abnormal skin sensations > Increased sweating (very common) > Other changes or problems: > Salt and water retention > Potassium loss > General body discomfort > Abnormally low calcium > Muscle weakness > Loss of muscle mass > Bone density loss > Bone fractures > Menstrual irregularities (women) > Growth suppression (children) > Decreased carbohydrate tolerance > Increased blood sugar levels > Cataracts > Glaucoma or increased intraocular pressure > Bulging eyes > Aggravation or masking of an infection > Rare instances of blindness > Tendon rupture > Suppressed reaction to skin tests > Kaposi's sarcoma > Hip or shoulder bone degradation > Secondary adrenocortical and pituitary unresponsiveness > Muscle twitching > Exaggerated rapid eye movement > > > > > >Hi Gracia, > >What kind of symptoms did you have that the cortef helped or did it > just > >make you feel better? > >thanks > >Bev > > > >Gracia <circe@...> wrote: > > > >I had several adrenal tests. All blood tests were normal. Saliva > was high > >normal, high, high normal, high. 24 hr urine test from AAL lab > showed > >ALL > >adrenal and sex hormones low. So every test had a different result. > Doc > >was a great doc but still told me to use licorice for adrenals!!! > Very > >frustrating, so I ordered cortef from http://www.mastersmarketing.com > in > >the UK and tried it on my own. I had to figure out the dosing for > myself, > >finally found what Jefferies recommends. When I next saw the doc I > said I > >am trying cortef, he asked does it work? I said YES it works great, > and he > >was fine with that. I have been on it for 2 years now. I noticed > good > >effects right away, certainly within a week. > >Gracia > > > > > Hi Gracia! > > > > > > Thanks for your lightening answer.You have written in your posting > today > > > that test on adrenal will show " normal " .Are taking cortef inspite > of the > > > fact that your adrenal is " normal " as per the report?If so how > much is > > > your dose?After how many days of dosage,you became " energetic " ? > > > > > > BR > > > > > > > Cortef (hydrocortisone) is a steroid, same as made by the > adrenal > >glands. > > > > Low doses support adrenals, high doses suppress them. See Safe > Uses > >of > > > > Cortisol by Jefferies MD. > > > > Gracia > > > > > > > >> Hi ! > > > >> > > > >> Your inputs are very useful.Especially adrenal support and the > meds > >for > > > >> it.I had a strong doubt.Answer me if the medicine belongs to > steroid > > > >> group.Normally steroid medicines are strong enough to give > extra > > > >> ordinary > > > >> and isntant energy to individual at that time. > > > >> > > > >> Please clarifiy me. > > > >> > > > >> B.R. > > > >> > > > >> > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2005 Report Share Posted June 2, 2005 <<You said that by the time the medication is stopped, the adrenals will be at their normal full production rate. I've been weaning since February and actually had a relapse once I got off the meds and my doctor put me back on the full 20mg I was taking and had me start all over on the weaning process. That was in March sometime. So from there I have been weaning for almost 8-10 wks. Everytime I get near the end of the weaning, I start having crisis. So do you think this is a sign this is perminent for me? >> I wonder why this keeps happening to you - it sounds to me like you may have some permanent decreased adrenal function, maybe there is some permanent damage to the adrenals? It would seem to me that if there was enough normally-functioning adrenal tissue left to meet your body's needs, you wouldn't go into a crisis once you went off the medication. Maybe they are partially functioning and can meet some of your needs, but not quite all of them? What explanation has your doctor given you? <<My doctor said that after I get off the meds, the adrenals would still be weak and I would need to keep stress doses on hand for up to a year later....is this what you have heard also?>> No, I don't recall ever having heard that. What exactly does he mean by 'weak', I wonder... not fully functioning, like I talk about above, not able to meet the body's needs? What if you have, say for an example, 75% adrenal function existing? Now, this I do not know but toss it out for consideration - if your adrenals are capable of regeneration, i.e. growing new functioning adrenal cells, how long would that take? Wouldn't you expect to see gradual improvement over time as the cells rebuild? Since the adrenal glands are so tiny... why would that process take a year? But what happens to them each time you are taken off the medications and go into crisis - does that stop any regeneration process? Does it even set it back - does it cause new cellular damage, so that essentially you keep getting bounced back to the same point, and have to start all over again? On the other hand, what if the adrenal glands have permanent scar tissue, and will never regain full function? Can your doctor differentiate between the two - a very slow, long term healing process versus incomplete function, or can he only assume what is going on? I don't have any answers, it's simply beyond the realm of my knowledge. I do wonder, though, if he thinks you can be weaned off the adrenal replacement, that it could be tapered down much, much more slowly and in much, much smaller increments - like 2.5 mg and months at a time - it would seem to me that way, if your adrenals do have the capacity to regenerate, they would be able to build up very slowly over the course of time as the medication is decreased. Did you ever read the book, " Adrenal Fatigue " ? I read it a while ago and though it was very good, I don't know if it has information that would specifically pertain to a situation like yours, but it might be worth a read. <<<<This does get confusing becuase the treatment is not consistent between doctors and also the information I get on various groups varies also. >>>>> I think it's confusing because nobody really knows all the answers - and everyone is different, an individual - this is why they say medicine is an art - it's not black-and-white, cut-and-dried, one-size fits all. I think the best one can hope for is a doctor who doesn't have a fixed mindset and is willing to listen to you and pay attention to your symptoms - but even then it doesn't mean that person is going to be right... some things that work well for one don't help another. <<I don't know if the fact I took in a large tablespoon of salt before going to the ER had anything to do with my Cortisol being higher or not but I did intake a lot to try to prevent the crisis. Usually or at least I'm told when you start going into crisis to take salt because usually it's low and potassium is high which is bad. I'm told if you bring the salt back up soon enough, balance can be brought back and you may avoid a crisisCould that have had an effect on the Cortisol test?>> Again, I don't know.... it is possible, I suppose.....I think the salt doesn't 'cure' anything wrong with the adrenals, but is more important in helping in general the body's functioning. I don't think there is any kind of feedback mechanism between salt and the production of cortisol, but if it can forestall a crisis, then maybe it might. What probably would be a good thing is to see if your doctor will order some serial blood work as your dosage decreases - maybe that could give some clue as to how well your adrenals kick in and pick up the slack, so to speak, especially when you get down to a very low dose. But at the heart of it all, I do wonder if there isn't some element of loss of adrenal function that can't be regained. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2005 Report Share Posted June 2, 2005 If you can find her address, please forward it to me. Much love, Pamela --- LaCretia Mozingo <lacretiamo@...> wrote: > I can't remember... I know her e-Mail address is > saltillo something.... I > recongnize her e-Mail when she comes on. I have her > address somewhere. I > always see her post as Trish... sorry... > > LaCretia > > > > >Hi LaCretia, > > > >Is the " Tish " you mentioend that helped you out, > >Letitia Wetterauer? > > > >Much love, > >Pamela > __________________________________ Discover Find restaurants, movies, travel and more fun for the weekend. Check it out! http://discover./weekend.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Actually extra salt is a great help! Most hypoadrenals are " salt losers " and can't maintain the balance between sodium/potassium. It has something to do with the adrenal hormone aldosterone. It really isn't a big deal to continue with h/c to treat symptoms. The biggest problem is the misinformation about it. No one should " go off " of h/c if they need it (OBVIOUSLY) Remember that h/c is cheap and cannot be patented, so big pharma would like us to be on other drugs instead. Gracia > Again, I don't know.... it is possible, I suppose.....I think the salt > doesn't 'cure' anything wrong with the adrenals, but is more important in > helping in general the body's functioning. I don't think there is any kind > of feedback mechanism between salt and the production of cortisol, but if it > can forestall a crisis, then maybe it might. What probably would be a good > thing is to see if your doctor will order some serial blood work as your > dosage decreases - maybe that could give some clue as to how well your > adrenals kick in and pick up the slack, so to speak, especially when you get > down to a very low dose. > > But at the heart of it all, I do wonder if there isn't some element of loss > of adrenal function that can't be regained. > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 ... You just posted all of the questions I have been trying to get answered... *sigh*. I too think there is perminent damage and posted this to the 's board. I asked out there how would they be able to measure the amount of damage the adrenals gland has. I know that at 90% damage you are told you have 's but what if there is 20% or 40%... how do they determine that? Is there a scan of some sort that can see the physical damage to the gland? I have had two blood draws during the weaning and so far...one came back at .2 and the other 4.5...but that was in the ER after taking in a lot of salt. Again, I don't think that would impact the numbers however...I haven't had anyone confirm either way if that would effect the test. Either way .2 you can't survive on and 4.5 is at the lowest end of the range and I felt it. LaCretia > ><<You said that by the time the medication is stopped, the adrenals will be >at their normal full production rate. I've been weaning since February and >actually had a relapse once I got off the meds and my doctor put me back on >the full 20mg I was taking and >had me start all over on the weaning process. That was in March sometime. >So from there I have been weaning for almost 8-10 wks. Everytime I get >near >the end of the weaning, I start having crisis. So do you think this is a >sign this is perminent for me? >> > >I wonder why this keeps happening to you - it sounds to me like you may >have >some permanent decreased adrenal function, maybe there is some permanent >damage to the adrenals? It would seem to me that if there was enough >normally-functioning adrenal tissue left to meet your body's needs, you >wouldn't go into a crisis once you went off the medication. Maybe they are >partially functioning and can meet some of your needs, but not quite all of >them? What explanation has your doctor given you? > > ><<My doctor said that after I get off the meds, the adrenals would still be >weak and I would need to keep stress doses on hand for up to a year >later....is this what you have heard also?>> > >No, I don't recall ever having heard that. What exactly does he mean by >'weak', I wonder... not fully functioning, like I talk about above, not >able >to meet the body's needs? What if you have, say for an example, 75% >adrenal >function existing? Now, this I do not know but toss it out for >consideration - if your adrenals are capable of regeneration, i.e. growing >new functioning adrenal cells, how long would that take? Wouldn't you >expect to see gradual improvement over time as the cells rebuild? Since >the >adrenal glands are so tiny... why would that process take a year? > >But what happens to them each time you are taken off the medications and go >into crisis - does that stop any regeneration process? Does it even set it >back - does it cause new cellular damage, so that essentially you keep >getting bounced back to the same point, and have to start all over again? >On the other hand, what if the adrenal glands have permanent scar tissue, >and will never regain full function? Can your doctor differentiate between >the two - a very slow, long term healing process versus incomplete >function, >or can he only assume what is going on? > >I don't have any answers, it's simply beyond the realm of my knowledge. I >do wonder, though, if he thinks you can be weaned off the adrenal >replacement, that it could be tapered down much, much more slowly and in >much, much smaller increments - like 2.5 mg and months at a time - it would >seem to me that way, if your adrenals do have the capacity to regenerate, >they would be able to build up very slowly over the course of time as the >medication is decreased. > >Did you ever read the book, " Adrenal Fatigue " ? I read it a while ago and >though it was very good, I don't know if it has information that would >specifically pertain to a situation like yours, but it might be worth a >read. > > ><<<<This does get confusing becuase the treatment is not consistent between >doctors >and also the information I get on various groups varies also. >>>>> > >I think it's confusing because nobody really knows all the answers - and >everyone is different, an individual - this is why they say medicine is an >art - it's not black-and-white, cut-and-dried, one-size fits all. I think >the best one can hope for is a doctor who doesn't have a fixed mindset and >is willing to listen to you and pay attention to your symptoms - but even >then it doesn't mean that person is going to be right... some things that >work well for one don't help another. > ><<I don't know if the fact I took in a large tablespoon of salt before >going >to the ER had anything to do with my Cortisol being higher or not but I did >intake a lot to try to prevent the crisis. Usually or at least I'm told >when you start going into crisis to take salt because usually it's low and >potassium is high which is bad. I'm told if you bring the salt >back up soon enough, balance can be brought back and you may avoid a >crisisCould that have had an effect on the Cortisol test?>> > >Again, I don't know.... it is possible, I suppose.....I think the salt >doesn't 'cure' anything wrong with the adrenals, but is more important in >helping in general the body's functioning. I don't think there is any kind >of feedback mechanism between salt and the production of cortisol, but if >it >can forestall a crisis, then maybe it might. What probably would be a good >thing is to see if your doctor will order some serial blood work as your >dosage decreases - maybe that could give some clue as to how well your >adrenals kick in and pick up the slack, so to speak, especially when you >get >down to a very low dose. > >But at the heart of it all, I do wonder if there isn't some element of loss >of adrenal function that can't be regained. > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Gracia, Do you know if salt would impact Cortisol reading on your labs? I would think not... should only effect your salt reading on the lab I would think? LaCretia > > >Actually extra salt is a great help! Most hypoadrenals are " salt losers " >and can't maintain the balance between sodium/potassium. It has something >to do with the adrenal hormone aldosterone. It really isn't a big deal to >continue with h/c to treat symptoms. The biggest problem is the >misinformation about it. No one should " go off " of h/c if they need it >(OBVIOUSLY) Remember that h/c is cheap and cannot be patented, so big >pharma would like us to be on other drugs instead. >Gracia > > > > Again, I don't know.... it is possible, I suppose.....I think the salt > > doesn't 'cure' anything wrong with the adrenals, but is more important >in > > helping in general the body's functioning. I don't think there is any >kind > > of feedback mechanism between salt and the production of cortisol, but >if >it > > can forestall a crisis, then maybe it might. What probably would be a >good > > thing is to see if your doctor will order some serial blood work as your > > dosage decreases - maybe that could give some clue as to how well your > > adrenals kick in and pick up the slack, so to speak, especially when you >get > > down to a very low dose. > > > > But at the heart of it all, I do wonder if there isn't some element of >loss > > of adrenal function that can't be regained. > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 , This is what I think also. I don't know, but I feel this. Bev " L. on " <res075oh@...> wrote: Since I know very little about it please regard my thoughts as _speculation_. But as I understand it during stress situations [illness, surgery, etc.] at least one of the products of the adrenal gland needs to [roughly] double. If it doesn't increase almost double you can go into crisis; maybe even fatal. So, if we assume your adrenal gland has slowly been brought back up from a dysfunctional level to, say, 100% _normal_ [unstressed] production things might seem great... UNTIL you run into a stressor [illness, surgery, etc.]. At that point your production is suddenly roughly one half of that needed to keep you out of crisis. Does this make any sense; or am I full of it [again! {ggg}]? >Message: 1 > Date: Thu, 2 Jun 2005 17:11:28 -0400 > From: " Every " <denisee@...> >Subject: Re: Re: adrenal support > ><<You said that by the time the medication is stopped, the adrenals will be >at their normal full production rate. I've been weaning since February and >actually had a relapse once I got off the meds and my doctor put me back on >the full 20mg I was taking and >had me start all over on the weaning process. That was in March sometime. >So from there I have been weaning for almost 8-10 wks. Everytime I get near >the end of the weaning, I start having crisis. So do you think this is a >sign this is perminent for me? >> > >I wonder why this keeps happening to you - it sounds to me like you may have >some permanent decreased adrenal function, maybe there is some permanent >damage to the adrenals? It would seem to me that if there was enough >normally-functioning adrenal tissue left to meet your body's needs, you >wouldn't go into a crisis once you went off the medication. Maybe they are >partially functioning and can meet some of your needs, but not quite all of >them? What explanation has your doctor given you? > > ><<My doctor said that after I get off the meds, the adrenals would still be >weak and I would need to keep stress doses on hand for up to a year >later....is this what you have heard also?>> > >No, I don't recall ever having heard that. What exactly does he mean by >'weak', I wonder... not fully functioning, like I talk about above, not able >to meet the body's needs? What if you have, say for an example, 75% adrenal >function existing? Now, this I do not know but toss it out for >consideration - if your adrenals are capable of regeneration, i.e. growing >new functioning adrenal cells, how long would that take? Wouldn't you >expect to see gradual improvement over time as the cells rebuild? Since the >adrenal glands are so tiny... why would that process take a year? > >But what happens to them each time you are taken off the medications and go >into crisis - does that stop any regeneration process? Does it even set it >back - does it cause new cellular damage, so that essentially you keep >getting bounced back to the same point, and have to start all over again? >On the other hand, what if the adrenal glands have permanent scar tissue, >and will never regain full function? Can your doctor differentiate between >the two - a very slow, long term healing process versus incomplete function, >or can he only assume what is going on? > >I don't have any answers, it's simply beyond the realm of my knowledge. I >do wonder, though, if he thinks you can be weaned off the adrenal >replacement, that it could be tapered down much, much more slowly and in >much, much smaller increments - like 2.5 mg and months at a time - it would >seem to me that way, if your adrenals do have the capacity to regenerate, >they would be able to build up very slowly over the course of time as the >medication is decreased. > >Did you ever read the book, " Adrenal Fatigue " ? I read it a while ago and >though it was very good, I don't know if it has information that would >specifically pertain to a situation like yours, but it might be worth a >read. > > ><<<<This does get confusing becuase the treatment is not consistent between >doctors >and also the information I get on various groups varies also. >>>>> > >I think it's confusing because nobody really knows all the answers - and >everyone is different, an individual - this is why they say medicine is an >art - it's not black-and-white, cut-and-dried, one-size fits all. I think >the best one can hope for is a doctor who doesn't have a fixed mindset and >is willing to listen to you and pay attention to your symptoms - but even >then it doesn't mean that person is going to be right... some things that >work well for one don't help another. > ><<I don't know if the fact I took in a large tablespoon of salt before going >to the ER had anything to do with my Cortisol being higher or not but I did >intake a lot to try to prevent the crisis. Usually or at least I'm told >when you start going into crisis to take salt because usually it's low and >potassium is high which is bad. I'm told if you bring the salt >back up soon enough, balance can be brought back and you may avoid a >crisisCould that have had an effect on the Cortisol test?>> > >Again, I don't know.... it is possible, I suppose.....I think the salt >doesn't 'cure' anything wrong with the adrenals, but is more important in >helping in general the body's functioning. I don't think there is any kind >of feedback mechanism between salt and the production of cortisol, but if it >can forestall a crisis, then maybe it might. What probably would be a good >thing is to see if your doctor will order some serial blood work as your >dosage decreases - maybe that could give some clue as to how well your >adrenals kick in and pick up the slack, so to speak, especially when you get >down to a very low dose. > >But at the heart of it all, I do wonder if there isn't some element of loss >of adrenal function that can't be regained. > > > > > > > > > -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.322 / Virus Database: 267.4.0 - Release Date: 6/1/2005 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 I think that's pretty good assessment. I think I recently read that adrenals can make up to 200mg cortisol a day under severe stress.. Gracia > Since I know very little about it please regard my thoughts as > _speculation_. But as I understand it during stress situations > [illness, surgery, etc.] at least one of the products of the adrenal > gland needs to [roughly] double. If it doesn't increase almost double > you can go into crisis; maybe even fatal. So, if we assume your adrenal > gland has slowly been brought back up from a dysfunctional level to, > say, 100% _normal_ [unstressed] production things might seem great... > UNTIL you run into a stressor [illness, surgery, etc.]. At that point > your production is suddenly roughly one half of that needed to keep you > out of crisis. Does this make any sense; or am I full of it [again! {ggg}]? > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2005 Report Share Posted June 5, 2005 I really don't know. I don't have much faith in the labs, just go by symptoms. Gracia > Gracia, > Do you know if salt would impact Cortisol reading on your labs? I would > think not... should only effect your salt reading on the lab I would think? > > LaCretia > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2007 Report Share Posted May 12, 2007 What is the lab code for the adrenal test? I have my labs but I don't know what the code is for that? M <veetee@...> wrote: Hi Palma, I tried Isocort for about 10 months, and I ordered it from the States for import into the U.K. I think I should have stayed on it for longer, say 18 months or so, but cost was a factor at the time. I do feel, but cannot prove it, that by taking the Isocort it helped with my depression. As I said I resisted the Doc's anti-depressants and it was tough, but I wanted my body to stand a chance of healing itself with the right kind of medicine for what ailed me. I do not think I was depressed in a clinical sense at the time. I would just feel low and cry for no reason, any time any place. I was not depressed about any one thing. Isocort is as good a place to start. No one bothered to look at my sex hormones at the time I was very ill, but I guess if they had, they would have found them of the scale and none existent! Love, Val Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 3, 2008 Report Share Posted February 3, 2008 According to the PIL (Patient Information Leaflet) they should be checking for adrenal function before giving thyroid hormones ~ so the logic is correct ~ test T4, T3, TSH, before adding adrenal support... Bob > > Hello everyone, has anyone got any thoughts on the following; > I've been to doctor, he organised a TSH T3 and T4 test, lab wouldn't do > T3 and T4 without him putting a reason. I'm pretty sure I need adrenal > support but should I wait until doctor does T3 and T4 tests before > starting to take anything? Will the adrenal support supplements affect > the results of the thyroid tests and therefore mean doctor will think > I'm not hypothyroid even if I am? But then if I wait till after tests > and he says I'm hypothyroid, I'm worried that if he prescribes me > thyroxine it won't work coz I need adrenal support and I know that > saying to him about adrenal support probably won't go down well because > so far he doesn't seem to be holistic in his approach or even open > minded! I hope I've made some sense, sorry if I haven't! lol. Ruth. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 3, 2008 Report Share Posted February 3, 2008 Unfortunately, doctors never see PIL leaflet and don't even know they are supposed to check their patients for low adrenal reserve. Even endocrinologists just laugh when we mention an adrenal/thyroid connection. My own lovely endocrinologists encourages me to continue to fight the good fight to get Armour prescribed within the NHS, but tells me, at the same time, NOT to mention an adrenal connection because all the other endocrinologists would just laugh at me, and that would take away the seriousness of our Armour campaign -0 I give up...or rather, I will NOT give up. Luv - Sheila According to the PIL (Patient Information Leaflet) they should be checking for adrenal function before giving thyroid hormones ~ so the logic is correct ~ test T4, T3, TSH, before adding adrenal support...Bob .. No virus found in this incoming message.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date: 02/02/2008 13:50 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 3, 2008 Report Share Posted February 3, 2008 The Adrenal support will not effect the results of your thyroid function tests. Have you read everything about the adrenals in our website and our Files on this forum? There is a questionnaire you can do to see if this could be your problem. You make great sense Ruth, so don't worry. You can buy Nutri Adrenal yourself as it is only a supplement and as such, you don't necessarily have to get your doctor to agree. Most of us take one form or another of adrenal supplementation - just like taking a multivitamin tablet each day. The best thing to do is to start taking Nutri Adrenal Extra as soon as possible, and then if you are diagnosed as being hypothyroid, you should, hopefully, have boosted your adrenal glands ready for you to start taking thyroxine. Hope this helps luv - Sheila Hello everyone, has anyone got any thoughts on the following;I've been to doctor, he organised a TSH T3 and T4 test, lab wouldn't do T3 and T4 without him putting a reason. I'm pretty sure I need adrenal support but should I wait until doctor does T3 and T4 tests before starting to take anything? Will the adrenal support supplements affect the results of the thyroid tests and therefore mean doctor will think I'm not hypothyroid even if I am? But then if I wait till after tests and he says I'm hypothyroid, I'm worried that if he prescribes me thyroxine it won't work coz I need adrenal support and I know that saying to him about adrenal support probably won't go down well because so far he doesn't seem to be holistic in his approach or even open minded! I hope I've made some sense, sorry if I haven't! lol. Ruth. No virus found in this incoming message.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date: 02/02/2008 13:50 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 3, 2008 Report Share Posted February 3, 2008 Thank you for reply Bob, what information leaflet are you talking about? Thanks, Ruth. thyroid treatment From: Bob.m9uk@...Date: Sun, 3 Feb 2008 12:54:26 +0000Subject: Re: Adrenal support According to the PIL (Patient Information Leaflet) they should be checking for adrenal function before giving thyroid hormones ~ so the logic is correct ~ test T4, T3, TSH, before adding adrenal support...Bob>> Hello everyone, has anyone got any thoughts on the following;> I've been to doctor, he organised a TSH T3 and T4 test, lab wouldn't do > T3 and T4 without him putting a reason. I'm pretty sure I need adrenal > support but should I wait until doctor does T3 and T4 tests before > starting to take anything? Will the adrenal support supplements affect > the results of the thyroid tests and therefore mean doctor will think > I'm not hypothyroid even if I am? But then if I wait till after tests > and he says I'm hypothyroid, I'm worried that if he prescribes me > thyroxine it won't work coz I need adrenal support and I know that > saying to him about adrenal support probably won't go down well because > so far he doesn't seem to be holistic in his approach or even open > minded! I hope I've made some sense, sorry if I haven't! lol. Ruth.> Think you know your TV, music and film? Try Search Charades! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 3, 2008 Report Share Posted February 3, 2008 Hi Ruth That leaflet is what is tucked inside every package of thyroxine tablets. Often we just pull them out and throw them away, but they are actually packed with information. luv - Sheila Re: Adrenal support According to the PIL (Patient Information Leaflet) they should be checking for adrenal function before giving thyroid hormones ~ so the logic is correct ~ test T4, T3, TSH, before adding adrenal support...Bob>> Hello everyone, has anyone got any thoughts on the following;> I've been to doctor, he organised a TSH T3 and T4 test, lab wouldn't do > T3 and T4 without him putting a reason. I'm pretty sure I need adrenal > support but should I wait until doctor does T3 and T4 tests before > starting to take anything? Will the adrenal support supplements affect > the results of the thyroid tests and therefore mean doctor will think > I'm not hypothyroid even if I am? But then if I wait till after tests > and he say s I'm hypothyroid, I'm worried that if he prescribes me > thyroxine it won't work coz I need adrenal support and I know that > saying to him about adrenal support probably won't go down well because > so far he doesn't seem to be holistic in his approach or even open > minded! I hope I've made some sense, sorry if I haven't! lol. Ruth.> Think you know your TV, music and film? Try Search Charades! No virus found in this incoming message.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date: 02/02/2008 13:50 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2008 Report Share Posted March 1, 2008 You don't have to leave this site Keri - I thought you were actually gaining some hope from what you have read here and from the responses you have received from other members. I needed to point out that being on different forums (especially when they are different countries), could cause you to become confused as to which road you should follow. If you want to go down the route of the American forum (Natural Thyroid Hormones) then that is absolutely fine, and vice versa. You can use this site if you wish for other information. We are specifically geared up to campaign for getting a better diagnosis and treatment protocol here in the UK because the problems we have are specific to the UK and we are secondly a support forum for UK residents. The end of the month seems a long way away, but really, it isn't and you will feel so much better and more assured once you have seen Dr Peatfield - and he will then be able to steer you down the adrenal pathway. None of us here are medically qualified, and we worry that one of our members may do something wrong and make themselves ill through following a regime that may not be suitable for them. That is why we recommend finding a doctor who knows about thyroid disease and the adrenal connection. You get good days and bad days, but one day, they will all be good days. Take things slowly. You will get there. Read, read and then read again, and gradually you will find things slotting into place and understanding the reason why these things are happening. Luv - Sheila Sounds as if I may need to leave this site and spend more time on the adrenal site - any change I find very difficult. I have supposedly been supporting the adrenals for a year now but obviously not enough -makes me very sad. The thought of hydrocortisone scares me and I don't think I will get the doc's support as the test for addisons disease came back negative although saliva tests from October are very low on cortisol. Also I don't register hypo t according to docs, just high antibodies which are overlooked - they will be taken into account when they affect the TSH over 5.5 I believe. I feel in no man's land which is why the doc keeps batting on about depression. Am seeing the psychiatric nurse on tuesday. Don't feel validated at all. Sorry to moan.Have found Natural Thyroid Hormones Adrenal group. Is anyone familiar with this one? It was via June's stop the thyroid madness site. Is this the one June? Have read the adrenal pages on the site but over confused now.luv keri No virus found in this incoming message.Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.21.1/1302 - Release Date: 27/02/2008 16:34 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2008 Report Share Posted March 1, 2008 Totally with you on this Bella in all aspects although I know little about HC, I know that I would not take it unless I really had to. As for the NAE, I take 3 a day now and 2 of them are am and 1 at 12 noon - If I up it for stress that I am aware is going to happen, I take 3 am and still the 1 at noon - works so well for me. Keri, this is the nicest group you could hope to join, please stay and make sure that you have every bit of knowledge to hand before you make any decision, no matter what med or supplement it is for, that way you are making the right decision for you based on your knowledge and not that of someone else who has been pretty much where you are but in their body which is totally different to yours. The one thing that I have learnt from this group that has helped me with every single health issue and not just the thyroid is the fact that we are all so very very different and that no ailment affects everyone in the same way. Luv nne Hi Keri,Don't you leave this group sweetheart. We are tons nicer than that other group for adrenals and there's lots of knowledge here too. Of course I am rather biased!! LOL. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2008 Report Share Posted March 1, 2008 > > You don't have to leave this site Keri - I thought you were actually gaining some hope from what you have read here and from the responses you have received from other members. Thanks Sheila. I didn't realise the Natural Thyroid Hormone site was American. I think someone suggested I join an adrenal site that's all but I am confused even more by other sites I've looked at - the variety of supplements people are takig for their adrenals (from the stop the thyroid madness site - adrenal link). I suppose I can wait for Dr P, it's just that I wanted to be a bit brighter by then and it's my 50th in April and for once I'd like to be able to celebrate. Will Dr P write to my doctor if I ask him? I have just got Dr Skinner's book as an interlibrary loan - looks very simply written, especially from the symptom level. As you say, he goes more the thyroxine route. So, I will keep the armour thyroid and keep on with what I have for adrenal support. Running out the dynamite adrenals so will now take the Nutri Adrenal Extra but at 1 first thing and another 3 before 1 pm. Maybe the increased dose will help - last April I just took 2 on the recommendation of Budd. I'm better with 'keeping it simple' at the moment. luv keri Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2008 Report Share Posted March 1, 2008 HI Keri Have you actually read the information on the adrenal/thyroid connection in our website. Dr Peatfield wrote that and I find it excellent. Also, the other site that I think is brilliant is Dr Lam's. He writes in such a way that makes you really understand http://www.drlam.com/A3R_brief_in_doc_format/adrenal_fatigue.cfm Luv - Sheila Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2008 Report Share Posted March 1, 2008 --- In thyroid treatment , " kericaswell " > Have found Natural Thyroid Hormones Adrenal group. Is anyone > familiar with this one? It was via June's stop the thyroid madness > site. Is this the one June? Have read the adrenal pages on the site > but over confused now. Keri I just wanted to encourage you. I've been at this now for over a year and when I first found the Adrenal group you mention I was completely overwhelmed to the point of tears. Not only do you feel ill I thought but on top of everything else you have to wade through heaps and heaps of information to even have a chance of getting better. The more I read the more I got confused. I thought I'd never get it. I really felt despairing and actually quite frightened as to what I was getting into. But not having any other option I stuck at it. And although nothing really " stuck " I just kept on reading. It is all very very complicated at first. It's not just you. It's a bit like learning a foreign language. But gradually one thing at a time starts to become clearer and the pennies begin dropping. And bit by bit (and it is that slow) it starts to make sense. At first I was reading about the thyroid AND adrenals to get an overview but then although I still read all the thyroid stuff I really concentrated on gaining understanding of the adrenals. If I learnt nothing else it was that you have to get your adrenals healthy before considering thyroid meds. I think the best thing to do is ask questions as they arise. No-one minds helping out because we too were glad of help ourselves when we first started learning stuff. Ane even all this time on after 12 months I still feel like I know nothing really compared to others! But I know far more now than I did a year ago. And I'm sure that'll be you this time next year! Chin up! x Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2008 Report Share Posted March 1, 2008 Hi Keri, Don't you leave this group sweetheart. We are tons nicer than that other group for adrenals and there's lots of knowledge here too. Of course I am rather biased!! LOL. If it helps at all I've been just where you are, had 'in range' blood tests and in my case it's been down to my darned adrenals. I'm still learning about my adrenals and sex hormones and how they affect everything, especially our thyroid and blood tests. If you go to the other site you may well feel pressured to take HC and I think everyone knows here what a big decision that is and the fact that it can only be done if and when you are ready. Take most of your NAE first thing and take the smaller amount in the afternoon. Don't be in a hurry to up your thyroid meds if you are on any because you really have to take things slowly when you have adrenal problems. Last bit of advice: read, read, read! No one is infallible and that's why you need to become an expert on yourself. Luv and ((((((((hugs))))))))) Bella > > > > You don't have to leave this site Keri - I thought you were > actually gaining some hope from what you have read here and from the > responses you have received from other members. > Quote Link to comment Share on other sites More sharing options...
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