adrenal failure following thyroid treatment

[edra]

I am interested in hearing from anyone who had long-term hypothyroidism, had it successfully treated, then had adrenal problems following that.

Briefly: I had long-term hypothyroidism (caused by Hashimoto's) whose symptoms first appeared in 1989, and which was not successfully treated until 2006, after I got rid of the antibodies.  I had had adrenal tests in 2002 and 2004 that showed borderline low (but still OK) output.  After I got my TSH/FT3/FT4 into normal ranges, my exhaustion and insomnia got much worse.  I had the same type of adrenal test done recently, which showed my adrenal output had gone very low, with total daily output of cortisol and DHEA about 1/3 of low normal.  My morning cortisol peak was very low, and my cortisol output from noon on was a flat line barely above zero.

If there is someone out there who has gone through this, I'd like to know what kind of treatment(s) you used to revive your adrenals.

[Mark Lupo, M.D.]

It is possible -- the best test for adrenal failure is an ACTH stimulation test where an injection of ACTH is given and Cortisol is measured usually 30,60 and 90 minutes afterwards.  With the history of hashi, there may be an immune attack on the adrenals, so adrenal antibodies may be interesting.  

If the adrenals are low, then steroid replacement therapy is necessary.

PS- how did you "get rid" of your thyroid antibodies?  Sometimes they will vanish over time after the thyroid is fully destroyed by the immune system but this is not typical.

[duchess101]

I was diagnosed with Hashimoto's in May of last year although I'm quite sure I've had untreated hypothyroidism for many years judging from all my symptoms.  I've been put Synthroid for the past year with the dosage starting at 50mcg and ending at the present wih 150mcg.  My TSH is still 4.1 and other labs show normal but low.  I see my endo every couple months each time with new lab results.  My TSH has come down from 10.71 and I have been feeling better but not nearly where I feel I should. I had horrible fatigue,  barely unable to get though the day I times.  Finely, of all people, my psychiatrist, after constantly complaining of how sickly tired I always felt, had my cortisol tested.  Sure enough It showed I was completely flat throughout the day, with the morning being extremely low.  He prescribed me Cortef, a corticosteroid, with a very low dose to take in the mornimg and early afternoon.  Immediately I felt a change.  I've spent months feeling like **** and now I maybe have two episodes during the week that I feel overly tired and sick.  He warned me that I cannot stay on this forever (there are lots of side effects)and that I have to discontinue taking it after about 5 months.  He told me it's giving my adrenals a "rest".  We'll see what will happen after that.  I'm a little nervous about going back to how I felt before the med. If anyone else has heard of this please let me know.

[New AggieMom]

I am a 49 year-old female that was diagnosed with Hashimoto's thryoiditis (hypothroidism)about 5 years ago. At the same time I went through early menopause.  All my hormone issues really started a few years after giving birth to my twins at 33.

I have found that I feel normal when my TSH level is kept at the lower in of the normal range--1.0 . Over the last 5 years my Endo Dr. has been successful in keeping me in this range by adjusting my dosage of synthroid. My dosages have run from .112 to .2. In April, 2006, my TSH jumped to 6.05 and my Endo Dr. increased my synthroid dosage to .250 (2 x .125 pills). I have always taken my synthroid at the same time each morning with water one hour before eating. So, I didn't know why it would have jumped to 6.05. I just received the results of the blood test that was run on July 3rd and my TSH level has gone even higher to 12.61. My Endo ran another blood test 2 days ago in his lab (the other tests were done in Quest Lab)just to make sure there weren't any control issues.  So I am waiting to hear from that test. I am looking for any direction that anyone can give me as to what would make my TSH level continue to rise. Is there another organ problem going on that is causing the elevation in TSH?
  
I also have hyperparathroidism that we are watching.  I had 2 parathroids removed in 2002 but my calcium never came down as was expected--it stays around 10.5 to 10.7.

[edra]

Forum M.D. (Mark?) asked how I "got rid" of my antibodies.

I didn't find out until 2003 that I had a positive response to the gliadin antibody test.  After deleting gluten from my diet, my anti-thyroid antibodies gradually went away.  It appears that this reduced the anxiety response I would get when trying to take thyroid hormone.  I'm now on 112mcg Synthroid with TSH=0.38, FT3=4.46 pg/ml, and FT4=1.42 ng/dl.

But there's obviously something else going on.  My adrenals are obviously low.  Getting my thyroid fixed has certainly not cured my primary symptom (insomnia).

[icelated]

isnt insomnia related to hyperthyroid? maybe your getting to much now that your thyroid is working? im no doctor though.