Autoimmune or Endocrine?

[DebMox]

Ongoing symptoms include:- never ending fatigue, BP that falls rapidly at will, swollen glands in throat and axilla regions, hearing loss in R ear, brown facial mask that is darkening, recurring pancreatitis, headaches, brain fog that makes me nonfunctional at times, abdo & back pain when having a bad "episode"! Inability to cope with stress when fatigued and start to yawn non-stop then collapse into a heap. BGL normal. Morning cortisols taken twice and within normal limits. TSH ranges from 0.87 to 1.52. Desperate for answers.

[DebMox]

Hey Niko,

Thanks again for replying. I have finally got a referral to an Endo' who "sounds" like she may be open to adrenal fatigue etc. Yes, we have the same problem over here with Endos' being all about diabetes and thyroid ca and little else. I am rehearsing my spiel to this Endo as I know I have only one chance to sell my case and get the testing I need. My GP, who has gone further than any other doctor I know, assures me that this Endo is a very knowledgable, humble Muslim lady who practices both traditional and natural therapies. Here's hoping!!!! Beginning of July I have an appointment. Let's hope I make it there.
This afternoon I fell into a tired mess in my armchair and promptly passed out. Felt my BP hit my boots, yawning non-stop one after another and then it's "goodnight"! Came to/woke up two hrs later. Aah stress....gotta hate it!!
Thanks Niko,

Regards,
Debra.

[TheLightSeeker]

Hi Debra.

I don't know how the health system works down in your country, but if it is anything like the NHS in the UK or the health systems of Canada and US,
Conventional endocrinology does not recognize low adrenal function, until it becomes complete adrenal failure (a little too late to reverse it)

If you have had unresolved issues and complications from cytomegalovirus,
Encephalitis etc., it is reasonable to assume that the chronic stress which accompanies these both at the physical level and the emotional level, has led to adrenal fatigue, with low thyroid function as a default survival mechanism to put your body at a low energy level for adrenal recovery.
This fully explains the weight gain.
You must insist to get accurate testing, reflecting bioavailable levels of cortisol ,  not total levels.
Also the thyroid testing, insist for the tests I mentioned before.
Note that low thyroid function should not be treated before the adrenals
And the thyroid function, once the adrenals recover, it usually normalizes,
  If it was a consequence of adrenal fatigue.

Endocrinologists here in Canada adhere to conventional protocols, thus keeping many patients in limbo because a. the testing is flawed
b. subclinical low adrenal function and low thyroid function are not recognized, specially type 2 hypothyroid (just like diabetes 2)
I have the feeling that  it's very similar where you are.

My suggestion is going to an ND or Functional Medicine Doctor, if such a designation exists there, but they must have training in adrenal dysfunction issues.

Take care
Niko

[DebMox]

Thank you so much for your reply Niko. I too have thought Adrenal but the two single cortisol tests and the fact that I can't lose weight have deterred my GP from this. My take on that is that due to my gastric surgery I had in 2011 that I have my body fighting against my weight loss. I initially lost 30 kgs rapidly and got to 98kg and then it stopped abruptly. I now fluctuate 3 kg and can literally drop that 3 kg in a day but no more.
I know I need more than one cortisol test to get an accurate picture, and the same for thyroid function, and looking forward to seeing an Endo for more precise testing. I had Cytomegalovirus 20 years ago and I think that has knocked off my adrenals. It was an acute attack that lasted ten days and was wrongly dx as Mono. I actually had encephalitis for ten days and have never experienced such scary and severe pain in my head in my life. Everything followed this, guttah psoriasis, constant strep throat etc. and that weight gain. Always been a chubby one but went through the roof and couldn't budge more than a kg. that's why I had a Vertical Sleeve Gastrectomy. What a mess. So sick of being sick!!!
Thank you so much and any more ideas would be most appreciated,
Regards,
Debra.

[TheLightSeeker]

Hi DebMox and welcome to the forum.

Your symptoms are highly indicative of low adrenal function as primary-
(tsh is not an accurate indicator of thyroid function and you need Free T3, Free T4 and Reverse T3 for accurate celllular function testing. Also 4x cortisol saliva testing to find out free bioavailable cortisol levels at 4 different times of the day and you could benefit from DHEA testing as well) hypothyroid secondary along with underlying low grade infectious condition(s).
In the event of serious chronic organ involvement, the development of autoimmune disease is also  a possibility.

I hope this helps, however, my comments are not intended to replace medical advice.

Please let me know if you need more details

Cheers.
Niko