Long time no see. I normalized one antibody that was high since '97.

[LazyMoose]

Long time no see.  think I posted a couple years ago, other than that its been a few years and I must say this new format they kept is not user friendly compared to the old one. I cam back wondering if any new people have lowered their antibodies as this was a hot topic once thought to be impossible. I asked several folks in that past who "assumed" their antibodies were better after some other treatment to please fill in the blanks with details (lab tests). No one would do this. No proof then. Have people shown this to happen here in the last few years? I actually normalized one of my two thyroid antibodies (proof on two tests in one years time). So only one antibody normalized, could say I was half successful. I still need my pig thyroid though- no level change (bummer). I do feel a little better, but I've done so much healthwise with holistic approaches, its hard to say if it was from better diet, diet healing a gut, or candida control, or all of the above.

[Red_Star]

I'd like to say I'm surprised but I'm not sad to say. I did find a bit of info that is interesting. Dr Kaslow lists "Hormone Imbalances that favor breakdown of tissue" as one of the causes of low total protein.

"A prolonged high blood concentration of cortisol in the blood results in a net loss of tissue proteins and higher levels of blood glucose."

- Precise Nutrition - All About Cortisol

**

"An increased level of blood chloride (called hyperchloremia) usually indicates dehydration, but can also occur with other problems that cause high blood sodium, such as Cushing syndrome or kidney disease."

- Chloride Labtest Online

**

"1. Cortisol decreases TSH, lowering thyroid hormone production.

2. Cortisol inhibits the conversion of T4 to active T3, and increases the conversion of T4 to reverse T3."

- Cortisol and Thyroid Hormones

[Barb135]

Would you be surprised if I told you I had an endo in charge of treating my adrenal adenomas?   She ordered 2 consecutive cortisol saliva tests, which both came back showing that I produced no cortisol, whatsoever, at that time of day, and a blood metanephrine and normetanephrine test, which were both within normal ranges... She decided that I did not have pheochromocytoma and pronounced me "fine"... She, apparently, saw no reason to order the Dexamethasone suppression test.

Not once has Cushings or sub-clinical Cushings, been suggested or thought of. For the most part, until I went to the NP, my problems have mostly been thought to be my own fault...

Interesting to note: My doctor's office posted the results of the blood draw I had done last week, on their portal, so I got to see them ahead of my visit this morning... In June, when I had blood work, my cholesterol and triglycerides were both over range, as was my blood glucose level.  This time, both, cholesterol and triglycerides were back to well within range and blood glucose was only 1 point over range.  

The only thing I've changed since June was eliminating wheat, dairy and as much sugar as I can from my diet (I don't eat soy and very little processed foods)...

My thyroid levels have remained almost the same as they were in June.  The only thing that changed was Free T4, which was 1.3 (0.8-1.8) in June and September just prior to changing my diet, but is now, 1.4 (same range); Free T3 is 3.2 (2.3-4.2) on both tests, with suppressed TSH.

In addition, Chloride levels are high and protein and globulin levels are low.   The high chloride could indicate dehydration, since I was fasting; however, the low protein and globulin may indicate malabsorption.  It will be interesting to see the NP at the end of the month and find out the results of the stool test I did.

I'm wondering if absorption issues may have been affecting my thyroid med, but the fact that my FT3 isn't changing might still suggest impaired conversion.

[Red_Star]

You might want to see an endocrinologist to run a few tests for subclinical Cushings. I found a couple of articles/studies which are far too long lol but I posted some of the info which is interesting.

"The authors reviewed records of 24 patients who underwent adrenalectomy for adrenal corticosteroid hypersecretion. They identified nine patients who had subclinical Cushing's syndrome (defined as patients with an adrenal incidentaloma and median serum cortisol of 2.0 µg/dL after 1 mg overnight dexamethasone suppression testing rather than the traditional cutoff of 5.0 µg/dL)."

"The median preoperative BMI was 33 kg/m2. Eight patients had hypertension and three had type 2 diabetes.

The median adrenal mass diameter as measured by CT was 3.1 cm.

Seven patients lost weight postoperatively with an average decrease in BMI of 2 kg/m2. One patient became normotensive and three patients were able to reduce antihypertensive medication."

Surgery May Improve Symptoms in Subclinical Cushing's Syndrome. by Peggy Peck, Executive Editor, MedPage Today

***

"The high prevalence of hypertension and metabolic disorders in patients with subclinical CS suggests that the clinically silent hypercortisolism is probably not completely asymptomatic. Variable extent and duration of subtle cortisol autonomous secretion may influence the clinical features. This hypothesis is supported by the fact that hormonal and clinical features improved in all patients after surgical treatment. This improvement, described also by other authors (9), was persistent during the follow-up period, even after resolution of the biochemical adrenal insufficiency."

Subclinical Cushing’s Syndrome in Patients with Adrenal Incidentaloma: Clinical and Biochemical Features _ The Journal of Clinical Endocrinology & Metabolism, Volume 85, Issue 4, 1 April 2000, Pages 1440–1448,

[Barb135]

I, too, wondered about the "unspecified hypothyroidism" with elevated antibodies, but that's what they classified it as...then in another place, the same doctor said "primary hypothyroidism", which is Hashimoto's - so we have to wonder what his real diagnosis would be, don't we??

He had also put "unspecified vitamin B-12 deficiency" instead of Pernicious Anemia in one place, but specified Pernicious Anemia in the other place, so it would seem that he's a bit undecided... lol

I've read about subclinical Cushings, but again, doctors have never been willing do the dexamethasone suppression test (or the 24 hr urine test).  

I do have the three symptoms you mentioned (high blood pressure, impaired glucose metabolism and weight issues), though, for the past few years, I've managed to keep my weight below the obese level - with great difficulty, though I'd never had weight issues prior to becoming hypo/Hashi's.

[Red_Star]

How can doctors say unspecified hypothyroidism with thyroid antibodies! smh.

I have a very large hump on the back of my neck and had a few tests done to rule out Cushing's (24 hour urine test and low-dose dexamethasone suppression test) but it turns out that lump is from chronic insulin resistance.

You might have Subclinicial Cushing's (SC) though which means you can show some degree of hypercortisolism without typical signs or symptoms of overt Cushing syndrome. It's not as easy to diagnose as overt Cushing's disease but I did read 75% of SC cases are diagnosed with the overnight 1 mg dexamethasone suppression test. Symptoms commonly mentioned with SC are high blood pressure, obesity and impaired glucose metabolism.

[Barb135]

Hey Red_Star... I'm not sure I was ever really in "remission", because my antibody count never did go completely back to normal; it just went down to less than 100 and the doctors quit testing it.  Most of them have never really acknowledged that I really have Hashimoto's anyway.  One of the actually listed "unspecified hypothyroidism" on my record - nowhere did he indicate that I have Hashimoto's.

I also don't believe that my nodules ever really went away.  I think the one ultrasound that indicated such was an error.  The doctor (my old endo) that ordered that ultrasound went out of practice less than a month after it was done, otherwise I think a follow up would have been ordered to verify its correctness.

I have never been tested for Cushings, because I don't have enough of the symptoms, though I do/did have a few of them, such as the excess hair (I had the facial hair lasered off, so doctors don't even know I had that...), of course, the weight issue, fatigue and high blood pressure.  I do not have osteoporosis, as most with Cushings have.  I do have some darkening and thinning of the skin in some places, but not the pad of fat between my shoulder blades or stretch marks.  I have easy bruising, but not the anxiety, depression, hair loss, headache, round face, insomnia, etc.

I've had cortisol (abnormal) and epinephrine tests, but never the low-dose dexamethasone suppression test.

I think it's important that I take spironolactone as a diuretic, which affects the hormone adrenal aldosterone.  It's not uncommon for aldosterone levels to be elevated when one has adrenal adenomas, but for some reason, neither my endo nor my pcp ever thought to remove me from the spironolactone and test aldosterone levels.

As for the Hashimoto's flare, right now, I'm putting my money on the high cortisol, nutrient deficiencies and out of balance gut bacteria... After having been wheat free for over a week, we went to an Italian restaurant for lunch today and I ate pasta and bread that I haven't been eating...Before I was even finished eating, I was burping and belching something awful and this evening, I feel like a bloated whale that's been washed ashore!!!

We'll see what comes of further testing, which was sent off yesterday.