Hi Allie,

Whenever an individual experiences physical, sexual, or psychological trauma in childhood, it most of the time presents issues for them through childhood, adolescence, and adulthood. The influence of stressful early experiences on the developing brain affects it greatly. Early abuse predisposes hormone systems to have a more exaggerated and prolonged response to subsequent stressors. Exposing the developing brain to stress hormones has multiple consequences as it affects gene expression, neurotrophic factors, myelination, neural morphology, neurogenesis and synaptogenesis. The impact of early stress on the developing brain depends on the age of the child (sensitive periods), vulnerability of the different brain regions, genetic and other environmental factors.

Have you ever dealt with these past traumatizing events with a therapist to just talk and express yourself in a safe environment? I am asking this..because I have seen quite a few people never deal with past trauma events and they end up affecting their adulthood years majorly, which triggers a chain reaction of events to occur from the body being stressed out.

Hope this helps,

Shannon

Dr. Jonathan Wright is in Tacoma/Seattle area. I believe Dr. Mariano respects him, maybe worth a visit?

Hopefully, Dr. M will see this thread and chime in.

@allie 984 wrote:

HI,

I am in Canada. Nowhere near Michigan, closer to washington state.
I took a medication 2 years ago that was the same as Armour. 30 mgs made me sweat, anxiety and another forum said it was probably adrenal fatigue. I just stopped taking it because I had no Dr to treat adrenals.

Yesterday I took 2 Isocort at a.m. and 1 grain of Westroid. It made me a little confused. Today I took 2 Isocort at a.m. and 1/4 grain of Westroid. I’ve been told that Westroid is as effective as Armour. I guess since I’ve never been on Armour and if the Westroid works I have no worries.
The one thing that bothers me being treated on symptoms only. But I guess that isn’t runusual. I am making a trip to Seattle in a couple of weeks so I am going to stock up on all my meds. (can’t get Isocort in Canada) only from my naturopathic Dr in another city. I’m also going to start taking Smart Focus. Apparently it is good for brain fog also. it’s full of vitamins and things. Costco in U.S sells it, can’t get in Canada.
Thanks for your encouraging words!

I am 51 years old and have had enough of taking anxiety medications, antidepressants.

I … have become almost desperate.

The question I would have is: does the physician know how to use psychiatric medications, or is it trial and error?

Whenever a person uses the word “desperate”, I know I am dealing with a person with hypothalamic-pituitary-adrenal dysregulation and high norepinephrine signaling.

First of all I come from a childhood of severe abuse. …

Throughout my childhood and youth, I was always depressed, suffered from anxiety.

As an adult I was always very thin and was treated for antidepressants from the age of 20 .

Abuse or trauma in childhood often results in hypothalamic-pituitary-adrenal dysregulation with low adrenal cortex output – including low cortisol.

I suffered from severe postpartum depression and that was when the antidepresssants started.

Pregnancy is an interesting state where metabolism is elevated and certain signals are elevated.
For example:
Thyroid hormone may increase up to 50% over non-pregnant levels.
Estrogen is at very high levels. Estrogen can have an antidepressant effect.
Progesterone is at very high levels. Progesterone has a mood stabilizing effect and anxiolytic effect.

The loss of this high metabolic state can predispose a women to postpartum depression – particularly if there are problems with the signaling systems and metabolism to begin with.

As a younger adult I was always sleepy, cold and got bronchitis almost monthly.

Sleepiness may indicate the presence of hypothalamic-pituitary-adrenal dysregulation, so long as norepinephrine isn’t excessive.

The sensation of subjectively low body temperature may occur with hypothyroidism and/or low iron.

Frequent infections may indicate the presence of an overactive immune system and a balance of pro-inflammatory vs. anti-inflammatory signals that leans to excessive pro-inflammatory signaling.

I was not able to tolerate Paxil, Prozac, or any of the drugs from that family. They worsened my depression.

I think that Nortrypliine was the first that gave me any sense of relief. I was up to 125 mg of that at one time. I was pretty out of it for a couple years on that dose!

Medications that raise serotonin signaling simultaneously may lower dopamine signaling. If a person already is low in dopamine signaling (e.g. low iron, low vitamin d, low thyroid hormone, Parkinson’s disease, etc.), then adding a serotonin-increasing medication may be intolerable and may worsen depression. The other underlying issues should be addressed first before addressing a serotonin deficiency with a serotonin medication.

Nortriptyline, notably was helpful to a certain extent. It has also antihistamine effects which may help sleep and may help reduce immune system overactivty.

In October 2004 I had a fully hysto, no ovaries left. I had severe endriometriosis. I’d also experienced severe bleeding before the hysto…. Since the hysto in October I’ve just not been myself. I often say when they removed my ovaries I think they took out half my brain.

Endometriosis may indicate an imbalance between estrogen signaling and progesterone signaling. For example, when adrenal output of progesterone is low, then Estrogen is not balanced by progesterone, predisposing a person to endometriosis.

I am on
2 pumps of estrogel,
25 mgs of nortrpyline,
.5 mgs of rivertol ( one at a.m. and one at p.m. and
50 mg of Seroquel. At bedtime. this is to help me sleep.

Seroquel is a complicated medication.

What is Rivertol? Could you give us its generic name?

In May my Dr. put me on Pristiq and told me I was depressed. Antidepressants do NOT work for me. I was on Wellbrutrin and tried Sam E and initally I felt great, lots of energy and within a few days became agitated and extremely tired and actually gained weight instead of losing it. My Dr. told me that was impossible as Wellbrutrin causes weight loss. It had the opposite effect on me!

Correction: antidepressants partially work. Some are more tolerable than others.

Seroquel, for example, has antidepressant properties and can be classified as an antidepressant.

Nortriptyline was helpful to a certain extent.

Wellbutrin helped temporarily.

SAM E helped temporarily.

Wellbutrin can cause weight gain if it worsens HPA Axis dysregulation, resulting in lower cortisol output, which then impairs thyroid signaling.

Psychiatric medications address nervous system dysfunction. They are the primary medications for doing so. With severely ill people, doing hormone optimization and nutritional optimization will not fully help someone improve. This is because nervous system signaling itself is being disregarded. Only when one addresses the full pathophysiology (i.e. all of the contributing causes) of an illness will a person improve as close to “normal” as possible.

My major symptoms are:

l

oss of libido
[*]fatigue

• weight gain

[*]extremely bad concentration
[*]unable to remember things
[*]depression
[*]anxiety and highly agitated
[*]thin hair- however not losing alot of hair
[*]thinner eyebrows
[*]tough getting going and waking in morning
[*]a bit of loss of enamel on teeth
[*]when I get a bit stressed, I sweat, get hot and can’t think straight
hot and sweating

…
TSH is only around 3.4

I am going to post these numbers which are from about a year ago.

TSH- Result – 3.4 Range- 0.38-5.5
Free T4- Result 11.1 Range- 10.5-20.0
Free T3- Result 4.1 Range 3.5-6.5

My family GP had me have a blood test for estriol ( about 3 weeks ago) and her receptionist called and told me to increase my estrogen pump to 3 from 2, I did this but I actually think I felt worse so went back to 2.

My current lab criterion for hypothyroidism related to mental illness are:
TSH >= 2.0 or
Free T3 < 3.3 or
Total T4 < 8.0

Ideally:
TSH < 1
Free T3 is between 3.3 to 4.2 in an adult
Total T4 is between 8.0 to 12.0 in an adult (not taking birth control or extra estrogen).

Achieving these targets means addressing problems in other systems – such as improving HPA Axis regulation and improving nutritino otherwise thyroid hormone becomes intolerable.

I recently spoke to a naturopathic dr. and he has started me on Isocort and Westhroid 2 grains / day.

I”m slowly trying to add these. He wanted me to start on 4 Isocort at rising and 2 at noon, 1 grain of Westhroid at a.m. and one later in the day.

I started on the Isocort about 2 weeks ago. I am only on 2 Isocort and 1 Westhroid – today is first day for Westhroid and I’m feeling kinda spacey and my mind is kind of foggy and I’m a bit shakey.

If a person has significant HPA Axis Dysregulation (e.g. in Posttraumatic Stress Disorder, I often find morning Cortisol < 5), then Levothyroxine is more easily tolerated.

I want to get off all these antidepressants and antianxiety meds. I’ve tried to get off Pristiq and it was hell. Any suggestions on getting off this stuff?

… My last physical about 2 months ago.

My Iron hemoglobin was at 11 – I think Dr. said ferritin was within normal range; she put me on 300 mg of iron but I changed it to 18 mg of full absorption.

I’m being tested for celiac disease.
My potassium has been a little high.
My kidney function was a little low.

What is the ferritin level? “normal” depends on what one is looking for.

When it comes to mental function, in a woman, my current ideal ferritin is 100-120.

It is far more useful to target ferritin for iron treatment than the other measures of iron.

…

Yes, I have dealt with those issues in my life. I don’t have the flashbacks that I used to have.
In the last couple years my counsellors and others have all stated they believed I had hypothyroid.

…

I am in Canada. Nowhere near Michigan, closer to washington state.

I took a medication 2 years ago that was the same as Armour. 30 mgs made me sweat, anxiety and another forum said it was probably adrenal fatigue. I just stopped taking it because I had no Dr to treat adrenals.

Yesterday I took 2 Isocort at a.m. and 1 grain of Westroid. It made me a little confused. Today I took 2 Isocort at a.m. and 1/4 grain of Westroid. I’ve been told that Westroid is as effective as Armour. I guess since I’ve never been on Armour and if the Westroid works I have no worries.

The one thing that bothers me being treated on symptoms only. But I guess that isn’t runusual. I am making a trip to Seattle in a couple of weeks so I am going to stock up on all my meds. (can’t get Isocort in Canada) only from my naturopathic Dr in another city. I’m also going to start taking Smart Focus. Apparently it is good for brain fog also. it’s full of vitamins and things. Costco in U.S sells it, can’t get in Canada.

…

I’ve been doing alot of research on this myself. I am being treated for hypothyroidism and adrenal fatigue. Hopefully, once my levels are normal I will start to feel better.

…

Thanks for your posting. I wept when I read it. I also attended AA and got alot out of it. I don’t blame my father for what happened because he was tortured as a child and was a prisoner of war. When he got help for his PTSD he was a new man. Finally, he was a happy man and enjoying life and he got sick with lung cancer and died.

I read your suggestions. I’ve started Isocort and 1/4 Grain of Westroid, yesterday I felt great. Today I feel awful. The sweats are so bad, I’m agitated and feel nauseated.

…

I just read your story on the other site. Wow, are you sure you’re not my twin ?? Our stories are VERY similiar, other then the fact that I am female. But many things that you wrote about, I also experienced.

I recall 2 years ago starting a new job. I had just moved to a new city and was hired to work 15 hours a week. They were scheduling me for 40 plus we were trying to start a new business. I was starting to think I was losing my mind. I had worked for this same company 22 years. My brain was so bad that I could not grasp anything. When I was assisting clients I would start to sweat, my mind would go blank and I ended up having to go to the ER. They sent me to the psych ward; here they interviewed me and felt I neeeded to be off work. Before I was leaving the ward the nurse took my blood pressure; and she said OMG do you need to lie down? I said to her ‘Oh, my blood pressure is always low” she said “I think you shoud lay down.
Later that same day a Dr that had ordered some blood work called and said he wanted to see me.

When i went to his office he told me I was anemic and that my pottasium was high. He said he didn’t know why that would be. So anyway, he told me to increase my anxiety meds from 50 mg to 125mg

High pottasium , anemic, low blood pressure, sweating…. no concentration. and the list goes on. BTW I just read a very interesting article about low sodium also. I am due to have my sodium and pottasium checked. I am sure these are going to come back abnormal. If so, would you say this adds up to low aldosterone?

Are there too many doctors / cooks?

I wonder if the naturopathic doctor can take over much of the treatment particularly if the goal is improvement in mental health.

I also wonder if nutrition is being addressed adequately. Low iron means there may be many nutrients which may be deficient.

If one was manipulating health at the level of signaling systems alone, then one is missing a huge area – metabolism and nutrition.

My other posts list a good book as a starting point for nutrition.

@allie 1078 wrote:

I’ve looked both of these terms up. If in fact I have hypothalamic-pituitary-adrenal dysregulation and high norepinephrine signaling. What are the treatments? I researched and found possibly GABA for the norephinephrine. Are there tests to diagnose ?

Treatments are aimed to target problems in the nervous system, endocrine system, immune system, metabolism and nutrition. HPA Axis dysregulation often has an immune system component, not just a nervous system and endocrine system component. Nutrition plays a large role.

There are many many approaches. Too many to discuss.

The treatments include psychiatric medications, other medications, a few herbal medications, hormonal treatments, nutrients, and behavioral treatments.

Before my hysto (ovaries removed) I was always cold, since my surgery I would go from cold to hot and hot to cold. Now I am always hot and sweat, but very little sweat. My temperatures are never low.

Hot flashes occur from surges of norepinephrine in an attempt to generate energy or maintain body temperature.

What is your left armpit temperature?

Improving HPA Axis regulation- Does this mean using Isocort?

IsoCort is one option in treatment. There are numerous options. One reason I have so many options is that I am a psychiatrist. Other specialists are not as familiar with the nervous system side of treating HPA Axis dysregulation. Nearly every psychiatric medication is an option in treating HPA Axis dysregulation, for example. But they have to be used wisely, with knowledge of how they affect the rest of the systems – which unfortunately is not well researched.

When you are treating your patients do you do salavia testing of cortisol before using treatments such as Isocort?

I use to do saliva testing. The problem was it was an out-of-pocket cost to patients and thus would end up being very expensive over time if repeated. Large national labs, such as Quest Diagnostics, have added saliva testing to their test menu. This is exciting in that it would then be covered by health insurance. But I’ve moved forward. Using conventional tests, I can get the same outcome.

I have 1 doctor. She prescribes my medications. I just started with the naturopathic Dr who has started me on the Isocort and thryoid med. I am hoping that I can talk to my family GP and she will work together with me on this .

I am working on the nutrition.

I have limited funds at this time. If you were to recommend testing which would you think are the most important at this time.
I have just read a book “You’ve hit menopause, now what? ” by Dr George Gillson and Tracy Marsden which I found very informative.
Stated that women who have their ovaries removed almost always have adrenal fatigue and DHEA problems.

A bare bones initial panel may include:

Free T3, Total T4,
Cortisol AM, DHEA-s, Progesterone,
Total Testosterone, Ultrasensitive Estradiol,
Fasting Insulin,
Comprehensive metabolic panel, Lipid panel,
Vitamin A (total retinol, total retinyl palmitate),
Vitamin D 25-hydroxy,
Vitamin B-12, Folate,
Methylmalonic acid urine,
Homocysteine,
Ferritin

An even more bare bones version would include:

Free T3, Total T4,
Cortisol AM, DHEA-s,
Comprehensive metabolic panel,
Vitamin D 25-hydroxy,
Vitamin B-12, Folate,
Homocysteine,
Ferritin

The less information I have, the greater the emphasis on the history and physical exam, and the fewer options there are in treatment. For example, it is very difficult to determine ferritin level from the history and physical. Both high and low levels can look alike, other than skin discoloration at the higher end, though this may not be apparent unless ferritin is extremely high. Thus, outside of diet and replacement level iron supplementation, I can’t be too aggressive in considering treatment with iron, given the risks involved. Reproductive hormone treatment would be very difficult to do without lab tests since they have so many interactions with the rest of the system, making it difficult to determine whether or not the level of testosterone or estrogen is high or low without plainly obvious signs.

One of my patients could only afford two lab tests. I ordered Total T4 and Ferritin. The Total T4 would give me an idea of the total deficit in thyroid hormone production she had given equivocal findings on history and physical. Outside of reproductive hormone treatment – which I would not consider in her – the much of the treatment was accomplished with information from the history and physical exam.