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Addison's Disease Message Board


Addison's Disease Board Index


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)

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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
[QUOTE] Your TSH is too high by today's standards (.3-3) but your FT3 and FT4 seem to be in ok ranges. I feel much better when my TSH is lower. So with a TSH that high, I would feel like garbage.[/QUOTE]

I do feel horrible. I just wish I could get back on thyroid meds, esp Armour.

[QUOTE]I have not had a stim test, but from what I have read, it looks like you have "passed". So while you have had some low readings, not sure. [/QUOTE]

I did plenty of reading up on secondary AI. I know I don't have complete AI, since I would have failed the stim test. But, there is room for accepting a diagnosis of partial AI, or at the least HPA axis failure, or dysfunction.

It is clearly shown in the low normal ACTH (or alost below range if one uses the older ranges that have 10pg/mL as the low end) and by the low DHEA-s, and resultant low testosterone.

[QUOTE]You really need vitamin D and iron. Try D3 - 1000iu daily and take iron daily to help. That will make a difference. Read the bottles so you don't take them when they interfere with the other meds. [/QUOTE]

I restarted my iron therapy. Obviously an increase in three points in a year is not sufficient. (was 20 feritin), so now I am taking iron twice a day.

The vit D I have just started on. Dr recommened 5000+ IU.

[QUOTE] There could be more going on, but your doc has not done enough tests - you could be going hypopituitary or more... does your doc treat a lot of adrenal patients - is he/she a neuro-endocrinologist? [/QUOTE]

What tests are you thinking of?

My dr is an MD who specializes in hormone treatments. I got his name through one of the adrenal boards. Apparently he does treat a number of cases like mine. He is willing to work with me at least.

I have spent a fortune! and many hours over the course of a year and a half to get this far. Most endos had no explanaiton why I could no longer tolerate the thyroid. I have been yelled at, humilated, and told to up my psych meds. I decided to find a dr who already practises the protocol I wanted to try - using cortisol to support thyroid therapy.
___________________________

I wondered if you had any explantion why I would feel "overstimulated" on a moderate level of HC, and why I experience the very bad dips in cortisol which precipate extreme anxiety? Do addisons persons have function of the adrenal medulla? I was thinking about some mechanism increasing my epinepherine when the cortisol wears off?

However, since I switched to AM only, the dips in their intensity have leveled off. I presume that in following the "traditional " treatment advice to take the HC before 8AM so as not to interfere with the HPA axis, seems to work better for me. But it is still a difficult time....not at all like I expected. :(

Finally, I do have a another variable in the mix - my psych meds. I was put on them (4yrs ago) when I should have been treated with thyroid meds and/or cortisol. They are Seroquel and Lexapro. I read that the Seroquel, even in small doses as I am taking (after tapering last year) can still significantly lower ACTH and cortisol. The Lexapro lowers T4.

I don't know if my HPA axis has been permantnely "down-regulated", which is the purpose of the Seroquel, and neither do I know about the long -term effects of SSRIs. I never should have been put on these drugs, esp. Seroquel, since I was already "down-regulated" becasue of my existing endocrine disease.

My medical records show I was already hypo 4.0 TSH and .9 FT4 in 1995! If only I had known!

To say I am distressed over my situation is putting it mildly:mad:





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