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The main mechanism for my anxiety and depression seems to be the thyroid, but is exacerbated by impaired and depressed cortisol rhythm. I was doing [COLOR="Magenta"][B]GREAT[/B][/COLOR] for the short time I was on Armour. Prior to that, no doing to shabbily on levothyroxine for a year and half. Came to a point where I could no longer tolerate thyroid meds. It has been downhill from there. :(
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Recent thyroid test (no meds 5 weeks+)

TSH: [B]5.121[/B] (.350-5.5)
FT4: [B]1.04[/B] (.61-1.76)
FT3 [B]2.8 [/B](2.3-4.2)

-----------

I suspect my adrenals were bad all along? since I went untreated for so long.


My dr has settled on the diagnosis of hypothyroidism and partial secondary AI.


[COLOR="Blue"][U]ADRENAL TESTS[/U][/COLOR]

DHEA-s [B]40[/B] ug/dL (32-240) 2/8/08
(day 8 cycle; 8:30 AM)

ACTH Stim 1/23/08

Cortisol, A.M. [B]14.5 [/B]
Cortisol 30 minutes [B]31.7[/B]
Cortisol 60 minutes [B]33.6[/B]


[COLOR="Blue"]Prior AM draw[/COLOR]

Cortisol [B]17.2[/B] mcg/dL (4-22)
8/1/07
7AM

ACTH [B]11[/B] pg/mL (5-27)
8/1/07
7MA


_______________________________________________________________
[COLOR="Blue"][U]Saliva test [/U][/COLOR] 11/14/07
(diagnos tech)

free cortisol rhythm

7-8AM [B]15[/B] nM normal [B]13-24[/B]
11-noon [B] 3[/B] nM depressed [B] 5-10[/B]
4-5PM [B]4[/B] nM normal [B]3-8[/B]
11-midnight [B]2[/B] nM normal [B]1-4[/B]

cortisol burden 24 (24-42)

DHEA pooled value [B]1 [/B] depressed ([B]3-10 [/B]ng/ML)
_________________________________________________________________

[COLOR="Blue"][U]Repro hormones [/U][/COLOR]
5/08

Progesterone: [B]25.8[/B] ng/mL mid-luteal (4.4 – 28.0)
(day 21)

Estradiol [B]315 [/B]pg/ml follicular no range
(day 10)

Testosterone [B]22[/B] ng/dL no range
(day 10)

LH [B]9.0 [/B]mIU/mL no range
(day 10)

FSH [B]4.1[/B] mIU/mL no range
(day 10)

free Testosterone [B]1.3 [/B]ng/dL (1.1-5.8)
(day 10)

______________________________________________________________

[COLOR="Blue"][U]Vit D & Iron[/U][/COLOR]

Ferritin [B]23[/B] ng/Ml (10-291) 6/8/08


Vitamin D, 25 hydroxy [B]21.6 [/B]ng/ml L (32-105) 2/14/08
Hiya hon
I am currently just tolerating 1 3/4 grains of Armour, I am having problems with anxiety too when I raise, takes ages for me to level out and I feel wiped out and breathless, however I am still nowhere near as wiped out and breathless as I was when I was on Levothyroixine.
I had a scary episode on that when I became confused, vomited, dizziness (I had had periods of dizziness for months) and apparently my pupils contracted and then relaxed when the doc shined the light in, I was admitted to hospital and they found nothin on a CT or any other problems. I have high BP and due to the confusion I suppose thats what the CT was for, but they did not put the episode down to anything at all.

So I have the problem of low saliva results for cortisol and no doc who is willing to prescribe me anything for it because my am cortisol was considered within range. My ferritin was 60 when I had it tested not as bad as yours. My B12 was also within range but when I took some my peritonitis stopped (gums had been bleeding for months and was getting infections) and I could breathe better.

Your question about the intolerence, yes I do to a certain extent have that as I explained I feel rotton on a raise, I understand when I raise I should be increasing adrenal support for a while each time, however my adrenal support is insufficient anyway as I cannot get hold of hc. The reason I mention the ferritin is that on the sites I have been on really regularly they always point to that as a major issue if you have problems tolerating armour or t3 and I do believe Janie says why in her book Stop the Thyroid Madness.
I honestly think a lot of this stuff happens because we suffer malabsorbtion due to our slow metabolisms and vital nutrients are missing. I am trying to put all that back with supplements. I use magnesium and calcium and the magnesium helps with muscle spasms. I use B comples sublingual, B12 sublingual, garlic for inflammation, vit c high dose for adrenals, adrenal cortex extracts sublingual, turmeric for inflamation, iron and vit C tabs, multivits, Q10, Vit D3 and unfortunately I am also stuck with old stuff from the seperate diagnoseses of depression and anxiety over the years, diazepam which unfortunately uses the T3 transporters, Seroxat, I am on Bp lowering meds which interfere with my Aldosterone called Olmatec and a water pill.... catches breath lol.
I am STILL looking for a suitable doc. One thing that did happen since I went on Armour which is worth a million, is that I no longer take my asthma meds as much, and the pains come and go whereas on Levo they were always there and I don't have as many black moods. I am still way under dosed so I do still have a lot of problems. That is why your post struck my eye. Adrenal issues are close to my heart, I read loads of forums and take part in quite a few to try and further my knowledge of this darn disease. I also read with interest papers on AI thyroid problems and adrenal issues. I also have a great interest in nutritional disorders and their relationship to anxiety disorders and mental issues.

Sorry to ramble lol.

God bless
Whitters
[QUOTE=sparkles916;3647345]I have only been diagnosed with partial AI, and my Dr hoped that a ful replacement would help me and most importantly enable me to go back on thyroid meds, which he agrees I could no longer tolerate due to the stress the thyroid meds put on my adrenals. I likely had weak adrenals or partial AI for some time as I was undiagnosed hypo for many years.

I wrote an earlier post, likening my trouble tolerating HC replacement 3x per day, as "chasing the tail of the dog". I am still full of ups and downs, and have moved my dose to AM only - which help a little.

I could not tolerate 20, went down to 17.5, then 15, then 12.5. In the AM with 12.5, there ensued hours of "surges" of anxiety and other overstimulated feelings.

I had to cut back to 10. I think my HPA axis is depressed now that I have been on HC for alomst a month. Since I have not stabilized, I cannot try thyroid meds again.

The anxiety and depression fill the day, with periods of relief from it - when I presume my normal (but depressed)cortisol rhythm picks up.

I don't know what is going on here. Any ideas?:([/QUOTE]



This is an old post but I wanted to reply anyway because I have difficulty with HC, and your situation is very much like mine.

I can't tolerate thyroid meds, I am on very small dose of Armour, my last ferritin was 7 and I can't tolerate Iron supplements either. I have been struggling with this for six long years already and nobody wanted to treat my adrenals until now. I was so optimistic and hopeful when I was prescribed Cortef, , but ever since I started it things are going even more south.

That was about a month ago when i started taking Cortef, but I feel worse now then I was before I started it. My problem before was that I had no energy and I couldn't tolerate thyroid meds, even vitamins, but ever since I went on Cortef I have many more symptoms. First of all I don't feel good after I take a dose, but couple of hours after I take it I get very sick, crashed, nauseated, faint, my back hurts a lot, I get nervous, just feeling terrible. Then when I take another dose those symptoms go away but I still don't feel right and I feel worse then before I ever started Cortef. It seems to me like I am totally suppressing my own production of cortisol, but dose that I take is not enough to compensate. If I take higher dose I feel lightheaded and still very crashed and just not right. I have not been on steady dose long enough because every dose I tried is not working and I have no idea what to do next.
Lately I have been taking 5 mg first thing in the morning, 5 mg at around 11 am, and 2.5 mg in the afternoon. I tried 7.5 mg in the morning but I felt worse then after taking 5 mg, and even worse couple of hours later when it wears off.
Hi sparkles, I will tell you about my intolerance and struggle with medications, hopefully it may help you some. I started having intolerance 5 years ago, when my Unithroid dose was increased from .25 mcg to .50. I had severe anxiety and PA, and irregular hear beats/ skipped beats on T4 meds. I tried different brand of T4 meds and had same or worse reaction. I was put on Armour, I think half a grain, and it was not much different. I went to dozen off different doctors, and finally one doctor prescribed compounded Armour, started me on 1/8th of a grain two times a day. From the first time I took it I loved it. It gave me sense of calm and my anxiety was not as bad any more. I had less energy and was sluggish almost all the time but anything was better then anxiety I had before. I was increasing very gradually, (compounded pharmacy can make you any dose you want) first morning dose, then weeks later pm dose. It would take me months before I would get comfortable on each dose increase. That's how I got to taking .31 grain now, two times a day, and just recently I tried third dose and I think it might work. I was suggested to try that before but with iron in between and having to eat it was hard to find time. I don't care now if I have to take T meds sooner then 4 hours apart from iron, I am still getting more. I try to take my am dose at 6 am, then at 10 am I take my iron, 2 pm another Armour, 6 pm another iron, 10 pm third Armour.
I think this is something that you should consider it, it might work. Not taking any thyroid medicine is going to make you feel very hypo and you'll never know what is thyroid and what adrenals. I wonder myself every day when I feel crappy, is it thyroid or is it adrenals?

I took 2.5 mg Cortef yesterday because I was really getting sick in the morning, I struggled thru the afternoon, but was ok in the evening. I did not take any today and I feel better.

Are you still taking Lexapro? Some of your symptoms might be from decreasing dose in Seroquel, but I think it would be wise to get off of it asap. I was on xanax for years for my anxiety, and like you, I was probably hypo all those years. My TSH 12 years ago was 3.5, and my T4 was in the bottom range. It took me long time to get off of it and it was not easy, that was before I was diagnosed with hypo. Then I was put on klonopin when I started having intolerance to thyroid meds, that was also very hard to get off of, but thankfully I was on a very small dose.

Breathlessness was big one for me too, I was not able to walk across the room, big stores were always my problem, still are, I was always gasping for air.

We have to stay positive and believe it will get better.
[QUOTE=dalmatinka;3698775]Hi sparkles, I will tell you about my intolerance and struggle with medications, hopefully it may help you some. I started having intolerance 5 years ago, when my Unithroid dose was increased from .25 mcg to .50. I had severe anxiety and PA, and irregular hear beats/ skipped beats on T4 meds. I tried different brand of T4 meds and had same or worse reaction. I was put on Armour, I think half a grain, and it was not much different. I went to dozen off different doctors, and finally one doctor prescribed compounded Armour, started me on 1/8th of a grain two times a day. From the first time I took it I loved it. It gave me sense of calm and my anxiety was not as bad any more. I had less energy and was sluggish almost all the time but anything was better then anxiety I had before. I was increasing very gradually, (compounded pharmacy can make you any dose you want) first morning dose, then weeks later pm dose. It would take me months before I would get comfortable on each dose increase. That's how I got to taking .31 grain now, two times a day, and just recently I tried third dose and I think it might work. [/QUOTE]

What is the difference between Armour and compounded Armour?

I tried everything too. Last dr (very expensive) put me on 1/2 grain armour. I knew it would be too much, so I tried 1/8 grain, but eventually and then 1/4 grain once a day. Eventually, as every time before, the small dose began to supress my thyroid function and I felt even worse. I wanted soooo badly to raise the dose. From the moment I started the intolerance was there and I just wanted so badly for it to work this time, believeing if I went slowly, I could get there.

I went off thyroid meds in Jan. Had a hellish time off, I think it was the adrenals, since I had the exact same "pyshco" anxiety (really, really, bad, like run down the street in terror anxety) when I had the low cortisol dips (esp at night) when I was on the HC. Then I went back on with the expensive dr in Feb. Then off again in March. Suffered tiill the end of May. Saw new dr who prescirbed HC. Been on a rollercoaster of craziness till a few weeks ago. :(

[QUOTE=dalmatinka;3698775]I was suggested to try that before but with iron in between and having to eat it was hard to find time. I don't care now if I have to take T meds sooner then 4 hours apart from iron, I am still getting more./QUOTE]

I have been working on my iron for a few months. I take ferrous sulfate elixir (liquid behind the counter) 44mg elemental iron, 2x per day. My ferritin was 21.


[QUOTE=dalmatinka;3698775]I took 2.5 mg Cortef yesterday because I was really getting sick in the morning, I struggled thru the afternoon, but was ok in the evening. I did not take any today and I feel better. [/QUOTE]

How is the cortisol weaning going? I think my adrenal condition is improving. I made the mistake of going to the dentist some weeks ago, I wondered if I would live. I was only just two weeks off the HC. Well, I went back for a follow-up the other day. Felt shaky at first, then by the time I went home I felt good - mood was better than usually. I figured that my adrenals had kicked in during stress....keeping fingers crossed.

But, still feel over all like crap. Especially mood is flat, and no energy, but slightly improved stamina and recovery. I have been doing laps at the pool and seem to fare much better and recovery is not all day or next day :mad:

As you point out, my symptoms could be from the Seroquel tapering. In the beginng, during the two weeks following no HC, I had prfound dizziness and pretty stong nausea. Mostly, this has passed. The residual symptoms of no nergy and flat mood vary throughout the day. Like today, I was pretty tired and flat, then around 5:15 just like a flash I was awake and felt "better". I think that the little ups and down correlate with cortisol variation - which while still low overall, are affecting my energy and mood.

I was feeling better mood-wise earlier, but now not so much, and this, I think is definately a Seroqel withdrawal problem. I had to speed up my taper, since with my adrenals and HPA axis being suppressed, the nightly Seroquel gave me a super low trough of cortisol and I was waking in the middle of the might in a panic after the Seroquel sedative effects work off like 6 hours later. So, the quier I tapered, the less intensely this was happening. I hoe this nightmare ends soon, I have about 1/3 more to go on the Seroquel. 2.5 mg per week of ten days, though I may strech it would more slowly now that the mid-sleep low cortisol awakenings are a little better.

Incidentally, about two weeks into the HC trial at 15-20 mg, I started to have this occur each night after I would take the Seroquel....that it would produce a superlow cortisol in the night. I have not slept uninteruptted for more than two months. I thought I would lose it!:mad:

[QUOTE=dalmatinka;3698775]Are you still taking Lexapro? Some of your symptoms might be from decreasing dose in Seroquel, but I think it would be wise to get off of it asap. I was on xanax for years for my anxiety, and like you, I was probably hypo all those years. My TSH 12 years ago was 3.5, and my T4 was in the bottom range. It took me long time to get off of it and it was not easy, that was before I was diagnosed with hypo. Then I was put on klonopin when I started having intolerance to thyroid meds, that was also very hard to get off of, but thankfully I was on a very small dose. [/QUOTE]

I am off the Lexapro and have been for sometime. I still take ativan, but as inflrequelty as I can. I can't wait to be off all this stuff and get back onto the Armour. I felt so happy, calm and energetic for the short time I was able to tolerate it. :) I don't know how long the adrenal supression will last, but hopefully a few momths down the road, if I survive, I will retest my thyroid and adrenals and see what the lay of the land is. :wave:





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