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Adrenal support & Synthroid----HELP!!
I was DX'D with Hashimotos in 2011 and was given Synthroid . I started with .25mcg and had difficulty right away with angina. The Endo then slowly titrated the dose up, but I still had some difficulty although thanks to Gimel's suggestion, I'm now taking the doses in quarters and find it helps a little with the chest pain. However I still feel really fatigued and still have all my Hypo symptoms. My Endo won't let me try Armour or any other ND because he said the T3 would be too potent for me and might bring on a heart attack.
I decided to take matters into my own hands and ask the opinion of a well known Naturopathic doctor here where I live who is also on the top thyroid doctor list. She asked me to bring a recent copy of my labs, which I did. She said my AM Cortisol was low at only 12, and that my DHEA was also low. She gave me Adrenal support with the instructions to take just one in the morning instead of the two the bottle suggests. She knows about my angina problem in the past with Synthroid and was being cautious. My question is this: Is it safe to be taking an adrenal support while I'm still taking Synthroid? I have read some things on line that said your supposed to correct adrenals first before going on any thyroid meds, BUT my adrenals were never addressed by my Endo---in fact he always said my adrenals were normal and so I just started the thyroid meds 3 years ago without any support for my adrenals. The Nautropathic doc said not to stop the Synthroid, but to call her right away if I have any side effects from the adrenal support. I still haven't started it yet because I'm afraid it will cause angina or worse, but yet I'm so desperate to try to feel better again since I still have no energy and therefore no quality of life. Has any one had experience with adrenal support along with thyroid meds? Am I just supposed to stop the Synthroid before taking the adrenal support even though I have been on it in various doses for 3 years? HELP! Thanks for any info or advice you can give me.
I decided to take matters into my own hands and ask the opinion of a well known Naturopathic doctor here where I live who is also on the top thyroid doctor list. She asked me to bring a recent copy of my labs, which I did. She said my AM Cortisol was low at only 12, and that my DHEA was also low. She gave me Adrenal support with the instructions to take just one in the morning instead of the two the bottle suggests. She knows about my angina problem in the past with Synthroid and was being cautious. My question is this: Is it safe to be taking an adrenal support while I'm still taking Synthroid? I have read some things on line that said your supposed to correct adrenals first before going on any thyroid meds, BUT my adrenals were never addressed by my Endo---in fact he always said my adrenals were normal and so I just started the thyroid meds 3 years ago without any support for my adrenals. The Nautropathic doc said not to stop the Synthroid, but to call her right away if I have any side effects from the adrenal support. I still haven't started it yet because I'm afraid it will cause angina or worse, but yet I'm so desperate to try to feel better again since I still have no energy and therefore no quality of life. Has any one had experience with adrenal support along with thyroid meds? Am I just supposed to stop the Synthroid before taking the adrenal support even though I have been on it in various doses for 3 years? HELP! Thanks for any info or advice you can give me.
I don't have adrenals or a thyroid (both surgically removed).
Cortisol testing is tricky and must be done not only a few times, but IMHO at least a couple of times of days (diagnostic times where there are ranges) and both free and serum. Then a stim test to give a better idea of how the adrenals respond to stress. At its heart, AI is a salt wasting disease so you would have some sort of issue with sodium and/or potassium as well show up sometime. Cortisol can vary when you are ill, or just by time of day so you cannot just judge by one test.
Personally, I don't like the OTC adrenal supplements as I find them impossible to really figure out how much you are getting as a replacement. But I don't think your endo is doing you any favors either - you need a better endo and it can be difficult to find a decent one that really knows what she is doing.
I take both replacements. I don't find that I have to adjust one for the other - and I replace everything. Other replacements do mess with my thyroid though.
Cortisol testing is tricky and must be done not only a few times, but IMHO at least a couple of times of days (diagnostic times where there are ranges) and both free and serum. Then a stim test to give a better idea of how the adrenals respond to stress. At its heart, AI is a salt wasting disease so you would have some sort of issue with sodium and/or potassium as well show up sometime. Cortisol can vary when you are ill, or just by time of day so you cannot just judge by one test.
Personally, I don't like the OTC adrenal supplements as I find them impossible to really figure out how much you are getting as a replacement. But I don't think your endo is doing you any favors either - you need a better endo and it can be difficult to find a decent one that really knows what she is doing.
I take both replacements. I don't find that I have to adjust one for the other - and I replace everything. Other replacements do mess with my thyroid though.
Thanks gimel---yes it would be nice if you could reach someone and ask their opinion on adrenal support. Mind you, I would only be taking one pill as opposed to 2 like the directions say. That is what the ND doc said to do.
I'll wait and not take it until I hear from you or someone who might have some useful information about the adrenals. My AM Cortisol is only 12.0, and the ND doctor says it's too low where my Endo says it's ok. .Again, the range on this is broad also, just like the TSH & FT3 is. However, I have read that the Cortisol is supposed to be at the high range in the morning, and slowly go down as the day goes on with the lowest being at bedtime. Maybe that is why I feel my worst in the evening since my neuropathy and fatigue are really bad by then.
Thanks again for helping me. What would we do without these forums where people can go and hear from others who understand their problems? My husband is absolutely no help whatsoever. He gave up trying to understand my illness over 2 years ago, so I have been dealing with this alone.
I'll wait and not take it until I hear from you or someone who might have some useful information about the adrenals. My AM Cortisol is only 12.0, and the ND doctor says it's too low where my Endo says it's ok. .Again, the range on this is broad also, just like the TSH & FT3 is. However, I have read that the Cortisol is supposed to be at the high range in the morning, and slowly go down as the day goes on with the lowest being at bedtime. Maybe that is why I feel my worst in the evening since my neuropathy and fatigue are really bad by then.
Thanks again for helping me. What would we do without these forums where people can go and hear from others who understand their problems? My husband is absolutely no help whatsoever. He gave up trying to understand my illness over 2 years ago, so I have been dealing with this alone.
I may be converting to T3, but I still feel so horrible. In addition to my other symptoms, I'm also very overweight and can hardly walk due to my neuropathy. Could it be that my T3 may show it's converting in the blood, but maybe the T3 can't get into my cells for some reason?
I'm supposed to see the Naturopathic doc in another week. Do you think I could just try one pill of the support and see if it helps my energy at all? Or do you think it could cause a big problem? I know you said you didn't know much about adrenals, is there someone on this forum who does? 12.0 does seem kind of low, since I have read that your morning Cortisol should be in the high range. Too bad, as I was so hoping I could find a good Thyroid doctor here where I live. My Endo is in California, and I only go once a year to see him, the rest of the time I talk to him on the phone, and my insurance won't pay for phone appointments. BTW he also says I'm pre diabetic and gave me Metformin to take. I'm going to try diet first though and see if it will help as my glucose fast is not that bad---it's only in the low 100's, but normal is below 100.
Anyway, I will just keep increasing my T4 dose in quarters like goolara told me and see if it will help. It will take a long time though since I still feel awful even though my T3 says it is increasing. Thanks for your thoughts on this, I appreciate it. Terri
I'm supposed to see the Naturopathic doc in another week. Do you think I could just try one pill of the support and see if it helps my energy at all? Or do you think it could cause a big problem? I know you said you didn't know much about adrenals, is there someone on this forum who does? 12.0 does seem kind of low, since I have read that your morning Cortisol should be in the high range. Too bad, as I was so hoping I could find a good Thyroid doctor here where I live. My Endo is in California, and I only go once a year to see him, the rest of the time I talk to him on the phone, and my insurance won't pay for phone appointments. BTW he also says I'm pre diabetic and gave me Metformin to take. I'm going to try diet first though and see if it will help as my glucose fast is not that bad---it's only in the low 100's, but normal is below 100.
Anyway, I will just keep increasing my T4 dose in quarters like goolara told me and see if it will help. It will take a long time though since I still feel awful even though my T3 says it is increasing. Thanks for your thoughts on this, I appreciate it. Terri
I'm doing just great, thanks. And you are too kind with your opinion. There are a number of dedicated and knowledgeable members here. You just happened to get stuck with goolarra and me. LOL
Anyway, I am pleasantly surprised to see that you are adequately converting the T4 med to T3. I say that because your Free T3 is higher in its range than Free T4 in its range. I am not very knowledgeable about adrenal issues, and I am not real comfortable with the Naturopathic doctor's conclusion. I do very well know that Free T3 that is too low in the range frequently causes hypo symptoms. Many of us find that symptom relief required Free T3 in the upper third of its range and Free T4 around the middle of its range. So there is plenty of room to slowly increase your T4 med, and not worry at this time about adding a source of T3, or starting adrenal support.
Your B12 is at a good level for many people. Your Vitamin D, at 57, is not a big concern. Your ferritin is not far below the range recommended for women ( 70-80). My recommendation would be to just continue with very slow increases in your T4 med until symptoms are relieved. The level of Free T3 required just depends on the patient. We are all different, and require different levels of thyroid hormone to feel best.
And by the way, if along the way your TSH becomes suppressed below its range, don't let the doctor get alarmed and tell you that you have become hyperthyroid, and reduce your meds, unless you do have hyperthyroid symptoms due to excessive levels of Free T3 and Free T4. TSH is frequently suppressed when taking doses of thyroid meds adequate to relieve symptoms. Many doctors don't know that.
Anyway, I am pleasantly surprised to see that you are adequately converting the T4 med to T3. I say that because your Free T3 is higher in its range than Free T4 in its range. I am not very knowledgeable about adrenal issues, and I am not real comfortable with the Naturopathic doctor's conclusion. I do very well know that Free T3 that is too low in the range frequently causes hypo symptoms. Many of us find that symptom relief required Free T3 in the upper third of its range and Free T4 around the middle of its range. So there is plenty of room to slowly increase your T4 med, and not worry at this time about adding a source of T3, or starting adrenal support.
Your B12 is at a good level for many people. Your Vitamin D, at 57, is not a big concern. Your ferritin is not far below the range recommended for women ( 70-80). My recommendation would be to just continue with very slow increases in your T4 med until symptoms are relieved. The level of Free T3 required just depends on the patient. We are all different, and require different levels of thyroid hormone to feel best.
And by the way, if along the way your TSH becomes suppressed below its range, don't let the doctor get alarmed and tell you that you have become hyperthyroid, and reduce your meds, unless you do have hyperthyroid symptoms due to excessive levels of Free T3 and Free T4. TSH is frequently suppressed when taking doses of thyroid meds adequate to relieve symptoms. Many doctors don't know that.
Hi Gimel, how have you been? Thanks for answering.
Here are my labs from Sept/Oct
TSH--3.79--(0.27-4.20)
FT4--1.1 (0.9-2.1)
FT3--3.3 (2.5-4.3)
B12--859 (211-946)
Ferritin--57 (22-300)
DHEA--43 (12-133)
Cortisol AM--12.0 (6.0-25.0)
I haven't had Vit D test done in a year, but it was 52 at that time. The Endo is going to test it in February. BTW it was goolara that told me to quarter my Synthroid doses for the angina, I was mistaken about thinking you did. You and Goolara are the best advisors on here in my opinion, so that's why I'm so glad you are here to try to help me about this new situation.
Thanks so much, Terri
Here are my labs from Sept/Oct
TSH--3.79--(0.27-4.20)
FT4--1.1 (0.9-2.1)
FT3--3.3 (2.5-4.3)
B12--859 (211-946)
Ferritin--57 (22-300)
DHEA--43 (12-133)
Cortisol AM--12.0 (6.0-25.0)
I haven't had Vit D test done in a year, but it was 52 at that time. The Endo is going to test it in February. BTW it was goolara that told me to quarter my Synthroid doses for the angina, I was mistaken about thinking you did. You and Goolara are the best advisors on here in my opinion, so that's why I'm so glad you are here to try to help me about this new situation.
Thanks so much, Terri
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