Finding a doctor who understands thyroid/adrenal problems

[Beth468]

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.

[stella5349]

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.

[enzymelover]

  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

[Jane0218]

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.

[Jane0218]

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

[carebear622]

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.

[carebear622]

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