Just for information, when taking cortisol meds, patients should also be taking an adequate dosage of DHEA to assure optimal levels. The DHEA offsets bad effects from cortisol, like those you mentioned. Having an adequate DHEA level is very important, and it tends to decrease as we get older, requiring supplementation for us to feel our best. So perhaps you needed both.
Barb-Yes, I'm still weaning off the Cortef. I was at 60mg & now I'm down to about 8. I take the Armour around 4:30 am then I take the Cortef either an hour later or whenever I wake up (I've been soooo tired & weak as of late & it's usually around 10am when I wake up) I take the full dose of Armour now. I tried your advice and split the dose but oddly enough, when I did this, I would end up feeling so much more drained. It's like when I took the whole dose in the morning, I would have the energy to get up, get myself & my dogs ready & go walk 2.5-3 miles. If I split it up, I felt so drained & exhausted! I couldn't do anything but stay in bed. I'm having a great deal of trouble going to sleep at night (fall asleep around 1-2am) In a very weird way its like I'm wired & exhausted all at the same time. Yes I still do the b12 shots but I've only been doing them monthly.
2 questions for you...
1.)What's an example of another thyroid med I could/should ask to be placed on?
2.) What is the difference between Magnesium citrate & chelated Magnesium & which should I take? I have had trouble with low magnesium before & several years ago, I went to a vitamin store & this was the type recommended/preferred. Per serving (4 HUMONGOUS horse pills
(I added this comment earlier but for some reason it didn't post)
My current labs as of 11:59am on Dec 27:
*currently on @8mg Cortef & 109mg of Armour Thyroid
Cortisol- 8.2 (8am= 8.0-19 & 4pm=4.0-11)
ACTH- 4.4 (7.2-63.3)
Tsh- 0.718 (0.450-4.500)
Free T4- 1.06 (0.82-1.77)
Free T3- 5.7 (2.0-4.4)
Sodium- 140 (134-144)
Magnesium- 1.6 (1.6-2.3)
I'm STILL incredibly EXHAUSTED & wore out (physically & mentally). I'm still very much depressed. My appetite is pretty non existent; eating maybe one healthy meal a day (usually a healthy salad). In spite of the lack of appetite, I continue to struggle with my weight. I've lost about 10 lbs (of the 30 lb weight gain from the steroid use) but that's been a slow go. I thought with as little as I eat, I should've lost a WHOLE lot more than just a measly 10 lbs.
Your thoughts
Your endo is either junior or not very experienced one and simply jumped into experimenting cortisol drug with you and I think that is the reason for most of the reason symptoms you are experiencing especially leg abdomen edema.
My suggestion is taper the unwanted cortisone in small steps and took it out fully. Adrenal fatigue is still vague and experimenting with it without the possible side effects is very harmful. To name a few it can raise your blood sugar levels and can lead you to diabetic very soon and all other related complications like nerve problems, heart problems etc. I am not saying hydrocortisone is bad for all but it need to be taken with caution and only if the case is very genuine and needed. Mild adrenal problems as you are experiencing in first place need to be dealt with better sleep habits, diet, reduction in stress, ignoring needless anxiety, fear etc and not by drugs in the first place.
Concerning thyroid condition too 5.5 TSH value does not even need any thyroid replacement pill as your Free T4 and Free T3 values were normal without pill. Pills are usually started when TSH go beyond 10 or if Free T4 go below reference range. So my suggestion you can either cut it off fully or partially under the supervision of another good experienced doctor. An experienced doctor is one who not quickly jump on prescribing unwanted medicines and diagnosis quickly.
Also the real thing which you need to deal with is Vitamin D deficiency as your level is way too low and your doctor need to deal with it by giving you suitable supplements to make it in optimal range.
Btw: i followed your advice & got my b12 & folate checked. On Oct 31- my b12 level was 532 (211-946) & my folate was 13.7 (>3.0) My vit D levels continue to be low so he put me on vit D 50,000u 2x week. I don't know if this is of any significance to you or not but my chloride level has been either under the low range or hovering just a hair above the lowest reference range
Typically, a saliva cortisol test is done by providing 4 samples in the same day... one in the morning, one at noon, one in the evening and one at night. Since cortisol is supposed to be highest in the morning, when you're getting up and getting ready for the day and lowest at night when you're getting ready to sleep, the idea is to see if your levels are where they should be at the various times of the day. The way you did your test, basically, told you nothing except what your levels were between 11 PM and midnight...
It isn't necessary to avoid dairy for 4 hours after you take your thyroid medication.. You only have to avoid taking calcium supplements for that long, because of the amount of concentrated calcium; you don't have to avoid all foods that contain calcium, because there isn't so much calcium in most foods that it's going to affect your medication... I take my thyroid medication between 5:30 and 6:00 am and if I want cereal or a glass of milk for breakfast, I go ahead and have it. I just take calcium supplements at night and I have nothing to worry about.
I also take a T3 medication and because my T3 dose is very small, I take it around lunch time, to keep from crashing in the afternoon... I still sometimes do.
I'm sure if you tried splitting your Armour, you'd see a difference in the way you feel, because it would keep the T3 more stable in your system. It's also possible that you need an increase in your thyroid meds since your levels in September were quite low, even though they were "in range"... Many of the symptoms you listed are those of hypothyroidism.
You're right that your vitamin D should be higher than it is, since you've been on the weekly 50,000 IU since March... It's not customary to prescribe more than that, though your doctor may decide to have you take it twice/week instead.
How long have you been on the B-12 shots? Your vitamin B-12 is also relatively low in the range, in spite of the shots. I have pernicious anemia (inability to absorb B-12 via the gut) and I find that I have to keep my level at the very top of the range in order to keep symptoms at bay. I take my shots on a weekly basis. In addition to the shots, you could try taking a sublingual or liquid B-12 supplement to see if that would increase your level. Be sure to get methyl B-12.
You might also ask to have your folate levels tested. Folate deficiency often accompanies B-12 deficiency and also causes extreme fatigue. For folate deficiency, you need to take a body ready folate, such as 5-MTHF... Do not take folic acid; it isn't the same thing.
I can see why you'd be having trouble sleeping. If you get some of these other issues resolved the sleep issue might start resolving, as well.
When are you scheduled to retest thyroid hormones? Be sure to get a copy of the report...
What type of saliva test did you take that was botched? Was it a 24 hr test? I find it hard to believe that your endo started you on the cortef not knowing whether you needed it or not...
I'm confused, but that's not unusual... ☺ Were the thyroid tests done in March, the first ones you'd had? The Free T4 and Free T3 do not indicate that you even need replacement medications. The only thing that's out of range is the TSH being too high. That could indicate a different problem.
In May, how long prior to the blood draw had you taken the Armour? It's odd that your FT levels would be lower after taking med than they were prior to taking it.
It seems that the higher the dose of Cortef, the lower your thyroid hormones seem to be...
The biggest thing I see is that you're taking all of your Armour at one time in the morning... most of us taking a medication with a T3 component, find that we have to take it in more than one dose, such as 1/2 first thing in the morning and the other half around noon/early afternoon. The reason for this is that T3 is fast acting and very short lived... it's into your blood, peaks and is gone within a few hours, so what's happening to you is that you're getting the whole slug all at once, then by the end of the day, you have nothing, but the cortef may be kicking in during the last part of the day...
It's normal for the adrenals to kick in when the thyroid fails, but once we start providing thyroid hormones again, things, typically, tend to go back to normal. That's why I'm surprised that the endo started you on the cortef, even though the test was botched...
The other thing I see is your vitamin D, which is obviously, way too low. How long have you been on the 50,000 IU weekly? Vitamin D deficiency can cause a lot of hypo-like symptoms.
Due to the horrible fatigue, I'd have to wonder if you've had vitamin B-12 tested... B-12 deficiency can cause the most horrible fatigue imaginable.
It should be noted that cortef can cause weight gain, swelling/edema, dry skin, increased sweating, and some of the other symptoms you're having.
You might want to talk to your doctor about discontinuing (tapering off) the cortef, then retesting to get a proper result to see if you really need that. Perhaps the thyroid hormones and vitamins are really all you need...besides, maybe a different doctor.
Hi bizzylizzy06... Thank you for the vote of confidence... :-)
First off, can you tell me what your exact symptoms are?
Secondly, do you have current labs you could post? Your doctor should be ordering Free T3 and Free T4, along with TSH, on a regular basis. Please post reference ranges along with any results, since ranges vary from lab to lab.
Once I know symptoms and see what your actual thyroid hormone levels are, I'll be able to give you a lot more information...