If she is as sick as you say she is, it is important that she be seen by an endocrinologist who will start testing for thyroid and adrenal hormone levels right away. Any endo should be able to do this. She can change doctors later if there is a problem. As far as I know, all endocrinologists would take her seriously, but I have found that it is up to the patient to insist on the quality care you deserve.
It sounds like she should have a cortisol test right away. This could be serious. Make an appointment with the first endo she can get in to see. As I said, she can always go elsewhere if she is unsatisfied.
Good luck to you, and your cousin.
Hard finding an endocrinologist in NYC? It was one of the medical capital's of the country? Ask your primary care doctor for a referral.
find a naturopath - they can help with both issues immediately. i see a GP who is involved with natural health, i take adrentone (by metagenics - which is a natural supplement to support adrenal insufficiency and my dr has prescribed hydorcortisone (for the adrenals too) i also take natural thyroid supplement which has both t3 and t4 in it.. most dr's give synthetic thyroid supplement which only has t3 in it... this is not sufficent to help most issues....
i know that HealthWorld in USA is the same company that i deal with in New Zealand....
hope this helps your cousin.... i have been diagnosed with Hashimoto's disease - this is an autoimmune disease that affects the thyroid.
sorry should have added that the Adrenals have alot to do with the thyroid too.. if one is low always checkthe other.. hence doing supplementation for both.. since i have been on both supports my thyroid tests have been improving......
Thanks so much for the responses. I'll post again soon, but she has had detailed blood work done. I made an appt for her with an endo this Thurs. Unfortunately, it seems that the recommended drs. don't take her insurance, but we're going to one anyway. I will list later the vitamins/meds she's taking for adrenal support and, 2 days ago, after urging her dr. for more help, he prescribed Armour - 15 mg/day. She's not taking it today, because she is experiencing severe nervousness. I got an email this morning saying "it is the middle of the night and I dont' know what to do, I feel really nervous, anxious, if I lay down I feel like I cant breath, I can sit still either. I dont know what to do."
Can it be so severe that she should be in a hospital?
Yes - there are literally 15 pages of endos that accept her insurance in NYC. I've read so much that it's so important to find a good one - but you are right - get in ASAP, then shop around.
Thanks, I'll write again soon, or maybe ask her to write the details here. I really appreciate the support.
An immunologist who is into natural medicine recommended licorice root for my adrenal insufficiency (after years of having CFS). It really helped and you can check online for more information.
Be sure your cousin has her adrenal function examined very thoroughly, BEFORE starting on thyroid support. Aiding thyroid function, when the adrenals are weak or dysfunctional, can lead to an urgent, LIFE-THREATENING adrenal crisis. A good endocrinologist should be very thorough with adrenal testing before prescribing thyroid medication.
This happened to my son. Although he had one cortisol test before he started Levthyroxine, he collapsed one week later (passed out), and began shaking and vomiting.
We took him to emergency and he got the care he needed, but we were very upset this mistake was made.
Be very careful about thyroid support, if you haven't had a thorough adrenal exam.
The thyroid and adrenals affect each other.
Enzymelover pretty much summed that up. Make sure the adrenals are functioning properly first then the thyroid.
I would like to say, unfortunately, that I worked in NYC and went to many doctors there and got a lot of poor care. I ended up having to travel far to get care. It is not easy to find a competent doctor to treat thyroid and adrenal conditions (or pituitary, which I had as well). Try neuro-endocrinologists as they may be more competent. If your GP is helpful, get them to run tests for you but know that tests like renin and ACTH are very picky and subject to lab error so watch the lab tech and make sure they are done properly (chilled, spun immediately, and ask to freeze immediately or your results will be skewed).
I just went to a dr who said adrenal fatigue was a very rare disorder! I was like please test me I failed the eye test. He put a flashlight to my eye in a well lit room for 2 seconds and said, everything looks fine, you don't have adrenal fatigue. I managed to get my thyroid blood work tested but he wouldn't do the saliva test.
All in all I feel your pain and yes finding a right doctor is a must. I imagine 80% of people don't have anything wrong with them so the other 20% of us who actually DO have something wrong, get screwed. Hope you find one soon and it's always better to overcheck everything than miss something.
Many endocronologists with this title are specialists in diabeties and not thyroid disorders. The best thing you can do to save yourself from inadequent care and expenses is to interview when calling asking the ratio of how many patients are seen as diabetics - vs - thyroid patients.
If you find that their practice is based more on diabeties - then you can bet for sure the thyroid and adrenals are not going to be looked at as an issue.
Many patients have found endos they are happy with - but you will hear more and more patients that leave those type of doctors and find MD's GP's and others - that understand the whole endocrine system and treats the whole thing as one. Not placing a bandaide on one thing and telling you everything is fine.
I'd like to make a comment about kapitichic statement on thyroid medication. She says below:
"i also take natural thyroid supplement which has both t3 and t4 in it.. most dr's give synthetic thyroid supplement which only has t3 in it..."
She is correct saying most doctors prescribe synthetic thyroid medication but synthetic meds are not T3 - they are T4 meds that require T4 to convert into a T3 hormone to balance the system to function symptom free of thyroid issues. The only synthetic T3 meds that are prescribed is a med called Cytomel and that is used in correlation with a T4 medication when levels of Free T3 are not normal in labs.Unless a reverse T3 lab is uncovered - which is a very controversial subject over on the thyroid forum.
If there is a combination of both adrenal fatigue and thyroid issues - it is right to treat the adrenals and heal them first before taking thyroid replacement medication.
Yet people like me who have no thyroid function at all due to surgery or RAI ( as I had) are forced to find a balance of keeping thyroid hormones at a level of functionability as well as repairing the adrenals to work too.
Also keep in mind that when your thyroid does not function optimally - then the adrenals will pick up the slack of that - and that will also burn them out - so ignoring thryoid function just to repair the adrenals could spin your whole system out of control.
The adrenals are very tough and can take a lot of issues before putting them in a CRISES as stated above. Trama or surgery in that area can definately put you in crises - but in the majority of the time - they can be returned to proper function prior to devastation simply by supplements and change in lifestyles. Constant abuse will continue the damage - so definately taking care of them is right.
The right protacol of decreasing thyroid medication is usually recommended - and getting adrenal support to strengthen them is the right way to look at this.
You can't ignore one disfuction in hormones to fix another - balance is key.
I am an Armour patient on 120mgs a day - At first I struggled emmensely with adrenal fatigue and my medication. The right avenue for me was decreasing meds and repairing adrenal function to balance it all. I am still not quite there yet - but the results have been night and day. I recently was also found estrogen dominiant which will throw a wrench in the whole process too.
Thanks everyone for the detailed responses. I have been to 3 doctors since I last wrote with my cousin, but we're still looking for a doctor that understands both the thyroid and the adrenals. One doctor in NYC spent almost 2 hours with her and said that she has Hashimotos - her thyroid is 3x bigger than normal, however, he didn't address her adrenals and deferred to the holistic doctor re: treatment. Maybe that is the way to go - have 2 drs., although 1 seems better.
She started Armour at 15 mg/day and now she's up to 60 mg after 2 weeks. After reading responses here, I'm wondering if this is even the right course of action. Even with Hashimotos, should she be fixing the adrenals first? She feels very slightly better after almost 3 weeks, but that really isn't saying much - she is still totally wiped out - definitely can't work, sometimes can barely make food to eat, but a few days a week she's been pushing herself to get out and walk, so we consider this an improvement.
How could it be that someone goes from totally active and healthy to totally non-functional within a few months?
We have another appointment with a doctor in NJ on Wed., however, I spoke to him last week, just to make sure he's the right doctor for us (found him on top docs at thyroid-info.com). I told him that my cousin has thyroid disease AND adrenal fatigue and he said that it is very unusual for someone to have both. After hearing that, I cancelled with him. But I rescheduled because he had 15 reviews of people saying that he's the best doctor ever.
I guess what I'm unsure about is the mixed advice I'm getting from people here, and the endos.
She is on adrenal support as follows:
ARginine with Magnesium
Cortico B5 B6
SO, if she's supporting her adrenals, is it OK to be on Armour 60 mg? It just doesn't seem right to forget fixing the thyroid for now and wait the months it might take to fix the adrenals.
What is the consensus - fix thyroid and adrenals simultaneously OR fix adrenals THEN thyroid.
We're also making an appt. with an osteopath soon.
Thanks so much.