Interesting how all of this is related - thyroid, adrenals and blood sugar.
I've also had frozen shoulder, high AM cortisol, and pre-diabetic glucose. Thay are all better now- all at the same time. Coincidence? dont think so.
I had a GTT done and felt nauseous. Way too much glucose on an empty stomach. Ugh.
My apologies to LazyMoose, as well, for going off topic...
Wow - had no idea diabetes or pre-diabetes would have anything to do with frozen shoulder... it will be even more interesting to see how the GTT comes out, then...
Here is something else I found of interest. Sorry to LazyMoose for going off the subject lol.
"Diabetes is the most common associated disease with frozen shoulder and a patient with diabetes has a lifetime risk of 10%-20% of developing this condition[7,8]. Patients with frozen shoulder have a higher risk of having some form of prediabetic condition with an abnormal fasting glucose or impaired glucose tolerance test[8]." World Journal of Orthopedics - Frozen shoulder: A systematic review of therapeutic options
Hmmm... that's all very interesting. I did get the information about chloride/dehydration from Labtestsonline.
My blood glucose levels were high again on my latest blood work, as well, and I'm being sent for a Glucose Tolerance Test, which I can't do for another week, since I had to have a cortisone shot in my shoulder for Frozen (capsulated) shoulder...
I forgot to add high cortisol can cause an increase in cholesterol and triglycerides.
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
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"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
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.
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
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"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,
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.
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.
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.
Hey Barb, when my mother went into remission for Hashi's her thyroid nodules also reduced in size and some nodules disappeared. It looks like you were in remission (mistaken for a "dead" thyroid gland) and Hashi's has been retriggered for whatever reason (I found various reasons below) and affecting the size of your thyroid nodule.
You mention adrenal tumours and cortisol. Have you been tested for Cushing's Syndrome?
Except from the article from Restartmed: How Hashimoto's symptoms change over time + "flare" up symptoms...
"List of Hashimoto's flare up sources:
Extreme physiological or emotional stress (death of a loved one, divorce, problems at home/school/work, etc.)
Physical trauma such as car accident or even repetitive physical trauma from extreme exercising/sports
Chronic nutrient deficiencies
Viral infections (CMV, EBV, etc.)
Other hormone imbalances that may alter immune system function
Exposure to endocrine disrupting chemicals
Exposure to heavy metals (the removal of dental amalgams has been shown to reduce thyroid antibodies in some patients)
Increased intestinal permeability due to overgrowth syndromes or intestinal dysbiosis"
Very interesting thread... sorry I had to bow out for a bit. I never did have elevated TgAb, though I did have elevated TPOab, which did go down after I started on thyroid hormones. I was told that was because my thyroid was "dead" and there was nothing left for the antibodies to attack, so they went into remission. They stopped testing antibodies for several years and as I noted above, my new NP just tested them and they're elevated again, so apparently, there's "something" left to attack...
I've also always had small nodules, never any dominant nodules though. That's changed now and I have one dominant nodule that's 1.1 X 1.0 X 0.8 cm. The ultrasound report stated that could be a thyroid or parathyroid nodule. Not sure how they could not tell the difference... I'll be sent to an ENT for follow up on that.
I've tried diet changes a couple of times, but it's been pretty difficult for a couple of reasons, mostly because it wasn't "doctor ordered", so family cooperation was slight to non-existent. It has been now doctor ordered, so it's going a bit easier. I've been asked to give up wheat, dairy, soy (which I ever eat anyway), sugar, processed foods (which I also don't eat much of), etc. I've only been trying it for a week, so haven't made a lot of progress and the sugar part of it is really difficult... :-(
I'm supposed to do an extensive stool sample, to check for a variety of parasites, since I did have H. Pylori at the beginning of the year, but that's all they tested for. I'll get that done this week.
Acid reflux has been one of my most prevalent symptoms for years - off and on. I've done the HCL with pepsin, which pretty well took care of the acid reflux. When I get it back, now, I take peppermint oil, dill pickle juice, etc to help restore acid.
My cortisol levels are also messed up, so that seems to be having an over-all effect, as well. In spite of having bi-lateral adrenal adenomas, the NP is the only one who has checked cortisol levels or thought it important to pay attention to them.
I'm finding it somewhat odd that after all these years, these things (dominant nodule, high TPOab, etc) would show up again after my thyroid was supposed to have been "dead".
My first autoimmune disease showed up when I was baby. Not sure of the trigger but there are many possible triggers mentioned such as environmental toxins. I don't suffer from acid reflux regardless of stomach acid levels. I have to put that down to chewing my food excessively (B12 malabsorption damaged my gag reflex).
Conventional medicine (anyone for that matter) really needs to get to he bottom of autoimmune illnesses. We are seeing the tip of the iceberg from the natural or functional medicine side- but its full of guesses. Its part genetics and seems to be influenced by diet. We know its not diet alone- cause a great part modern/western society would be ill from modern convenience/ junk food.
I tried a anti-oxalic acid diet (Dr suggest) for three months, which excludes nightshades, nuts ect. It did nothing so I checked that off the list.
I'll try my HCL again (even though I digest great) due to my candida past.
I found this in regards to nightshades and inflammation...
Excerpt from the article What are Nightshades and Do They Cause Inflammation?...
"Because nightshades are only a problem for a small number of people, it’s overkill to suggest that everyone should avoid them.
People with arthritis are sometimes advised to avoid all nightshade plants because they are said to cause inflammation. But this advice really only applies to people who have a sensitivity to solanine. For these folks, eating nightshade plants causes an inflammatory reaction—including joint pain.
Because most people are not sensitive to solanine, however, I think it’s misleading to characterize nightshade plants as “inflammatory,” and it’s certainly overkill to suggest that everyone with arthritis should avoid them—especially because they have so much going for them nutritionally.
Nightshade plants are high in antioxidants, which actually help reduce inflammation. And chili peppers also contain capsaicin, a strongly anti-inflammatory compound. So, if you’re an arthritis sufferer, I’d think these would be foods you’d want to eat more of—unless, of course, you are among the minority that is sensitive to them."
**
I checked lab ranges and my mother's TgAb levels are always <10 (lab range is normal <60). When I first had Hashimoto's thyroiditis my TgAb was 150 but went back to <10 for 5 years until my most recent lab result (up to 120).
I'm not surprised at the increase in TgAb since I have severely depleted stomach acid due to chronic stress (causing a lot of deficiency states including iron deficiency anaemia) and stomach acid is crucial to good digestion/absorption and immune health. I need to start taking my mother's Betaine HCL with pepsin supplements.
My mother had severe systematic candida until she started betaine HCL with pepsin supplements and increased her stomach acid. Candida does not like an acidic environment. Probiotics are also acidic as well.
Red Star- interesting about the alkaloid in night shades decreasing TgAb (the antibody I still have).. I say interesting because there are also sources that say nightshades should be eliminated in a "anti-inflammatory autoimmune diet". I might read up on that more, since my TgAb was still elevated. Confusing.
That said, I still eat nightshades like sweet peppers but replaced white potatoes with sweet potatoes. Guess that's where Paleo and Autoimmune diets differ.
My main quest was to see if there was anything I could through diet to help boost my immune system to rid whatever lyme or candida I have left....the natural way. The fact that it normalized my TPO was a coincidental surprise.
Red Star- interesting about the alkaloid in night shades decreasing TgAb (the antibody I still have).. I say interesting because there are also sources that say nightshades should be eliminated in a "anti-inflammatory autoimmune diet". I might read up on that more, since my TgAb was still elevated. Confusing.
That said, I still eat nightshades like sweet peppers but replaced white potatoes with sweet potatoes. Guess that's where Paleo and Autoimmune diets differ.
My main quest was to see if there was anything I could through diet to help boost my immune system to rid whatever lyme or candida I have left....the natural way. The fact that it normalized my TPO was a coincidental surprise.
I LOVE bacon. I just bought 2kg (4.4 pounds) of bacon actually. I've read Susannah Mushatt Jones (died age 116) ate 4 rashes of bacon with eggs daily and and the oldest living cats (died age 38 and 34) ate bacon and eggs daily as well.
I found something very interesting on lowering thyroglobulin antibodies (TgAb)!
"The results of this study show a selective decrease in TgAb but not TPOAb levels in patients with Hashimoto's thyroiditis after 12 weeks of anatabine supplementation. Anatabine is an alkaloid found in plants of the Solanaceae family, including tobacco, tomatoes, potatoes, peppers, and eggplants (8).
Although the mechanism of action of dietary anatabine on thyroid autoimmunity remains to be elucidated, it may produce immunomodulatory effects through activation of α4β2 or α7 cholinergic receptors similar to nicotine and other structurally related agonists (9,–11).
In a mouse model of thyroiditis, anatabine decreases thyroidal IL-1β and IL-18 levels (7), and in other experimental disease models it suppresses the inflammatory transcription factors signal transducer and activator of transcription 3 and nuclear factor-κB (12,–14)."*
Solanaceae is also known as nightshades. My TgAb is usually in normal range as is my mother's. I believe my TgAb was a bit elevated a few years ago when I was first tested though. My mother's TgAb is usually normal..not sure if she has ever had elevated TgAb actually. I'd have to check all the labs.
But reading this study is interesting since my mother loves tomatoes. I bought 28 tomatoes at a local market and she ate them all in 2 weeks! I'm not a fan of eating tomatoes like that but I do like tomato sauce. We both like potatoes as well.
My mother had her testing done recently (she was in remission for Hashimoto's thyroiditis after she stopped taking acid blocker nexium and started betaine HCL with pepsin supplements and digestive enzyme supplements) but due to a lot of emotional stress had retriggered her hashi's (TPO rose again) but her TgAb is normal.
*Anatabine Supplementation Decreases Thyroglobulin Antibodies in Patients With Chronic Lymphocytic Autoimmune (Hashimoto's) Thyroiditis: A Randomized Controlled Clinical Trial
J Clin Endocrinol Metab. 2014 Jan; 99(1): E137–E142.
Published online 2013 Oct 31. doi: 10.1210/jc.2013-2951
I added non-gmo corn chips as my only chip "cheat", only has 4 ingreadiants. Still do bacon on occation, but with no antibiotics, nitates or sugars. And bison or natural suages for processed meats (whole30). My "diet" is not a weight loss plan, but could be if I needed to be.
Not on any probiotics, natural, supplimented or fermented for 9 months. I did consume them years ago when first trying to correct leaky gut with gut candida. The correct natural food in its natural state, seemed to eliminate this past need.
Yogurt is a commercial joke- look at all the sugar in it! same with Kerfir. Candida eats sugar and carbs.
I dont feel good after any milk products, so I eliminated all of it. Almond milk is my new friend. Some of them have to many chemicals too so not all brands are equal.
Sounds interesting.
I also am in my early 50's. And I would like to lose about 8 to 10 lbs which by most popular height/weight BMI type charts would put me about at the top of normal, or very bottom of the overweight category. My wife on the other hand, in order to get to that same place on the chart has more weight to lose. And I think if I want to remain alive, is all I will say about my wife's weight! LOL!
On the whole 30, I didn't find any food sensitivities. My wife and daughter did with gluten. Makes them feel jittery, anxious similar to if they had too much caffeine.
To go back on the "whole30" modified, I will probably not give up dairy completely. I have switched to coconut milk almost exclusively. About the only dairy I have is cheese and occasionally yogurt. (and frozen yogurt from time to time). So keeping cheese in my diet seems pretty safe.
I think the main weight loss are from two factors. #1, staying away from added sugar and stuff that has added sugar in it. and #2, staying away from gluten. Not so much of the gluten itself, but rather all the foods that gluten is in, such as breads and gluten pasta's etc.
Another challenge for me being a big meat eater is staying away from processed meats. I LOVE bacon, Ham, Salami, summer sausage, jerky etc.
Also potato chips are my nemesis. But I have found lays "simple" and also some chips that are cooked in avocado oil. They are not strictly on the diet, but are about as good a "cheat" as I can find without completely blowing it. Like anything else. Just having enough will power to not overdo the "cheat" is the key.
Do you do any other added probiotics? Do you eat fermented veggies, Kombatchu etc?
Im my experience, ERFA and NP acella (both NDT) absorb better than the few other brands, thus FT4 is a little higher than the others. T3 does not bind to protiens, thus does not seem to matter amongst NDT brands.
I also did the whole30 version of Paleo for first three months, now just a little less strict (some non-gmo grains now). Yes it costs a little more, but clean eating is more popular today and its now more affordable. This is easier for less-social introverts such as myself LOL (live alone). I do less social eating today, and if its outdoor summer social eating, I pack my own food. I feel physically better to some extent, not in a huge way, but it is noticable. Long term will tell I guess. This would be tough for high social and or family people.
Paleo in general has a more positive effect than organic + no-Paleo. So many "organic" eaters also eat non-paleo, then whats the point? I'm not 100% organic, not in meats or veggies. Since Paleo is whole foods, one does not consume the slury of gravies laced with glutan and chemicals, and animal milk (typical midwest "hot-dish" meal is a big no no). My gut feels the best ever in my life.
This is somwhat of and over due experiment on health. In my early 50's but always tried to have an active outdoor lifestyle, so I had only a little weight to lose anyway, by by 5lb.