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Addison's Disease Message Board


Addison's Disease Board Index


There is a link between the adrenal and thyroid glands in that they are both part of the endrocine system, but there are distinct differences on how they fail. Many people (estimates are as high as 10% of women over 65) suffer from hypothyroidism (lack of thyroid hormone), most commonly caused by an autoimmune attack on the thyroid gland (Hashimoto's disease). This conidition causes a vast amount of symptoms and the onset is insidious (read as... hard to detect). The lowered thyroid hormone level causes your entire metabolism to slow down which in turn lowers your usage of cortisol (the main "stress" hormone of the adrenals). This typically isn't a problem; but your adrenal function should be tested before you start thyroid meication. If you are one of the small minority (something like 0.33% of hypothyroid patients) who also has adrenal failure (auotimmune attack on the adrenal glands, Addison's disease) the sudden jacking up of your metabolism by exogenous thyroid hormone can deplete your diminished cortisol reserves to dangerous levels (leading to an Addison Crises) through increased use.

Let me emphasize, it is a small percentage of people who suffer from both Hashimoto's and Addison's disease (a condition called Schmidt's disease or Polyglandular autoimmune syndrome type II), somewhere around 14-20 people per million of the general population in the US, while a significant number of people suffer solely from Hashimoto's disease (around 3 per 1000 according to the NIH with overt hypothyroidism). Your doctor will probably test your adrenal function prior to starting thyroid medicine, and either do routine follow-up tests every couple of years or test you for anti-adrenal cortex antibodies (around 1% of Hashimoto's patients have them, and 30% of those progress to Addison's).

This of course brings us to the topic of "adrenal fatigue" and subclinical Addison's disease. There is a body of research to support subclinical Addison's disease, which is where a patient has the autoreactive antibodies to their adrenal glands and they show evidence of damage through skewed biochemistry (i.e. plasma renin activity changes). A significant number of these people over time will continue to progress to Addison's disease and I would think that their doctor would monitor them closely. The "adrenal fatigue" syndrome is a nondistinct syndrome developed in the 80s or 90s to explain people who always "feel bad" but have no evidence of hormonal imbalance. It does not have a lot of support in the established medical community. The syndrome does not show up on normal adrenal function tests and as such has come under fire. I personally don't believe in "adrenal fatigue," but I have never claimed to know everything :)

There is a documented and significant rise in your chances to develop a second autoimmune disease once you have developed one. So if you have Hashimoto's disease than you are at higher risk to develop such things as Addison's disease (rare), pernicious anemia (fairly common, lack of ability to absorb vitamin B12), vitilogo (fairly common, loss of pigmentation), and diabetes (rare to develop type I later in life, but possible); BUT your chances are still pretty slim. As pertaining to your surgery one of the hallmarks of developing Addison's disease is hyperpigmentation and this is usually evident in recent surgery scars as the stress of the surgery is usually enough to deplete your cortisol levels.
divermom--reading your post I was wondering if your heat intolerance is related to your adrenal problem, thyroid problem, or what????? I have Hashi's but when I try hormone replacement, I get hotter than my normally being hot all the time. That's what makes me quit the thyroid replacement, although my tsh is 6, and free t4 low. I show a low cortisol at my 8 a.m. but normal the rest of the day. I am lost as to why I'm always hot. Have you found out how your heat intolerance fits into the picture? :confused:

Karen
Divermon:

Ya that helps, my saliva labs were the following:
Testosterone: 127 (50-200 pg/ml)
DHEAS: 35.4 (3-10 ng/ml)
Cortisol Morning 6.7 (3-8 ng/ml)
Cortisol Noon .5 (2-4 ng/ml)
Cortisol Evening .7 (1-2)
Cortisol Night 1.0 (.2-1.5)

So as you can see my labs were low also, normal blood tests dont show this very well.
Anyway DHEA is an indication of your stress level, the way my doctor explained it to me was my body is fighting in the morning to make cotisol so my DHEA goes up because of the stress the adrenals are putting on your body. LOW Dhea can be a bad thing because your body isnt able to fight stress off. ITs your bodys way of coping with stress. Your male l am assuming so your testosterone looks good, how old are you, the older you get the lower the valvues. I am 27 and my testsoterone has been as low as 200 with the range from 200-1000. So for a 27 year old male 200 in this type of range is way low.
I would have the doctor do the following labs if you want to know whats really going on with your adrenals:
Metyrapone test (this tests your pituitary function)
ACTH Stim Test: Tests your adrenals to see if they can be stimulated
Prolactin: Cand tell if you have a pituitary tumor
Aldosterone: Another steroid made by the adrenals
IGF-1: Part of the feedback system

These are just some general tests that could give you a little more insight, if you want you can also take adrenal extract, this can help rebuild the adrenal glands, however you shouldnt take the extract if your going to have these tests done. Adrenal Extract will raise your cortisol levels and give bad results for your blood test.
This is a long and slow process, l have had 2 MRI;s of my Pituitary and 2 CAT scans of my abdomen and chest along with having all the labs done twice and sometimes 3 times. Its not easy figurring out the problems the adrenals/thyroid can cause.
Hope this helps let me know what happens.

VAN
I have Addisons Disease (diagnosed by having a full blown crisis that put me in a coma) and I was treated for Graves disease 20 years ago, which means I now have low thyroid. Both of mine were autoimmune and I take 50mcg of synthroid, 30 mg of cortef, 1 florinef tab a day. This is just a friendly warning for all of you out there to be sure and get lots of calcium, take actonel or fosamax if they put you on it and be sure to follow directions by your endocrinologist as close as possible. We are still having a hard time regulating my thyroid even though they gave me radioactive iodine 20 years ago to kill it out. It just slowed it down and I still can't take medicines like cold medicines or it causes heart palpitations. I have osteopenia and I am typing with two broken bones in my left arm due to the steroids we take. I am by no means saying I am a pro, but if you have doubts, always ask to be taken to an endocrinologist because they understand these interactions best of all. Good luck and if you have any questions please write me. I will try to help any way I can. This stuff is NO FUN!
Thanks for your comments Van, I'll follow those tests, and see what the Endo runs. I often order my own tests as well, so I can augment if need be (unless it a reactionary test, of course).

When I was looking at your thyroid post a couple of weeks back, I had searched on you, and read a number of your previous posts. You sure have something going on there, and have been through a lot. I hope you find some answers too.

I went to my GP, who is usually hard to get in to see, and saw his Nurse Practitioner instead. I wanted to see if it was a good idea to try some Cortef for a couple of weeks, and see how I did. Unfortunately, she knew nothing about that, or thyroid (is a TSH-worshiper), and just passed me on to the Endo..... 3 month waiting time. I have an excellent endo though, so... guess I'll just suffer for another 1/4 year.

I was considering cautiously trying something mild, just as an experiment - not sure I want to do that. Are these adrenal extracts you mention, available from common sources (health food stores)? And what ingredient do you look for that makes one brand Cortisol-increasing, versus just a "support" supplement?

Sonya - Are you saying that the Cortef/Florinef can cause osteo? Ghee, that sounds fun. My wife is on Actonel. Judging by her reaction, I'd be in trouble taking that stuff. Sorry about your bones - both in general, and specifically to the two in mention.
i hope you can help me im on 25 of levothyroxine excuse me im from england !! and she wants me to get up to 50 wich will take time! as i get bad palps from them,
iv had this for about 3 years tshof 8... and the doc didnt tell me i was that for 3 years! as he said it was boderline nno warning for the future nothing! anyway im very low on iron and i cant seem to make it up and now they said im low cortisol! ive listened to your boards but i dont make any of it.
does this mean i could have addisons! and if so is it treatable without your bones crumbling! im new to this im seeing an endo in 4 weeks but id like some info if anyone can help me im proper lost in this! also my periods are v.heavy and she said my protien is high lots of love from katxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx i.s.h.t. !!!! :wave:





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