Delightful eh? hehe.
Good to see you are feeling better. :)
This is my guide on how to interpret ACTH stimulation results that I have put together from reading various websites.
*Healthy adrenal function:
Cortisol levels should double from a normal base cortisol range within 60 minutes.
*Primary adrenal insufficiency:
Cortisol does not double from the low base cortisol range within 60 minutes. ACTH will be at the top of the range or above range.
*Secondary adrenal insufficiency:
Low base cortisol range can double, triple, quadruple within 60 minutes. ACTH will usually be in the bottom half of the range to the very bottom, but not usually below the range.
*Mild primary adrenal insufficiency (low adrenal reserve):
A normal baseline cortisol range with a subnormal response to ACTH stimulation.
*Mild secondary adrenal insufficiency:
A low or low normal baseline cortisol range with a normal response to ACTH stimulation.
NOTE: If a person is unwell, the diagnosis of adrenal insufficiency cannot be excluded by a serum cortisol level.
It's best to start off low dosage because high doses can really see too quick a drop in natural hormone production. I found that out with hyperthyroid symptoms for a week then worsening hypothyroid symptoms for another month as thyroid medication build up in the blood.
I also had to deal with worsening adrenal fatigue due to thyroxine such as severe coma like fatigue 15 + hours a day where I barely move or speak, dizziness, numbness. A good reason to correct adrenals before taking thyroxine!
Excerpt from Integrative Psychiatry - Serotonin...
"The following factors can cause low serotonin levels:
Artificial sweeteners (aspartame)
Dietary deficiencies of nutrient co-factors
Ecstasy, Diet Pills, and certain medications
Hormone Imbalances (thyroid, adrenal, estrogen)
Lack of exercise
Lack of sunlight
Problems converting tryptophan to Serotonin
Problems with Digestion
Stress and Anger
High Cortisol Levels
Low Serotonin Symptoms
Low serotonin levels are often attributed to anxiety, depression, panic attacks, insomnia, obesity, fibromyalgia, eating disorders, chronic pain, migraines, and alcohol abuse.
Negative thoughts, low self-esteem, obsessive thoughts and behaviors, PMS, and Irritable Bowel Syndrome are also symptoms of low serotonin."
I should of said as I had to wait for thyroid medication build up in the blood and do a better job than my thyroid gland was doing. :)
Dear Red Star,
Thank you so much for all the good information you provided me! Now, I am wondering something else, perhaps you know. I AM aware of the interaction between thyroid and adrenals. But another thing I'm interested in knowing is, does a person have to stay on adrenal insufficiency medicines always... or is it merely to boost it up enough to where a natural (if less powerful) endocrine correction takes place?
I will be seeing my Primary Doc in about a week, I will be asking him if I've been miserable because the particular AI meds have actually created more of a problem than before... the side effects I've read about are like my condition, which began to ruin my health and upset my well-being so much, that after much mulling over, I am beginning to think the drugs for AI they gave me were simply too much, and I wonder, as I said in the first part of this post, if I should even be on the drug long-term at all.
Now, I DID call these endos to talk all this over, and I was so shocked that they wouldn't discuss it, rather they felt they were correct. After that disappointment, I knew I couldn't live my life as a 25-yr-old on a motorcycle (I'm 63 yrs old), and so I cut my drugs in half. This helped a lot.
Even so, gradually the strange side effects took over, worse and worse, particularly with the severe depression. So, for the last three days, I decided to cut my AI meds by 1/2, and then added back in 1/2 of my antidepressant, which my psych doc has been urging me to do, even before all this mental health stuff began (and physical problems too). I HAVE to say, whether it was the reduction of Hydrocort or adding in Zoloft, I have slowly improved. Of course, it's too early to tell, but it suggests medication may be the problem here.
I, too, have read about letting adrenal meds build up before fooling with thyroid meds (sort of the opposite of you, but I DID read this), but I never would take the thyroid stuff they first gave me because it felt like I was having a killer heart attack, that's for sure!
In the end, I just can't help but think that, you see, I was hospitalized for two months last winter, and when I came out of there, I was a wreck. They had begun me on maybe a dozen meds, when all I ever took was three. And it was at this time that I went off my antidepressant and felt better (BUT I also went off all the stuff they wanted me to take, and simply returned to my old meds).
But the biggest changes I've noticed, keeping in mind my lowering AI and increasing (adding back in) my antidepressant, the main things that are better are these: I'm nowhere near as depressed, I am not as nervous and upset (crying), and I am not itching and as irritable. I am still not well, but by the time I see my doc in a week, could be the change will be more dramatic, and then he can refer me to some new endocrinologists, to perhaps get something I read about: An Endocrine Scorecard.
This is a holistic point of view, where ALL endocrine systems are measured as best as possible, and the big picture becomes more apparent. Could be, for example, that I may indeed need my AI Hydrocortisone-type drugs, but perhaps a different kind that has less side effects, and also a much lower dose, which I've lowered the dose myself (altho this worries me, to do this). Could also be if they measure all my numbers monthly, for example, until I manage to hit the right grouping of numerical measurements of my endocrine system, WHO KNOWS, maybe I'll wind up not needing anything; rather just a six-month check of the "big picture," to make sure I'm not putting myself into danger by not taking any endo drugs, or to make sure whatever I am taking is correct.
If you have any further thoughts, or if someone else does, now that I've really put the whole story out there, I hope you all will share anything you know. Every little bit helps, and not only will more information help me, but it will of course help readers. Thanks so much again, Red Star, and thanks ahead of time to any others.
By the way, Red Star, I didn't mean to ignore your very good list of possible causes of low serotonin (causing depression). I think they are very helpful to me, in trying to discover why I have been depressed IN GENERAL for about 15 years.
Medications was listed, and the first time I took Zoloft was when I was on Klonopin (a tranquilizer for Panic Disorder), it made me feel sad, so they put me on that Zoloft, to not only fight that, but also to help with the Panic. Well, I DO think I'm one of those people who wind up even sicker than before, that is more depressed, by taking an antidepressant, the very thing that is supposed to help with that.
Another few things you listed DO apply to me, as I went through the "change" about the time I was put on Zoloft, which would be: Hormone imbalance, and since my estrogen, etc., was off more than ten years ago, NOW I'm also dealing with a possible adrenal/thyroid problem. But as for the latter, I once had "thyroiditis," which "itis" does indeed suggest what it means, that my thyroid began to overproduce from irritability (probably to make up for estrogen, etc., levels dropping?).
Sure enough, I had a really great doc at the time, and he put me on some sort of mild but very pleasant drug (I'd have to look it up, but it was a beta blocker). And for about four months, once I hit a certain number, he stopped those, which I really hated to let that drug go, but of course I did. All my numbers for thyroid returned to normal.
A couple other things that may figure into my serotonin being too low, and which have happened within the last year, are lack of exercise, lack of sunlight, stress... and I'm wondering about "high cortisol levels." I'll ask my doc to look into that. He has done a couple really complete blood level checks, which I think cortisol is on there, but he'll have to look at my record and see... or he may just ask my new endocrinologists to have a look at it.
And of course, the opposite end of the spectrum that you gave me, low serotonin COULD be causing a bunch of the listed things you gave, in particular: anxiety, depression, panic attacks, chronic pain (I was in a bad car wreck and fractured spine and twisted/pulled muscles into forever spasms, off and on, which worsened as I aged... wonder if it was change in endocrine system that contributed?). I also had IBS for a little while, and up until recently, I had perfect colonoscopies, but a recent CT scan showed I had bunches of pockets in my bowel, where just five years before my bowel was fine!
Oh, what a tangled web women face, in particular, when their endocrine levels blast out all over the place during the "change." I hope I find a good endocrine bunch, ones that THIS time will work with me, unless my own doc feels like he can handle all this (I don't think so).
I'll at least keep you all posted if anything new comes up regarding all this, and again, anything else anyone wants to contribute is welcome.
BY THE WAY, GO OUT AND VOTE! (I voted early, last Tuesday!)
I've had a long list of medical conditions (many on that list above) but in particular my severe depression was due to vitamin B12 malabsorption due to autoimmune pernicious anaemia in my case. Once you have suicidal thoughts your serotonin is seriously low! My mother's cause of severe depression was due to insufficient stomach acid causing malabsorption and was made even worse taking nexium (acid blocker).
There is a symptom that is unique to hypothyroidism called myxedema. There is a demo on youtube you might be interested in: Hypothyroidism Type 2: Myxedema Symptoms.
Unless you have Addison's disease, I would think you shouldn't need to be on adrenal medications all your life. I taxed my adrenals due to chronic undiagnosed hypothyroidism but I had serious adrenal insufficiency with severe vitamin B12 deficiency, two month severe hyperthyroidism, 6 months severe mental and physically stressful job.
My pupils would fluctuate in the light so fast it was less than a second! And when I dragged the top of a pen lightly across my belly the skin turned bright white then spread over 2 inches. I was in a bad way~! It took 18 months to get over naturally after my worst bout.
I live in Australia btw. :)