Adrenal Insufficiency Community
Has anyone seen Dr. Lam?
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Has anyone seen Dr. Lam?

I am considering contacting Dr. Michael Lam, but am so afraid of yet another sham doctor. His website and books are fabulous, and what he says makes sense. I just want to feel well again.

If you've had any contact with him or his office, or you've followed his protocols, I'd love to hear about your experiences.
17 Comments Post a Comment
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Avatar_f_tn
Do you have diagnosed adrenal insufficiency?  Dr. Lam treats adrenal fatigue but not adrenal insufficiency....they are not the same thing.  Vitamins and minerals cannot treat adrenal insufficiency as it is a condition where the adrenal glands cannot produce adequate amounts of the body's natural hormones.  Paleo diets are excellent for improving the function of the human body....we are what we eat, but true adrenal insufficiency can't be cured by changing a diet or taking supplements.  We all wish it could!
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Avatar_n_tn
I have not been diagnosed with adrenal insufficiency, but severe adrenal fatigue that just doesn't seem to improve no matter what (24hr saliva cortisol test was flatlined very low, but pituitary tests showed normal function), and I'm terrified of crossing into insufficiency. I currently take 15mg of HC a day, down from 25mg a year ago because I was afraid of such a high dose, and wonder if taking HC was a bad move on my doctor's part.  I also have no thyroid due to cancer, which complicates things.  My neurotransmitters test shows norepinephrine and epinephrine are very elevated, while serotonin and GABA are very low, and my hormones are tanked, so I'm constantly frazzled. I'm only 38, and this has been going on for a few years now. I can't exercise because I end up sick if I do, and I used to run 5 miles a day. I constantly crave sweet and salty foods, but when I eat sugar I feel horrible. The brain fog and memory issues are so bad I lost my job recently. Something needs to change!  If anyone on here has any suggestions, I'm desperate.
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Avatar_f_tn
What were your symptoms before AI?
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Avatar_f_tn
I meant to ask what your symptoms were before taking hydrocortisone.
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Avatar_n_tn
I apologize, Buckupnow, I am only just now seeing your question.  My story is a rather long one.  I grew up in a very poor and abusive family, and lived every day afraid it was my last.  I was finally able to leave when I was 17, and at the same time found out that I had lung cancer (from being in a house full of smoking drug users my entire life - I've never done a drug or smoked in my life, thank God).  I worked three jobs and went to school while going through cancer treatments.  At 22 I was diagnosed with cervical cancer, and again worked three jobs and went through treatments.  I am a very driven person, and so never rested, double majoring in college, then going to grad school, and then law school.  I've never let myself rest.  It was in law school that everything finally seemed to catch up to me.  I had battled depression and anxiety my entire life, and was always wired but tired.  I just couldn't keep up anymore.  I went to the doctor, who noticed a lump on my thyroid, which had been there since I was a teen.  Biopsies confirmed yet a third cancer, and I had two surgeries and radioactive iodine, all while continuing to attend law school and graduate.  I had been a fairly active person, ate healthy (mostly organic and vegetarian) since my first cancer, but always felt one step away from collapsing.  After my thyroid was removed, I had horrible panic attacks, multiple times a day, often being woke up in the middle of the night by them.  I was exhausted, but couldn't sleep, and my depression and anxiety skyrocketed.  I also put on 40 pounds in less than three months after having my thyroid removed, but any exercise laid me up in bed for days.  I eventually gave up on it and have literally felt like a shell of a human being for years.  My thyroid surgeries were in January of 2007.  About a year and a half ago I had reached a point where I simply couldn't bring myself to do anything.  I was so exhausted, depressed, in constant pain, and my brain felt like it was completely shut off from me.  I was having heart palpitations and dizzy spells, and any stress would cause panic attacks or I would start shaking and couldn't think clearly or speak, but doctors told me it was all anxiety and I just needed to take some Xanax (which I refused to take given my family history with drugs).  I finally found a doctor that tested my adrenals.  24hr saliva cortisol showed I was extremely low throughout the day, and then it would come up at night, which explained why, even though I had always been a morning person, I was exhausted all day, but couldn't sleep at night.  My doctor started me on 25mg of HC (divided daily) and switched me to natural thyroid replacement.  She determined that my body was not converting synthetic thyroid hormone to usable T3, and she suspected the thyroid removal was the straw that broke the camel's back, so to speak.  Not only was it stressful on my body, but the inability to use the replacement thyroid meds just made the situation worse and burned my adrenals out even faster.  It's been a little over a year now, and I still have horrible brain fog and get shaky and weak.  Exercise still sends me to bed more often than it helps, and I get shooting pains throughout my body that my doctor chalks up to fibromyalgia.  More than anything, I want my brain back.  It literally feels like pressure has built up in my head.  I also have horrible air hunger.  Very similar to panic attack feelings, but without a full blown panic attack.  I have found that drinking a glass of warm water with about 1/2 tsp of sea salt has helped a ton, and I monitor and support iron, B vitamins, calcium, and magnesium.  I've tried to come off of HC, very slowly, and will do okay for a few days after a 2.5mg reduction, but end up having to take more when I get horrible shaking fits and anxiety.  We, of course, can't test adrenals again, since I'm on HC and can't seem to wean myself off.  Any thoughts or suggestions are very much appreciated.
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Avatar_n_tn
I forgot to mention, My DHEA and pregnenolone are virtually nonexistent, as are my progesterone and testosterone, but estrogen is "normal".  I currently take 5mg of DHEA daily, as well as 50mg of pregnenolone.  We did test ACTH, HGH, and FSH, which came back normal, but I was on HC at the time, so I'm not sure how accurate it was.  
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Avatar_f_tn
Sounds like myself.  AI is horrible.....I hope to wean off too....someday.
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Avatar_n_tn
So, does that mean what I have is already AI?!  How do I know?
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Avatar_n_tn
are you on any type of thyroid replacement???  25 mgs of hydrocortisone is not that high of a dose--I take 30 mgs.  My family doctor thinks I am going to get osteoporosis, but fortunately, a family friend, who is a doctgor--and a little better informed, told me that I shouldn't get any side effects from that dosage because they were only giving me what my body was producing.

I flew across the US to see a doc who specialized in balancing the endocrine system--he was surprised that our friend/doctor was knowledgeable about the safety of physiological doses of hydrocortisone, apparently many doctors are not.

I have secondary adrenal insufficiency, i also have low DHEA, low testosterone, low progesterone, high estrogen--and high sex hormone binding globulin.  I had an ACTH stim test to diagnose my secondary AI.  Bopth my cortisol and my ACTH were low, so my endo did the stim test---which I failed.  Between the original  ACTH and cortisol tests--I had steroid shots in my heels---and had the stim test 19 days later.   second endo pulled me off everything because he thought the shots caused the insufficiency--but 3 separate doctors did not feel the shots would have shut my adrenals down completely.

I take 30 mgs of DHEA, 3 mgs of testosterone cream, 200 mgs of progesteron for 10 days of the month, and I have just raised my NP thyroid to 5 grains.  I'm on multiple supplements also--I need blood work again---but my doc has had some major illnesses--and I may need to find a new doc--that will be a trick!!
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Avatar_n_tn
kevieb, thank you for your response.

I was placed on 25mg of HC in November of 2011, but was able to wean down to 15mg daily (divided 7.5, 5, 2.5) about 6 mths ago, but have recently needed to stress dose a lot, so I am dreading needing to increase my dose again.

I am on 2.5 grains of Naturethroid daily, and all of my thyroid levels (TSH, free T3, free T4) have looked good at this dose.  I have to stay suppressed due to the cancer, so my TSH is below 0.5, and my free T3 is at the very top of the normal range.

I just went in to see my dr again yesterday, and we are running a whole battery of tests to check for allergies and other issues, as this has been done rather piecemeal before.  She is having me do a 24hr urine cortisol to see what my levels are on HC, since she doesn't believe an a.m. cortisol test tells us anything.  I never did the ACTH stim test, but did do a 24 hr saliva cortisol and ACTH, GH and FSH tests before starting HC.  ACTH, GH and FSH were normal, but saliva cortisol was flatlined low.  DHEA, progesterone and testosterone have been basically nonexistent.  Estrogen is normal, but dominant given the low progesterone.  

My dr suspects that after my thyroid was removed and I was placed on synthetic T4 only meds, I was not able to properly convert the T4 to T3, so my adrenals (already heavily taxed) tried to take up the slack and eventually burnt out.  When she tested my reverse T3 before changing me to Naturethroid it was very elevated.

I guess I just want to know if my adrenals are completely fried and if I will be on HC forever, or if there is a chance my adrenals will come back.  At the moment I have serious doubts.  I am on multiple supplements as well, and it just seems to keep getting worse.

I certainly understand the issue of trying to find a good doctor.  Took me 6 yrs, and she's close to retiring, so I'm getting very worried.  Good luck with your search!
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Avatar_n_tn
geokatgrl--i don't seem to be getting better, either--but my doc had told me it could take up to two years to balance the endocrine system.

glad you got off synthetic T4.  I found an article by an endocrinologist explaining why TSH tests were not accurate and basically said that if you are on synthetic T4 only--you will be hypo to one degree or another.

My husband and I both were originally put on suppression therapy, too!!!  The doc used to let my TSH go to 0 and was happy about it.  I remember asking him if he read my thyroid test different than he read other peoples' tests, and he told me that he did.

Well, he retired, and somehow, over time, my husband and I both got treated as hypothyroid patients instead of thyroid suppression patients.  Our family doctor was about to lower my hubby's synthroid level once--and I reminded them that he was supposed to be on suppression therapy--the nurse talked to the doc, and came back and said they were not going to lower it.

so, I have medical records from years back that say I am hypothyroid, when I wasn't---I fought an insurance company once, when I first went to an endo--they said pre-existing---I was able to pull up old medical records with my original diagnosis and won my case with the insurance company.

I am now listed as hypothyroid, but my doc wants to seee my levels at .0  he says he knows I am on a good dose of thyroid if my TSH is that low.

I have wondered how they can test your adrenals once you are on HC.  I feel so crappy most of the time, still, that I don't think I would know the difference if I was weaned off---unless I went into adrenal crisis because my levels dropped too low.

Have you ever had your DHEA tested?   You seem to have similar, but not exact deficiencies to me---I also have low levels of several minerals and vitamins.  I know that the symptoms of almost all of them being low are almost the same---I'm kind of thinking I'm just not going to feel better until everything is gotten up to optimal levels---if it can be done.
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Avatar_n_tn
My DHEA has been consistently low despite supplementation, and when I try to take more I get acne and greasy skin and hair.  My dr is currently testing everything under the sun at one time (allergens, hormones, metabolic panel, etc.), so hopefully we'll have some answers.  I've been working with her for almost two years already, and, from what I can tell, she knows what she's doing.  I'm just a really tough nut to crack I guess.
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Avatar_f_tn
Who is your doctor? I would love to find a doctor who cares.
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Avatar_n_tn
My doctor is in Kansas City. Where are you located? I have friends who see doctors in other states that seem good as well.
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Avatar_f_tn
I am in Oklahoma...close to Tulsa.
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Avatar_m_tn
I was considering getting a second opinion from Dr. Lam. I don't know if I have AF or AI.  Does anyone know a great doc in the Los Angeles area?
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Avatar_f_tn
Questions based off your information: have you had your androgen (estrogen, progesterone and testosterone), aldosterone and serum renin levels tested yet? You sound similar to what I've gone through getting the AI diagnosis. It turns out I was simply more attuned to my adrenal glands turning off than most (I was affected early). My cortisol was flatlined across the bottom and my ACTH was low normal (negative feedback; all this meant was I'm probably not secondary). We went with hypoadrenal until late last year, when it became evident the hc wasn't fixing everything. Three rounds of bloodwork later and we find I have no aldosterone and almost no renin (hyporeninemic hypoaldosterone). Why we never tested this before is beyond me, as aldosterone will go before cortisol due to the physiology of the adrenals. Anyway, I'm now officially AI and the florinef is making big differences. I'm having my androgens tested Monday and some other kidney tests soon (testing for acidosis), as I can't shake the sugar cravings.
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