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Finding a doctor who understands thyroid/adrenal problems
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Finding a doctor who understands thyroid/adrenal problems

Hello, I am helping my cousin out who has suddenly (in the last 3 weeks) became homebound because she is so ill.  She saw a holistic doctor who said that her thyroid is low and that she has adrenal fatigue.  She has all the symptoms of both.  After a detox diet which coincided with her quick and steep decline, he told her "to think happy thoughts" to decrease her stress.  If only it was so easy to get better.

Everything that I read on the internet tells me how important it is to find a doctor who treats both the thyroid and the adrenal gland, and doesn't blow it all off as a psychiatric problem.  She said that she doesn't even have the energy to pick up the phone and make calls, so I want to find a doctor for her.  I'm finding it hard to find to find recommendations for a good endocrinologist in NYC, so I'm left to just calling doctors blind.  What should I be asking them on the phone to find out if the doctor is good?  I don't want my cousin going from doctor to doctor and being sick for years because she needs 120 mg of T4 and she's only getting 30 mg, or something like that.

Thanks.
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If she is as sick as you say she is, it is important that she be seen by an endocrinologist who will start testing for thyroid and adrenal hormone levels right away. Any endo should be able to do this. She can change doctors later if there is a problem. As far as I know, all endocrinologists would take her seriously, but I have found that it is up to the patient to insist on the quality care you deserve.

It sounds like she should have a cortisol test right away. This could be serious. Make an appointment with the first endo she can get in to see. As I said, she can always go elsewhere if she is unsatisfied.

Good luck to you, and your cousin.

Enzy
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Hard finding an endocrinologist in NYC? It was one of the medical capital's of the country?  Ask your primary care doctor for a referral.
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find a naturopath - they can help with both issues immediately. i see a GP who is involved with natural health, i take adrentone (by metagenics - which is a natural supplement to support adrenal insufficiency and my dr has prescribed hydorcortisone (for the adrenals too) i  also take natural thyroid supplement which has both t3 and t4 in it.. most dr's give synthetic thyroid supplement which only has t3 in it... this is not sufficent to help most issues....

i know that HealthWorld in USA is the same company that i deal with in New Zealand....

hope this helps your cousin.... i have been diagnosed with Hashimoto's disease - this is an autoimmune disease that affects the thyroid.

good luck
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sorry should have added that the Adrenals have alot to do with the thyroid too.. if one is low always checkthe other.. hence doing supplementation for both.. since i have been on both supports my thyroid tests have been improving......
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Thanks so much for the responses.  I'll post again soon, but she has had detailed blood work done.  I made an appt for her with an endo this Thurs.  Unfortunately, it seems that the recommended drs. don't take her insurance, but we're going to one anyway.  I will list later the vitamins/meds she's taking for adrenal support and, 2 days ago, after urging her dr. for more help, he prescribed Armour - 15 mg/day.  She's not taking it today, because she is experiencing severe nervousness.  I got an email this morning saying "it is the middle of the night and I dont' know what to do, I feel really nervous, anxious, if I lay down I feel like I cant breath, I can sit still either.  I dont know what to do."

Can it be so severe that she should be in a hospital?

Yes - there are literally 15 pages of endos that accept her insurance in NYC.  I've read so much that it's so important to find a good one - but you are right - get in ASAP, then shop around.

Thanks, I'll write again soon, or maybe ask her to write the details here.  I really appreciate the support.

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An immunologist who is into natural medicine recommended licorice root for my adrenal insufficiency (after years of having CFS). It really helped and you can check online for more information.

Best,

PlateletGal
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Be sure your cousin has her adrenal function examined very thoroughly, BEFORE starting on thyroid support. Aiding thyroid function, when the adrenals are weak or dysfunctional, can lead to an urgent, LIFE-THREATENING adrenal crisis. A good endocrinologist should be very thorough with adrenal testing before prescribing thyroid medication.

This happened to my son. Although he had one cortisol test before he started Levthyroxine, he collapsed one week later (passed out), and began shaking and vomiting.
We took him to emergency and he got the care he needed, but we were very upset this mistake was made.

Be very careful about thyroid support, if you haven't had a thorough adrenal exam.
The thyroid and adrenals affect each other.

Enzy
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Enzymelover pretty much summed that up.  Make sure the adrenals are functioning properly first then the thyroid.
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I would like to say, unfortunately, that I worked in NYC and went to many doctors there and got a lot of poor care. I ended up having to travel far to get care. It is not easy to find a competent doctor to treat thyroid and adrenal conditions (or pituitary, which I had as well). Try neuro-endocrinologists as they may be more competent. If your GP is helpful, get them to run tests for you but know that tests like renin and ACTH are very picky and subject to lab error so watch the lab tech and make sure they are done properly (chilled, spun immediately, and ask to freeze immediately or your results will be skewed).
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I just went to a dr who said adrenal fatigue was a very rare disorder! I was like please test me I failed the eye test. He put a flashlight to my eye in a well lit room for 2 seconds and said, everything looks fine, you don't have adrenal fatigue. I managed to get my thyroid blood work tested but he wouldn't do the saliva test.

All in all I feel your pain and yes finding a right doctor is a must. I imagine 80% of people don't have anything wrong with them so the other 20% of us who actually DO have something wrong, get screwed. Hope you find one soon and it's always better to overcheck everything than miss something.
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Many endocronologists with this title are specialists in diabeties and not thyroid disorders. The best thing you can do to save yourself from inadequent care and expenses is to interview when calling asking the ratio of how many patients are seen as diabetics - vs - thyroid patients.

If you find that their practice is based more on diabeties - then you can bet for sure the thyroid and adrenals are not going to be looked at as an issue.

Many patients have found endos they are happy with - but you will hear more and more patients that leave those type of doctors and find MD's GP's and others - that understand the whole endocrine system and treats the whole thing as one. Not placing a bandaide on one thing and telling you everything is fine.

I'd like to make a comment about kapitichic statement on thyroid medication.  She says below:

"i  also take natural thyroid supplement which has both t3 and t4 in it.. most dr's give synthetic thyroid supplement which only has t3 in it..."

She is correct saying most doctors prescribe synthetic thyroid medication but synthetic meds are not T3 - they are T4 meds that require T4 to convert into a T3 hormone to balance the system to function symptom free of thyroid issues. The only synthetic T3 meds that are prescribed is a med called Cytomel and that is used in correlation with a T4 medication when levels of Free T3 are not normal in labs.Unless a reverse T3 lab is uncovered - which is a very controversial subject over on the thyroid forum.

If there is a combination of both adrenal fatigue and thyroid issues - it is right to treat the adrenals and heal them first before taking thyroid replacement medication.

Yet people like me who have no thyroid function at all due to surgery or RAI ( as I had) are forced to find a balance of keeping thyroid hormones at a level of functionability as well as repairing the adrenals to work too.

Also keep in mind that when your thyroid does not function optimally - then the adrenals will pick up the slack of that  - and that will also burn them out - so ignoring thryoid function just to repair the adrenals could spin your whole system out of control.

The adrenals are very tough and can take a lot of issues before putting them in a CRISES as stated above. Trama or surgery in that area can  definately put you in crises - but in the majority of the time - they can be returned to proper function prior to devastation simply by supplements and change in lifestyles. Constant abuse will continue the damage - so definately taking care of them is right.

The right protacol of decreasing thyroid medication is usually recommended - and getting adrenal support to strengthen them is the right way to look at this.

You can't ignore one disfuction in hormones to fix another - balance is key.

I am an Armour patient on 120mgs a day - At first I struggled emmensely with adrenal fatigue and my medication. The right avenue for me was decreasing meds and repairing adrenal function to balance it all. I am still not quite there yet - but the results have been night and day. I recently was also found estrogen dominiant which will throw a wrench in the whole process too.


  
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Thanks everyone for the detailed responses.  I have been to 3 doctors since I last wrote with my cousin, but we're still looking for a doctor that understands both the thyroid and the adrenals.  One doctor in NYC spent almost 2 hours with her and said that she has Hashimotos - her thyroid is 3x bigger than normal, however, he didn't address her adrenals and deferred to the holistic doctor re: treatment.  Maybe that is the way to go - have 2 drs., although 1 seems better.

She started Armour at 15 mg/day and now she's up to 60 mg after 2 weeks.  After reading responses here, I'm wondering if this is even the right course of action.  Even with Hashimotos, should she be fixing the adrenals first?  She feels very slightly better after almost 3 weeks, but that really isn't saying much - she is still totally wiped out - definitely can't work, sometimes can barely make food to eat, but a few days a week she's been pushing herself to get out and walk, so we consider this an improvement.

How could it be that someone goes from totally active and healthy to totally non-functional within a few months?

We have another appointment with a doctor in NJ on Wed., however, I spoke to him last week, just to make sure he's the right doctor for us (found him on top docs at thyroid-info.com).  I told him that my cousin has thyroid disease AND adrenal fatigue and he said that it is very unusual for someone to have both.  After hearing that, I cancelled with him.  But I rescheduled because he had 15 reviews of people saying that he's the best doctor ever.

I guess what I'm unsure about is the mixed advice I'm getting from people here, and the endos.  

She is on adrenal support as follows:

DHEA
Phosphatidylserine (PS)
Phyto ADR
Ribose
ARginine with Magnesium
Iodoral
Vitamin D
Cortico B5 B6
Rhiodola
5 HTP
Theanine

SO, if she's supporting her adrenals, is it OK to be on Armour 60 mg?  It just doesn't seem right to forget fixing the thyroid for now and wait the months it might take to fix the adrenals.

What is the consensus - fix thyroid and adrenals simultaneously OR fix adrenals THEN thyroid.

We're also making an appt. with an osteopath soon.

Thanks so much.
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Hi Beth......well........you certainly have been very diligent with your cousin.......she's so lucky to have you as an advocate..........In 1978, I was convinced I was dying..........was dizzy half the time......no energy whatsoever.......just a complete feeling that something was terribly wrong.....inside.......I finally went to an endocrinologist......who.....in 30 minutes.......after physically examining me, diagnosed Addison's disease........and started me on hydrocortisone before the blood test to confirm the diagnosis was back........at the time......it took weeks before getting the results.........when it did come back.......my levels were so low......he wanted to repeat the test because he wasn't sure anyone could even be alive.......with the levels he saw.........my point being........I think your cousin needs to be tested for Addison's........before the thyroid is tested and treated. If her adrenals aren't working properly........she could be in a life threatening situation........especially if you say......she's still not feeling very well........I went to five doctors who said I was just fine.......and kind of treated me like I was a canidate for pyschiatry instead of something being physically wrong............from everything you've been through..........that's my very best advice to you........find someone who will test her for Addison's........it could save her life !..........peace and love......Norma
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If she is taking Armour thyroid right now - it is very important to balance both the adrenals and the thyroid together.

Most of the time - many thyroid patients - especially when they are left undertreated or under medicated for their disorder the adrenals were required to work twice as hard - hense making them work that hard - tired them out.  It takes for most people quite a long time for an adrenal crises to happen due to just a low thyroid function.

Addison's is rare - it can happen - but it is rare. Adrenal fatigue is a very controversial approach - and should be looked at as a real condition.

I am on Armour - and if there is one thing I can tell you is you do need to support your Adrenals to get the absolute most out of your thyroid medication.

No one can just say support the adrenals before the thyroid. What happens when you have literally no - or low - thyroid function and you need the meds to live?

It is a complete balancing of both glands to get everything functioning properly again. Supplements for both thyroid and adrenals are needed to require repairing both situations at the same time.

When I was at my worst on adrenal fatigue - my Armour was still giving me TSH and Free T3 lab numbers within proper ranges but my symptoms were unbearable. Once I "lowered " my Armour and started fixing the adrenals - slowly my symptoms started to go away. This took months.


Then as they began to function the way they should - my TSH on my labs were classified as Hyperthyroid - but I had no symptoms.

What I think best is to have a complete 24 hr cortisol check on your cousin. Get the test to see if she shows an abnormal level of cortisol through out the day.  See off that test if she even requires HC treatment or just adrenal support. Get here thyroid labs done TSH FT3 and FT4 again to see where her function is at and compare that to her symptoms.

Depending on those labs a small decrease of Armour may be needed. - OR even an increase - No one can know for sure without proper labs. Simply adding Vit's and minerals may help too. The list is endless and requires a solid - steady approach with one doctor willing to follow through accordingly.

If you read about Armour thyroid is is completely safe and normal to have a lower TSH with a higher free T3 and be optimized without hyper symptoms.

This is a very time consuming situation and no one can expect immediate results.

SInce she is on Armour now - I see you went to the top thyroid doctor directory already.

I think you can find that most MD's on that site are very qualified for Armour treatment and will definately be able to get you in faster to get the process rolling. That is how I found my doctor now and he is doing a fabulous job. I am not impressed that this doctor you spoke to said it is unsusal to have both adrenal and thyroid. If you have the time I would call a few more before putting all your eggs in on basket on him.  It's free to call right? and just because they "say" the are the best - may not be everything.

you know what I mean?

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I just want to mention that I went to numerous Doctors, who dismissed my complaints, saying that I needed to be on Anti-depressants. I thought that is absolute garbage because I believe that most people know their body more than a Doctor does, that is you know what is normal for you and what isn't.  I am now going to wonderful Naturopath and I suggest that you try one of those Beth, because they are all familiar with Adrenal and Thyroid issues and able to try them.
Good luck to you...
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I'm so happy to have found this forum!  All posters seem very caring AND reasonable in their suggestions/opinions.  I truly hope someone will take the time to read this long post and offer some help/suggestions/opinions for me.  I'm freaking out and have been calling in sick to work.  Maybe it's been my adrenals all along?  

I, too, feel my problem is biological in nature, not psychological.  I've been adamant it's my thyroid, although my thyroid tests have come out normal the past 4 years.  My grandmother had, my mother and younger brother have hypothyroidism. I thought maybe I have 'subclinical' hypothyroidism' which many specialists don't believe exists, but I've found this adrenal forum and wonder if it's been my adrenals all along?

First off, I've had a hard life, but I've coped.  Lots of stress--work and personal.  Because of the current economic conditions, I can't quit my very stressfull job because there aren't any opportunities out there for me.

Symptoms all my adult life (I'll be 48 next week):
Slow to wake up--brain fog/cobwebs in the brain, but then alert and quick and ready to roll after a couple hours---NOT tired, just brain fog, sensitivity to sound or interaction with people is a big issue.  I have to sit and basically stare out a window or at the weather channel while my brain catches up to my body;
Sensitivity to cold; Cold hands and feet and nose, even in warm weather;
Hard to stay awake at night--I could never party late with my friends, had to leave a few hours before them--just couldn't keep my eyes open.  When I get tired, I have no choice and I have to go to sleep.
Not tired or fatigued during the day--I'm fine once that stupid brain fog disappears;
Thin nails, they bend easily when they grow long;
Low body temp (around 97.5); Low blood pressure (tested yesterday at 106/68);
Need about 9-10 hrs sleep--not because I want to, but because my body dictates it.
Not heavy in weight, was always thin, have gained a bit over the past 10 years, but still within normal range;
Chest spasms after a period of high stress (taking a multi-vitams with magnesium has helped to a degree);
No problem falling asleep (but see below);
Sensitivity to sugars--I can't drink full strength, sweetened juices or teas or sodas; I have to dilute them down to about 1/3 sweetened to 2/3 water.  Otherwise, I become so tired I can barely stay awake.  A sandwich with mayo on it is a killer!  I can't stay awake after one!
Sometimes I start shaking if I have't eaten, feel like I'm going to faint if I don't eat something RIGHT AWAY.
Mild melancholy runs in the family, including me--not depression, not debilitating.  All my family memebers have been very productive, just not over-achievers;
Tinnitus.

Within the past few months, these symptoms have cropped up:  Note: I've had a severely stressful job for the entire past year.  This is the most stress I've ever dealt with for such a long duration.  All coworkers in my dept. agree 3 people should be doing my job, but no help is forthcoming due to the economy.  The stress level is so high that when I took off 13 days for the holiday break, it took 10 days before I felt able to relax.  I'm hyped up all the time from the stress and feelings of being overwhelmed.  I think it's gotten to the point the stress is manifesting itself physically--but is that because my adrenals have taken all they can take??? :

Brain fog/cobwebs are harder to shake off.  They've been lasting all day, on most days the past couple of weeks;
Don't fall right to sleep anymore--all I can think of is my job and the problems of it.  If I get up during the night, I don't fall right back to sleep like I used to.
Calling in sick because I can't handle the stress of the job;
Very pale facial skin--I am getting comments from people at work that I don't look well;
Just this past week:
Really poor concentration; hard to remember if I've done something or to remember to do things (very unusual for me);
Very poor memory;
Feelings of being overwhelmed and frightened;
Nauseau after eating--it's very mild, but kind of scary;
I can't eat as much as I used to, and I LIKE to eat!

My GP wants me to see a shrink, but I know in my gut it's not depression or anxiety (I'm on minimal meds for that stuff already because the medical world feels this is my problem).  I know my body, like you all do.  But I don't know enough to figure out what the biological problem is, and it seems, from reading this thread, it may be very difficult to find someone who will believe in me and find the physical culprit in this. (I'm in eastern PA.)

I checked the top-docs, too, and set up an appt with the same doctor Beth's cousin went to.  I hope Beth posts the results of that meeting.  I've also set up a 2nd appt with and Endo got good reviews on that web site.

I wonder of BlueCross/BlueShield pays for Naturopathic doctors....

Any thoughts/suggestions/recommendations will be so appreciated.  I'm afraid I won't be able to work all week next week, and I don't think my doc will put me on disability due to stress.  That of course leads to additional stress (how will I eat without any income?).

Thanks!





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Extreme stress can be a killer too. You need a vacation! I'm glad to see you have appoinments with an endo and thyroid doc. Trust your intuition. The thyroid and adrenals effect a huge number of body functions, that's why you have so many symptoms. And yes, you do have the symptoms of hypothyroidism and adrenal dysfunction.

Please let us know what your docs tell you.
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Hi Jane,

My cousin and I have come a long way in knowledge since my first post here the end of Oct.  You must live in the NY area  if you've been to the doctors that we've been to.  We have been to 4 doctors from the Top Docs list and none of them worked out unfortunately.  The NJ doc dismissed the thyroid symptoms (he thought lab #'s were fine), didn't believe in adrenal fatigue, but did pick up on her "profoundly low ferritin."  We didn't go back to him.  We moved onto holistic doctors and found one we thought was great in Brooklyn, but she has proved to have no clue with a "just go on with your life and stop reading so much on the internet," attitude.

Funny, I hadn't read the post above from Feb. 3 til just now, but last week, 2/11, we went to see a naturopath in Yorktown Heights, NY.  I never heard of a naturopath before, had no clue what they did, but based on the reviews we went.

I think (time will tell) that we have finally found the cause of my cousin's symptoms, which the naturopath discovered - heavy metal toxicity - specifically Mercury (a main cause is dental fillings).  Check out this article which describes the symptoms - http://www.yeastinfectionadvisor.com/mercurypoisoning.html.   I'm not sure why more doctors don't know about this, but all of a sudden, everything makes sense.   Here's another article with a huge amount of info on this http://www.heall.com/healingnews/may/heavy_metals.html.  It's old, but still relevant in it's findings.  If you want more info about this Naturopath, send me a message.

We have not yet begun the chelation treatment, and she won't start to feel better for 3 months, with a year as projected for complete recovery, but I am super-hopeful because low thyroid, adrenal fatigue, low cholesterol, low blood pressure, candida, low vitamins, minerals, enzymes and on and on are all symptoms of heavy metal toxicity.
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Hi Jane........of course the symptoms you've described can be due to a number of things.........and......they do say stress is a real killler..........but in the case of your adrenals not working properly........stress really CAN be a real killer. Please find a good Endo and insist on having your adrenal function checked. This is not someting you want to play around with. Best of luck to you..........peace and love......Norma
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Thank you all so much for posting!
(Beth did the doctor's last name in NJ start with a 'J'?  I'll send a PM about this in case Beth doesn't see this.)

I don't think it metal toxicity because I don't have many of the symptoms Beth noted.  But I am very happy she thinks she's found an answer for her cousin.

I am sick.  I wish I could see a Naturopathic doctor, but my insurance won't pay for it.

All my symptoms seem to point to adrenal fatigue.  I am at work, but it's incredibly difficult, as the brain fog really limits my abilities.

I have an appt with a new General Practitioner doctor on Monday and I think I should insist on having my adrenal function checked.  Will a GP do this?

I think the Endo I'm seeing on Tuesday is the same one Beth's cousin saw, so I'm not too excited about that.  I have another appt with another endo, but couldn't get in until the end of March.

In the meantime, I cry a lot because I'm so scared. I started taking B-stress vitamins yesterday, but who knows if that will help?  And I'm trying to eat more protein, which I think helps with adrenal function.

I hope on Monday the doctor will give me a note saying I can't work, which would allow me to go on short-term disability and get better.

Thank you all for caring enough to respond.  You have no idea how much that helps me go on.
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   Yes, a GP can order a cortisol test, but if you are seeing an endo in the same week, they will do the same test, and more (hopefully).
Bring a journal of your symptoms with you to the doctors; time of day you have them, and anything you might have done that helps you feel better, such as a bit of salt to relieve nausea, for example. Writing it all down can help your doctor with a diagnosis.
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Yes - about the name of the NJ Doc.  In general, and I'm sure there are exceptions, I found that Endos didn't see the whole picture.  I'm not even sure if a GP believes in adrenal fatigue and will test for it.  Your better bet is a holistic doc, although I haven't found any that accept insurance.  There are self tests you can do.  I discovered a great site:  www.stopthethyroidmadness.com, and there are great Yahoo Groups: NaturalThyroidHormones and NaturalThyroidHormonesAdrenals which are very helpful.

Re: the Naturopath we found in Yorktown Heights, NY, his fee to diagnose you is very reasonable.  Contact me for more info.  He calls himself a "master clinician" which means that he'll figure out what's wrong with you.
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enzymelover:  Thanks for the advice.  I don't have a journal; my symptoms are pretty much constant.  I don't know what you're talking about when you mention the salt, though.  Is that supposed to help the nausea?

Re: Endo--I'm scheduled to see the same dr. Beth's cousin saw. I'm sure he'll write me off.  There is a disclaimer at the start of his top-docs recommendations that says he tends to rely heavily on lab tests.  And Beth mentioned that he doesn't believe in adrenal fatigue.  I don't see much reason to go to him at all.

Beth:  Unfortunately, Yonkers Heights is too far from me.  I live in a Philadelphia suburb.  

To all:  I am trying to get on disability in order to get better; I can't work well at all.  I kind of just sit here.  Can't concentrate, bad memory.
Does anyone know where (online) can I go to find out about disability?  My sister has told me that PA doesn't have it.  My firm offers it but only if its non-work related.  I'm not sure what a doctor will say my problem is if I can find one who will write me a note.  My sister said I could go through federal SSI.
If anyone has any place I can go online, I would really appreciate, as I can't think straight these days.
Thanks!
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   Yes, if it truly is a low cortisol problem, salt can help with nausea. Your symptoms sound like hypoglycemia also, which can be adrenal caused, as the adrenals are involved with insulin regulation.
Have your blood sugar levels checked at different times of the day, especially when you first get up in the morning (nighttime hypoglycemia is fairly common), and during those times you feel like crying (an effect of low blood sugar) or panicky feelings.
Most doctors will just give you a home test kit, if you believe this is a possible cause.
Brain fog is also a symptom of low blood sugar. (as well as other stuff, of course).
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enzymelover:  you sound very informed about all these things.  I read that adrenal fatigue can cause hypoglycemia, so your saying it as well just validates that for me.  Thanks.

Thanks for the info on the salt.  And for the info on the blood sugar home testing.  I didn't know I could get a kit from a doctor.  Thank you for that!
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  Good luck with your doc. appoint. tomorrow. Don't let him make you walk out of there no better off than you are now. You know you are not well, and I don't believe it's all in your head. It's time to get some answers. There's a lot that doctors can do, (and insurance will pay for) if you are insistant that they listen to your symptoms (they seem to be better at reading about them, they listen, but they don't hear, which is why I suggested the journal).

I hope your doc orders the right tests and gets you some answers. Insist on a blood glucose kit, and monitor your blood sugar consistantly for a few days, if for no other reason than to rule out this problem.

You should have your adrenal hormones tested: aldosterone, cortisol and DHEA, and of course a metabolic panel and electrolytes.

My son never had an anxiety problem, until his adrenals crashed. He was symptomatic long before it showed up on a blood test, which is how it is with so many illnesses. Before he got sick, he had so much energy and was so outgoing, he was ready to take on the world. If his doctor had listened to me from the first, he would have gotten the help he needed much sooner.

So, stare your doctor in the eyes if you have to, and make him really think about what you're telling him. That's what you're paying him for.
( Ummm..... don't go overboard though...... we don't want to act crazy, now do we?) :)

Enzy
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Wow !!  That was alot of reading.  But this post was very helpful.  I am experiencing severe exhaustion, thyroid labs perfectly normal.  Well I have a ton of questions for my pcp tomorrow afternoon.
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Maybe my cousin's doctor has us barking up the wrong tree, but the more I read about mercury toxicity caused by  fillings in the mouth, the more I'm learning how dangerous this is and how many unexplained ailments are caused by this.  This article was a real eye-opener: http://www.lef.org/magazine/mag2001/may2001_report_mercury_1.html and there are hundreds of articles saying the same thing.  
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   I too, believe the information about mercury in tooth fillings being a cause of a number of health problems. I have a large number of silver fillings and have had many root canals over the years, and my mouth is in bad shape. So far, no terrible health problems for me, but I want to get my silver fillings replaced at some point in the near future to get the mercury out of my mouth. Maybe I won't be quite so tired and blurry eyed all the time!
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Try to find a Natropathic Doctor if only for a visit to have them get the lab work set up.  Tell them your insurance doesn't cover them, they might get you a lower fee for cash.(doesn't hurt to ask). Mine saved my life, yet the doctors I saw after dragged their heels, including a renown Endocrinologist. The bloodwork will show where you are at.  Do you have Quest Labs nearby?  He uses them for labs as they do a better job.  After you get the results, see a GP you trust or a specialist. (My primary Doc did not care for Natropaths, so he did very little.) A test of a great doctor is one who will not let his "pride" interfere regardless of your choice of Dr's. The cortisol test is done early a.m. and it is fasting.  There is another cortisol test done by an Endo. which takes a blood sample, injects a cortisol stimulating drug, then takes samples 30 mins, 60 mins 90 mins later. I would suggest total thyroid, adrenal, pituitary, vitamin levels, hormone levels, as well as the 'usual' labs of iron, blood counts, vit d3 levels.  I wish you luck.  I am still working on getting my adrenals addressed, they are only addressing the thyroid  and very low vit d3 levels.

Karen
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P. S.  Stress is a major factor, do not let anyone start you on antidepressants or relaxants till you have had all the necessary testing done to see where your levels are, they may make you feel better at first, but will not stop the damage being done to your body.  Hopefully you will get better dr''s than I found(other than my natro.)  Be your own advocate, bring in your journal of symptoms, triggers, and results(fatigue, wired, etc..) this will help your dr.s if you have it in writing, makes it more 'real' for them.

Good luck.
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Karen,
  Thanks so much for the post.

  I think I've found a holistic doctor (she calls herself a functional medicine doctor) who will be able to help me.
  She ordered 23 different blood tests.  I also was given at at-home test kit that will measure cortisol levels throught the day and info on my serotonin, norepinephrine, etc levels.
   She said I definitely have severe adrenal fatigue. She asked many, may questions and also performed she did the eye test on me and they did not contract with light.  I've read this is an indication of adrenal problems.  She also feels I have Hashimoto's and may have hypoglycemia, and I may be going through menopause, too.
She's started me on a large dose of fish oil to help with the 'brain fog' I'm experiencing.
Once all the blood test results get in she'll probably start me on a regimen of supplements.
   She's sympathetic and listened to me.  She ansered questions that all prior doctors haven't been able to answer (like the reason why I can't go to sleep if I take a multivitamin after 4PM is because I'm highly sensitive to all meds/supplements and the B vitamins(energy) keep me awake.  No other doctor has ever even tried to answer that question.  She was thorough, smart, and I think I lucked out here.
   I've also started working with a holistic therapist, who believes that my lifelong 'general anxiety' is post-traumatic-stress-disorder due to a traumatic event I experiened early in my life.  She's fantastic and has connected so many pieces of the puzzle of my life together into one basket.  She plans on using the EMDR technique to help me reduce my overall anxiety level, which she believes causes me to stress out more easily than most people, thereby causing the adrenal fatigue.

I've been on antidepressants and anti-anxiety meds since my 30s, but very, very low doses because I hate synthetic medicine.  I am hoping these two professionals will heal me and allow me to get off those meds.

So, right now I think I found a good team and am keeping my fingers crossed.

Karen, thank you so much for caring. It means a lot to someone like me, who has been feeling so lost and scared.
Jane
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I've posted before thinking I have adrenal fatigue.  I though I found a doctor who could help me, but now I'm not sure.
I got a bunch of tests done (still waiting on the saliva test which will give info on cortisol and neurotransmitters).  The dr. said I'll probably get hasimoto's hypothyroidism, and wants to start me on synthroid.
I am very, very, very sensitive to meds and vitamins and supplements.  I can only tolerate about 1/3rd of normal doses.
1)  I thought hashimoto's and hypothyroidism were different diagnoses?  Am I wrong?
I thought I had adrenal fatigue (I have all the classic symptoms) and read I shouldn't start any meds for the thyroid because they could hurt poorly functioning adrenals. I'm very confused because this dr said adrenals and thyroid work together.  I was sent to a psychiatrist because my anxiety level is so high and I'm having bad sleeping problems.  The shrink thinks it's depression related, but I just don't feel depressed.  I'm really anxious, and am on diazepam (for many years) to help that, but it's increased dramatically the past couple of years, since my stressors have increased.  By the way, I've been very 'high-strung' all my life and started on diazepam in 2003.
FYI: My severe headaches and nausea and constant hunger disappeared about a week after I stopped working.   My brain fog has eased up a bit in the last week.

2) I read that helping the adrenals get back in shape will be faster taking medications like hydrocortisone, Cortef or Isocort as opposed to going with vitamin supplements,  dessicated adrenal, or herbs.  Is this true?

3) What do the following results mean to you?
Selenium 290 (100-340)
T3, Reverse 29 (11-32)
T3, Free 295 (230-420)
Vitamin B12 327 (200-1100)
Vitamin D 15 (>30)   --this is low and I've been given Vit D supplement  
Thyroid Peroxidase Antibodies 177 ( or = 1.00 mean Antibody detected)
From March tests:
Sodium 134 (135-146)
Cortisol, Total 12.5 (4-22)
T4, Free 1.1 (0.8-1.8)
TSH, 3rd generation 1.88 (0.40-4.50)

I'm so very confused and feel like I have to be the doctor and diagnose myself.  I have to get better real soon, because I have to work.  If I don't work I don't have insurance or money to live on.  What would I do?  My job is a big stressor, but I'm not strong enough to search for another.  I tried the top-docs website and there's no one near me who is good from that site.  I just don't know where to turn.  It's been 5 weeks and I'm only a tiny bit better.
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  Hi Jane.  Sorry you're still feeling rotten. First of all, your serum sodium is low, which is an indicator of adrenal fatigue. Taking synthroid before hydrocortisone (or fludrocortisone, if tests indicate this is what you need) could lead to lightheadedness, vomiting or passing out, depending on the severity of your condition. You said you're still waiting for your saliva cortisol results. Just be very careful to have adrenal support in place if you decide to go with synthroid. Unfortunately, i don't read test results well enough to comment on your other levels.
Hashimoto's is hypothyroidism that is caused by an autoimmune disorder. There are many other causes of hypothyroidism also.
Don't depend on just one cortisol test either, unless the level is so extremely low there can be no doubt.
Oddly, my son's adrenal insufficiency was first noticed on a hair mineral analysis test. The sodium and potassium loss was so dramatically obvious.
It's interesting that your nausea and headaches subsided after you stopped working. Perhaps there is something in the building contributing to your illness. Have you heard of "sick building syndrome"?
Don't give up on your holistic doc just yet. Ask her to explain why she thinks you have the diagnosis she comes up with. She should be able to point to specific results on your tests, and explain them to you.

Take care,   Enzy
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I agree with Enzy - stick to this protacol with this doctor. She is right on about the sodium linked to adrenal fatigue.

As we all know thyroid function and adrenals go hand in hand. Here's what I see in your labs.

Mostly, WOW your B's are LOW. Didn't anyone pick up on that? That's related to thyroid/adrenal disfunction - big time.

Concentrating on the thyroid labs here - You are not balanced. Your Rt3 is high - your pooling T3 hormone significantly. Your Free T3 is LOW - little hormone is moving around in your system to relieve any hypothyroid symptoms. and your a bit HIGH on the FT4. FT4 is the needed hormone to convert into FT3 - It's reversing - You should benefit from Cytomel ( T3) and be backed off Synthroid right now.

My thoughts on adrenals - You need the 24 hr test for sure. What time of day was the test done? at a 12.5 blood test that would be normal right around 3 to 5:00 in the afternoon. There is nothing else to go on.

Hypothyroid is low functioning thyroid. Hashimoto is antibodies attacking the thyroid to cause low function ( dies off the gland) which results in low functioning  Autoimmune Hypothyroidism.
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Hi Jane,  You should definitely join two ***** ******:

NaturalThyroidHormonesADRENALS
NaturalThyroidHormones

The people there, Janie, Val and others are amazing with the support and knowledge.  They analyze lab results and have experienced exactly what you are feeling.  Another invaluable website is www.stopthethyroidmadness.com.

From everything that I've read, Armour Thyroid is superior to Synthroid.  With just a little research (search google for 'armour vs. synthorid' or 'benefits of synthroid' which just turned up results of the disadvantages) you'll learn a lot more about Armour.

Re: your labs, I know very little but do know that the Free T3 should be at the top of the range, and the reverse T3 looks too high which is an indicator of Hashimotos.

Sometimes, a doctor/RN is open minded to trying different thyroid meds.

But, if there's one piece of advice that I can give, and that is to join those 2 ***** ******.
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Oops - made a mistake.  A high Reverse T3 is NOT an indicator of Hashimotos.  There's another test (don't know it) and if the presence of antibodies is positive, then it's called Hashimotos Thyroiditis.

And sorry, moderator - I didn't know that mentioning other groups was not OK - won't do it again.  Jane, if you want to know the location of those groups, send me an email.
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Thanks all of you so much for posting.  My anxiety is increasing by the minute, and I've had to take more diazepam to stop crying.  Your posts do make me think I've picked the wrong doctor, though.
The doctor didn't say anything about adrenal fatigue at our last visit.  She didn't say anything about low sodium or low B's being linked to adrenal fatigue.  All she talked about was maybe I would get Hashimoto's and that it would be OK to take synthroid even though I said I'm concerned about my adrenals getting messed up even further.
I mentioned Armour and she's willing to prescribe that, but I read on some other sites that it may not help someone like me who is so very sensitivie to meds/vitamins/supplements.  Something about the ratio of T4 to T3 being very high.
The problem with B's is if I take even small doses in a multivitamin, I get very jittery.  Maybe I should take a children's dosage?
My doctor said nothing about the low Bs and that bothers me a lot, as well as her not saying anything about the low sodium.  
How in the world does someone find a doctor who knows what he/she is doing?  I dont' have the stamina or motivation to call a bunch of places and keep repeating my case.  I'm on disability from work for the past 6 weeks, but they'll only wait so long before they terminate me.  Which adds a lot more stress.
My husband has been taking off so much work time to try to help me, and it's taking a huge toll on his emotional reserves.
I though of going to an ER, but I'm worried they'll put me in a psych ward and not even look at the physical side of things.  My anxiety is out of control and I have to get help with that, but then what?  I am so scared.
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Hi Jane........I can't help but notice, by reading the progression of your posts.......that your anxiety seems to play a large roll in how you're responding to the results of your blood tests.On the one hand, you seemed rather confident in your latest doctors ability to get to the bottom of your problems. But.......after the test results.......your confidence seemed to plummet and you asked many of the well meaning people in this forum for their opinions. It seems you'll get many, many, differing opinions as to what your results mean.........whereas it's my opinion that you return to the doctor in whose confidence you believed.......and ask her........what do the low B's mean ?..........should I be taking synthroid before we settle the adrenal problems ? all the questions you have.......ask her directly and see if you can't again build the confidence you had. I'm also sure that you're aware that the diazepam you've been on for quite a few years......is valium......and can act as a depressant for some people. I would speak to your psychiatrist about that issue.......it could be playing with your head with all this anxiety you're feeling. I guess what I mostly have gotten from reading your posts........is......that you're getting lots of differing and sometimes conflicting advice from some very well meaning people..........but..........they're not doctors.........and if you ask more than one doctor.......you may get many differing opinions.........so.......it boils down to picking one person to believe in.......then.......do what they say. I wish you nothing but the very best in your quest for answers.........I can hear the panic in your posts and it's very understandable..........good luck............peace and love......Norma
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Thanks for your post, and I do understand how you got the impression you did.
I left some things out about my 2nd appt with the doctor that also have me wondering if she was a good choice.  
At our 1st appt, based upon the symptoms I stated and a couple of in-office tests she performed, the dr initially was adamant I had adrenal fatigue, was possibly menopausal (I've had a hysterectomy so we can't tell the usual way), probably had hypoglycemia, and a host of deficiencies, and the lab results would give her a plethora of diagnoses that would allow her to begin treatment and extend my disability.
On the 2nd visit, she had no idea who I was.  She did not remember our 2 hour appointment 10 days ago.  She made no mention of adrenal fatigue or any of the other disorders.  She said I was premenopausal and I said, "The results show I'm pre-menopausaul?"  She said, "You still menstruate right?"  I reminded her I had a hysterectomy.  She apologised and said she forgot.  My anxiety did rise up quite a bit because she seemed to have no idea why I was even there.  We had to remind her of the pending 24-hr cortisol tests.
She did agree to extend my disability, and when she was filling out the forms, she said she didn't know what the diagnoses codes are.  So 1st she tried looking at the blood work up order, which has codes on it.  Then I gave her notes from my therapist, which she copied verbatim because the dr said she didn't know what Axis I, II, III, or IV meant.
This troubled my husband and me that she wasn't familiar with some medical terminology as well.
My husband says he was completely fooled from the 1st appt, he thought she was going to be great.  He went away from the 2nd appt very upset (for me) and angry (he never showed her this).  
I'm happy my husband was with me because he was able to see this a bit more objectively than I.
We'll go back to her when the cortisol tests come back to see what they say.
But we both were disappointed in her lack of preparedness and lack of knowledge of how the adrenal and thyroid interact.  
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The Hashimoto indicator is the TPOab and Tgab test. Thank you for clarifying the Rt3 has nothing to do with Hashimoto.



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Wow Jane........no wonder your confidence in your doctor hit the floor.......I don't know what to make of her behavior.......it certainly is baffleing !She sounded so confident during your initial visit........and only 10 days later acted like she'd just met you ? Strange indeed. Well.....I guess you're stuck at least till you get your cortisol test results back.........hopefully they will tell you something.......if of course......she can interpret them correctly. What a shame.......after all the differing opinions you've had to listen to.Hopefully.........she was just having a really off, off day ! When you see her again, it'd be nice if she could restore the original confidence you had in her. Sometimes we forget.......Dr''s are only people..........quite fallibale......like us ! About her not knowing what the Axis tests were.......I don't know WHAT to say. Except......I'm an R.N. { haven't practiced since 1968 }........and I don't know what they are........but let's face it......40 years is a long time to be out of the game. All I can say is......I'm so sorry you're having so much trouble getting the proper help. When I get to your stage { and I've been there }........I tend to pray for help and direction......if you believe that aid can help you.......use it..........it's worked for me when nothing else would. I wish you the very best of luck in getting help. Hopefully those cortisol tests will tell you something !..........peace and love......Norma
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i have been reading your comments even though somewhat dated.  i too am looking for naturopath for the same symptoms.  did the dr in yorktown work out for you?  since i live in the area i would like to try him/her.  could you list his name and address?
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Stella,  my Armour has been making me hyper and anxious in the morning By afternoon it calms down I am trying multidosing taking 30mg at 8 am and then 30 mg at noon. Little better take Tums and ibuprophen to calm me down. had saliva test and cortisol was high in am  Taking vit c vit b complex iron hema plex. Have low energy trouble thinking at times blood pressure has been a little high used to be so high functioning had thyroid removed for pap cancer jn 2000.  Armour worked beautifully for years until I took diabetes meds whicj I am off of now controlled by diet. Any advice. Thanks Karen. ***@****
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Jane,
It probably is stress.

But what about Candida and Lyme disease.  I have major brain fog from both.
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I recognize alot of your symptoms very well.  Here are my thoughts:
Need cortisol levels checked.  Check for problems of pituitary gland (its the master gland which sends signals to the thyroid, adrenal, hormones, etc. to do their jobs). (  Nausea after eating, weakness, faintness or dizziness.)

Check for blood abnormalities, such as Thal trait (low count, small, or slightly misshapen blood cells which results in sleepiness and the kind of borderline underachievement you described).  Sounds worse than it is.

Check for insulin resistance as well.

Eat lots of vegetables to build up blood. Protein too to stabilize blood sugar levels throughout day and avoid progressing to diabetes.  Mild exercise, fresh air and sunshine for vitamin D which supports a bunch of other functions.  Don't take iron unless blood test shows you are in fact deficient. Can make you worse if you have the Thai trait.  First and foremost get cortisol levels/pituitary checked out as it is the only condition I mentioned above which is life threatening. Listen to your body and what  works for you. Be careful about mega doses and questionable supplements.  First do no harm. Balance and old fashioned common sense will take you far.  
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