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Wow Allie Dr. M jumped in here with both feet I can’t tell you how great he is we have been posting back and forth for some time.
One thing comes to mind that is going on Isocort needs to be started low and slow I started on 2 pills and went up 2 pills every 5 days until I was doing 4 pills in the morning and 2 at lunch and dinner time for a total of 8 pills a day. I started on Armour witch is about the same as Westtroid 1/4 Grain with the first 2 pills of Isocort. I then took my Temps after being up 3 hrs every 3 hrs. 3x’s a day then I would add them up and div. by 3 this is the avg.
If your avg. gose up or down more then 2ths your adrenals are not supported yet and going up on Thyroid meds can end up pooling in your blood and not get carried into your cells.
So this can take some time starting on meds one needs to give them time to work.
Some times peoples adreanls get supported fast and the need to go higher on your Thyroid meds makes you feel hypo again after just starting it. So I went up every 2 weeks 15mgs when my adrenals were supported. Talk with your naturopathic Dr. about this most if them are very good with this problem.
You can read how I got started at my Thyroid forum here is a link it might help you.
http://forums.realthyroidhelp.com/viewtopic.php?f=5&t=24
Like you I am not a Dr. just a person that has suffered in the wrong hands of some Dr.’s.I have learned a lot from Dr. M he is great most of what he has said in the past put me on the right track in finding out what was wrong with me.
It’s a shame you can’t get to see him I am sure he is the Dr. that could help you a lot of people fly in to see him and he then can test and treat you by Email.
Quote:
Hot flashes occur from surges of norepinephrine in an attempt to generate energy or maintain body temperature.
What is your left armpit temperature?
Hi Dr. M,
thanks for all the info. I’m just trying to absorb everything right now. My brain works a little slow most days.
My left armpit temperature is 96.5 – that’s today. using a digital thermometer.
Yesterday, I did as my naturopathic Dr had suggested and took
4 Isocort at rising and 1 Westroid.
2 Isocort about 5 hours later.
1 Isocort EveningAlthough I was hot, it was not too bad. I also got alot done and my concentration level seemed better. I even felt like eating. I slept like a baby last night.
My labs came back on the Ferritin, Celiac, Sodium and Potassium. Yesterday my Dr. nurse called and told me they were all normal, but my iron was a little low. ( I have been supplementing)
I am going to see her tomorrow to get the results and will post them.I am also going to discuss with my naturopathic Dr. having these tests done that you have suggested.
I wish I could fly to see you! Unfortunatly, I’m in Canada and financial times are rough right now. Anybody that has the means to see Dr M, is LUCKY!
I am just so thankful for these forum boards.
__________________________________________________500 mg Vitamin C
1000 mg D
Iron supplement
2 Pumps Estrogel
50 Mg Pristiq (ugh) – Wanting to get off this one as I think it’s contributing to the sweating.
25 Mg Nortrpyline
50 Mg Seroquel
.5 Mg Benzo’s twice daily.Hi Phil,
Oh, I know Dr M is amazing! Took my temp under my left armpit. Totally different temperature.
Yes, I did read how you went up on your Isocort and Westroid.
I feel that I need to give my naturopathic the benefit of the doubt. If I ‘m going to be under his care. I am going to try this and see how I feel. If it doesn’t work out, then I will have to seek out other options.
My family Dr. has been so adamant that my thyroid levels are normal, that she has me wondering. I don’t have some of the symptoms that alot of people have that are hypo, even though my last TSH was 3.1.I’m going to talk to my naturopath about dong the salava testing. I am fearful of coming off the Isocort to do the Cortisol levels as I did try for 1.5 days and crashed. I was sweating so bad, and so unmotivated I did nothing but lay in front of a fan. (it has been hot here also), but I just can’t seem to tolerate the heat.
I really appreciate your information- you put alot of insight into my husbands problems also. thanks so much!
@pmgamer18 1121 wrote:
Wow Allie Dr. M jumped in here with both feet I can’t tell you how great he is we have been posting back and forth for some time.
One thing comes to mind that is going on Isocort needs to be started low and slow I started on 2 pills and went up 2 pills every 5 days until I was doing 4 pills in the morning and 2 at lunch and dinner time for a total of 8 pills a day. I started on Armour witch is about the same as Westtroid 1/4 Grain with the first 2 pills of Isocort. I then took my Temps after being up 3 hrs every 3 hrs. 3x’s a day then I would add them up and div. by 3 this is the avg.
If your avg. gose up or down more then 2ths your adrenals are not supported yet and going up on Thyroid meds can end up pooling in your blood and not get carried into your cells.
So this can take some time starting on meds one needs to give them time to work.
Some times peoples adreanls get supported fast and the need to go higher on your Thyroid meds makes you feel hypo again after just starting it. So I went up every 2 weeks 15mgs when my adrenals were supported. Talk with your naturopathic Dr. about this most if them are very good with this problem.
You can read how I got started at my Thyroid forum here is a link it might help you.
http://forums.realthyroidhelp.com/viewtopic.php?f=5&t=24
Like you I am not a Dr. just a person that has suffered in the wrong hands of some Dr.’s.I have learned a lot from Dr. M he is great most of what he has said in the past put me on the right track in finding out what was wrong with me.
It’s a shame you can’t get to see him I am sure he is the Dr. that could help you a lot of people fly in to see him and he then can test and treat you by Email.
@allie 1136 wrote:
Hi Phil,
Oh, I know Dr M is amazing! Took my temp under my left armpit. Totally different temperature.
Yes, I did read how you went up on your Isocort and Westroid.
I feel that I need to give my naturopathic the benefit of the doubt. If I ‘m going to be under his care. I am going to try this and see how I feel. If it doesn’t work out, then I will have to seek out other options.
My family Dr. has been so adamant that my thyroid levels are normal, that she has me wondering. I don’t have some of the symptoms that alot of people have that are hypo, even though my last TSH was 3.1.I’m going to talk to my naturopath about dong the salava testing. I am fearful of coming off the Isocort to do the Cortisol levels as I did try for 1.5 days and crashed. I was sweating so bad, and so unmotivated I did nothing but lay in front of a fan. (it has been hot here also), but I just can’t seem to tolerate the heat.
I really appreciate your information- you put alot of insight into my husbands problems also. thanks so much!
One of the rules of thumb in medicine is to always look at the patient first to determine if there is a problem. Then you confirm the problem with a lab test.
One of Ron Rothenberg MD’s favorite statements is “When in doubt about a lab test, look at the patient.” Don’t rely only on the lab test to determine what is occurring. He is a famous anti-aging specialist, a professor of family practice at my medical school, UC San Diego.
When I examine a patient, I take their history then do a physical exam. Based on this information, I determine if there is a problem with the patient’s neurotransmitters, hormones, cytokines, nutrition, etc. Then I look at the lab tests to confirm what I am seeing. I find it a lot of fun to predict the lab results based on the history and physical. Often, my findings match the lab. The advantage I have is that I can correlate the lab test results even within the “normal” range with a person’s behavior.
Too often doctors cannot read lab tests correctly. They were taught that if a lab test result is within the reference range, it is “normal”. But that is not true. They have to correlate the result with physiologic function, not a reference range. They don’t realize that a reference range is a statistical arbitrary choice, that health occurs within a continuous spectrum rather than black and white ranges.
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In regard to the saliva test for cortisol, I would not stop the patient from taking IsoCort when doing the lab test. What would that accomplish?
The only reason to stop IsoCort prior to the test is to determine if the patient has restoration of function in the Hypothalamic-Pituitary-Adrenal Axis so that they would no longer need IsoCort. But this would be at the end of the treatment, never in the middle of treatment. For example, this may be done 2 years after treatment, as discussed in the book, Adrenal Fatigue by James Wilson ND.
The purpose of doing a saliva test during treatment is to determine if the dosing is appropriate and to see whether or not the treatment is accomplishing the task of at least restoring appropriate cortisol levels necessary for adaptation to stress. To do this, I would not stop IsoCort. Stopping IsoCort would be like stopping testosterone replacement therapy before determining testosterone level.
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Rather than doing a saliva test for cortisol, I find it easier to just do a blood test with a morning cortisol, DHEA plus or minus the other adrenal hormones to determine the output profile of the adrenal cortex. As a person improves, the AM cortisol rises up to the usual target of between 17-20 ug/dL.
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I find the use of cortisol and other adrenal cortex hormones a supportive treatment. I usually do not find it sufficient to restore HPA Axis function when a person has a mental illness such as depression or anxiety. It can help improve function but it does not ultimately restore function so that cortisol replacement can be ceased.
The other problems in the nervous system, endocrine system, immune system, metabolism, and nutrition and psychological issues have to be addressed before HPA Axis function can be restored. In other words, the whole system has to be tuned up. The HPA Axis dysregulation resulting in low cortisol output is the manifestation of other problems in the system. Adding back cortisol and other adrenal cortex hormones cannot fully address these problems (e.g. hypothyroidism, nutritional problems, excessive sympathetic nervous system activity, excessive pro-inflammatory cytokine activity, insulin resistance, etc. etc.).
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If you read Hypothyroidism Type 2 by Mark Starr MD, you can see how armpit temperature can be used to help determine thyroid hormone status.
Things are much more complex than Mark Starr’s account, however. For example, temperature does not mean only thyroid hormone level, rather temperature is a summation of both thyroid hormone signaling, norepinephrine signaling, and metabolism-nutrition. These factors have to be teased apart before one can fully rely on temperature as a thyroid measurement.
Generally, a left axillary temperature under 97.0 degrees F, is going to at least indicate the presence of suboptimal thyroid hormone signaling (either at the signaling level or metabolic-nutritional level). When it gets close to 94.0 degrees, the amount of thyroid signal loss is larger. Adding more thyroid hormone won’t correct the metabolic-nutrient defects, though may help function to a limited extent. Overshooting the mark with thyroid hormone treatment may occur if one doesn’t take the metabolic issues into account. One will have to be ready to make adjustments in thyroid hormone (either increasing or decreasing) depending on metabolic-nutritional status.
Realizing thyroid treatment can overshoot the mark, I no longer agree with Mark Starr on using massive doses of thyroid hormone to try and raise temperature up to 98.0 degrees since later down the road almost all the time, I will have to reduce the dose since the patient will start developing signs and symptoms of hyperthyroidism when the rest of the system is fixed. From his point of view, one doesn’t do lab testing, rather one simply relies on armpit temperature to determine the dose of thyroid hormone. This view is too simplistic, essentially using thyroid hormone as one’s primary and only tool.
My current rule of thumb is to achieve at least a total T4 of 8.0, with a maximum of 12.0. Then address problems in the rest of the system before considering any further increase in thyroid hormone. Interestingly, I seldom see a patient who needs more than the usual physiologic maximum total T4 of 12.0.
My labs- Other then the ferritin being low any other things I should be concerned with?
What would be causing low Urea?Ferritin Result 14 – Range 20-160
General Chemistry:
Sodium 139 – Range 135- 145 mmol/L
Potassium 3.9 Range 3.5-5.0 mmol/L
Urea 2.6 Range 3.0-7.5 mmol/L
Creatinine 70 Range 50-100 mmol/L
Estimated GFR 77 mL/min/1.73 sq mSerum Proteins
1gA 1.88 Range 0.60-3.00 g/LImmunology
tissue Transglutmase Ab igA 2 Range 0-20Pathologist comments: 1gA tissue Tansglutaminase Ab negative. Fales negative result may be seen in the setting of IgA deficient and dietary gluten withdrawal
I would check your Aldosterone and Renin levels your sodium is on the lower side with Postassium does the heat of summer bother you are you craving salt and feel dehydrated. I have this problem and was put on florinef .1mgs in the morning with 1 tsp 3x’s a day of sea salt in my water starting first thing in the morning. After this I felt great now that I had bypass sugary they took me off it. I am retesting Aldo and Renin again feel bad the way I did before taking florinef. And I am dehydrated my sinus drainage is so dam thick I can’t get it out of my throat. Here is a good link about this problem that happens from bad Adrenals or being Secondary.
http://www.tuberose.com/Adrenal_Glands.htmlHeart Dr.’s have me on a low sodium diet only 1200 mgs / day I feel they are dam wrong about this.
@allie 1159 wrote:My labs- Other then the ferritin being low any other things I should be concerned with?
What would be causing low Urea?Ferritin Result 14 – Range 20-160
General Chemistry:
Sodium 139 – Range 135- 145 mmol/L
Potassium 3.9 Range 3.5-5.0 mmol/L
Urea 2.6 Range 3.0-7.5 mmol/L
Creatinine 70 Range 50-100 mmol/L
Estimated GFR 77 mL/min/1.73 sq mSerum Proteins
1gA 1.88 Range 0.60-3.00 g/LImmunology
tissue Transglutmase Ab igA 2 Range 0-20Pathologist comments: 1gA tissue Tansglutaminase Ab negative. Fales negative result may be seen in the setting of IgA deficient and dietary gluten withdrawal
@pmgamer18 1162 wrote:
I would check your Aldosterone and Renin levels your sodium is on the lower side with Postassium does the heat of summer bother you are you craving salt and feel dehydrated. I have this problem and was put on florinef .1mgs in the morning with 1 tsp 3x’s a day of sea salt in my water starting first thing in the morning. After this I felt great now that I had bypass sugary they took me off it. I am retesting Aldo and Renin again feel bad the way I did before taking florinef. And I am dehydrated my sinus drainage is so dam thick I can’t get it out of my throat. Here is a good link about this problem that happens from bad Adrenals or being Secondary.
http://www.tuberose.com/Adrenal_Glands.htmlHeart Dr.’s have me on a low sodium diet only 1200 mgs / day I feel they are dam wrong about this.
Thanks Phil,
The Dr. never even mentioned the sodium and potassium- I asked for a photocopy of my labs. I suspected these would be in the lower range of the “normal”. So, I am going to the health food store for the sea salt. AND YES to the heat bothering me!!! It’s been hot here , it’s been 100 Degrees here and HOT, but all winter I was hot and sweating. UGH.
Yes, to the Aldosterone levels being checked. Just putting everything together.I need to get the iron up also. This really concerns me.
I’m sorry you are having problems again. I have respect for Dr’s, but as we know they are over worked and often just don’t have the time to do the assessments. I feel my physician has tried really hard to be thorough, but is so stuck on those labs numbers.
Like my husband his testosterone levels was 10. 2 the normal range was 10-200! That’s a huge difference. He’s supplementng now.
Feel better soon !!I had blood work done last Wed. see the Dr. in 2 weeks if my Aldosterone and Renin levels are the same as they were last time when I had to take florinef with Sea Salt in my water this helped me so much to feel better. I just think heart Dr.’s are not up on this and can’t see holding down my sodium like they want me. Sure is I had high BP levels and such I could see this but I don’t yet they have me on blood pressure pills and my BP is to low I get dizze standing up.
This is whay I feel my heart Dr.’s are wrong I have Adreanl problems my pituitary does tell them to work rigth. O they work when I did a ACTH stim test my levels jumped way up. Here is a cut and past by Dr. David Brownstein from his book “Salt Your Way To Health” I just don’t feel right on this low sodium Diet.
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Dietary Villain or Foundation of Health?Low-salt diets have been recommended for many years. It is not too hard to find an article in a magazine or medical journal recommending that the readers lower their salt intake. Like dietary fats, salt has become a convenient boogeyman, responsible for all manner of health ills. Government agencies, the American Medical Association, and many dietary groups all recommend a low-salt diet.
Conventional wisdom holds that consuming less salt will lower your blood pressure and reduce your chances of heart disease or a stroke. By now, everyone knows that a low-salt diet is healthy, right? Wrong. But unfortunately, this is another one of those cases where conventional medical wisdom simply does not add up.
To develop an accurate understanding of the importance of salt in a healthy diet, we must look beyond what passes for “conventional wisdom.” A review of the research literature, as well as my own clinical experiences have convinced me that unrefined salt is vital to good health.
Hypertension and Salt
Early in my medical career, I accepted the “low salt = lowered blood pressure” hypothesis unquestionably. My medical training was clear: A low-salt diet was good and a high-salt diet was bad. In all hypertensive cases, I was taught to promote a low-salt diet. In fact, I was taught that in order to prevent people from becoming hypertensive, it was better to encourage them to adopt a life-long dietary plan of low-salt. However, my experience with promoting a low-salt diet to treat hypertension was not successful. Not only did I find a low-salt diet relatively ineffective at lowering blood pressure, but I also found a low-salt diet made my patients miserable due to the poor taste of their low-salt food.
It wasn’t until I began to look at my patients in a more holistic manner that I began to research the medical literature about salt. What I found was astounding; there is little data to support low-salt diets being effective at treating hypertension for the vast majority of people. Also, none of the studies looked at the use of unrefined sea salt, which contains many valuable vitamins and minerals such as magnesium and potassium, which are vital to maintaining normal blood pressure.
The conclusion that salt causes high blood pressure is based primarily on a couple of studies; neither have conclusively established a causal link between salt consumption and hypertension.
Although considered a part of medical orthodoxy, the idea that salt consumption causes high blood pressure is relatively recent, and is, in fact, based on questionable conclusions drawn from a handful of studies.
The first report of a relationship between salt and high blood pressure appeared in 1904. Two researchers, Armbard and Beujard, asserted that salt deprivation was associated with lowered blood pressure in hypertensive patients. Over the next 50 years, this theory was tested in various studies, which usually involved giving test animals huge amounts (10-20 times greater than normal) of refined salt, to induce hypertension. As would be expected, when the animals were no longer overdosed, the blood pressure levels returned to normal.
Given the high amounts of salt being given to the animals, the correlation to a human population should have been suspect, but that did not stop medical researchers from erroneously extrapolating the results to human salt consumption.
The most popular study cited to prove the “increased salt = elevated blood pressure” link was the INTERSALT Trial. This study looked at over 10,000 subjects aged 20-59 from 52 centers in 39 countries. The authors of the study looked at the relationship between electrolyte excretion (i.e. sodium in the urine) and blood pressure. A higher salt intake will result in a larger amount of sodium excreted in the urine. Although there was a slight relationship between blood pressure and sodium excretion, a “smoking gun” could not be found. This study showed only a mild decrease in blood pressure, even when there was a dramatic decrease in salt excretion.
The results of this study did show that various indigenous groups in South America and Africa did consume relatively little salt and had low blood pressure. But these tribes were relatively untouched by modern life as whole – they generally did not drink or smoke, they were physically active and their diets consisted primarily of whole, unprocessed foods. In all likelihood, these factors were more significant in determining blood pressure levels than relative salt intake.
Study after study has failed to establish a significant causal relationship between salt intake and hypertension. In fact, there is some research that would seem to point to a different conclusion.
Every 10 years, the government conducts the National Health and Nutrition Examination Survey (NHANES). This comprehensive analysis of thousands of citizens looks at various markers of health, including the relationship between inadequate mineral intake and hypertension. After reviewing the data gathered from several surveys, researchers concluded “Our analysis confirms once again that inadequate mineral intake (calcium, potassium and magnesium) is the dietary pattern that is the best predictor of elevated blood pressure in persons at increased risk of cardiovascular disease.”
The Center for Disease Control’s own data over the last 30 years clearly shows little relationship between low-salt diets and hypertension. This data unequivocally shows that ensuring adequate mineral intake is much more important to maintaining low blood pressure.
Salt & Heart Disease
Another purported benefit of a low-salt diet is a reduced risk of cardiovascular incidents, such as heart attacks or strokes. But again, the evidence is less than overwhelming. In fact, there is some compelling research which seems to indicate that low-salt diets may actually increase the likelihood of a cardiovascular event.
Eleven trials, which included follow-up from six months to seven years, were reviewed. Researchers found that there was no difference in deaths and cardiovascular events between the low-salt groups and the high-salt groups. Systolic and diastolic blood pressure declined in the low-salt group by very small amounts. The authors of this review comment that the miniscule lowering of blood pressure with a low-salt diet did not result in any significant health benefit. They also comment, “It is also very hard to keep on a low salt diet.”
In another study, researchers examined the relationship between a low-sodium diet and cardiovascular mortality. Nearly 3,000 hypertensive subjects were studied. The result of this study was that there was a 430% increase in myocardial infarction (heart attack) in the group with the lowest salt intake versus the group with the highest salt intake.
Why would a low-sodium diet predispose one to having a heart attack? Low-sodium diets have been shown to cause multiple nutrient deficiencies, including depletion of minerals such as calcium, magnesium and potassium, as well as exhausting B-vitamin stores. There are numerous studies touting the benefits of magnesium in treating cardiovascular disorders. Adequate amounts of potassium and B-vitamins are also crucial for healthy heart. Many studies have shown that a deficiency of minerals, particularly calcium, potassium and magnesium is directly related to the development of heart disease as well as hypertension.
Unrefined Salt & Health?
We have established that a low-salt diet is not very effective at significantly lowering blood pressure in most people. In fact, as salt levels have declined in this country over the last 50 years, there has been no trend toward lowered blood pressures in the population. Could mineral salt usage result in a significantly lowered blood pressure? Many minerals, including magnesium and potassium have a direct anti-hypertensive effect. As previously mentioned, the NHANES study revealed that a pattern of low mineral intake, specifically magnesium, potassium and calcium were directly associated with hypertension. Repeated measurements over 20 years have confirmed the relationship between low mineral intake and elevated blood pressure.
Unrefined salt has a wide range of minerals including potassium and magnesium, providing the body with a complex of nutrients that it needs to function optimally. The use of unrefined salt will not cause elevated blood pressure; in fact, due to its abundance of minerals, it can actually help lower the blood pressure in hypertensive patients.
Salt & Special Health Concerns
Researchers have looked at numerous studies to arrive at their recommendations for sodium intake. Hypertensive patients can improve blood pressure moderately by limiting their sodium intake to 3-7 grams (app. 1.5-7 teaspoons) per day. Too much of anything can be a problem for the body. Salt, like any other substance, should not be taken in excess. Since refined salt is a toxic substance, there should not be any refined salt in anyone’s diet.
However, there is a great difference between refined and unrefined salt. I recommend only the use of unrefined salt in one’s diet. This will supply the body with over 80 minerals that are useful for maintaining the normal functioning of the body. My experience has shown that the use of unrefined sea salt has not resulted in elevated blood pressure in my patients. The addition of small amounts of unrefined salt to food or cooking will not adversely affect blood pressure or other health parameters in someone with normal kidney function.
While there is considerable research indicating that unrefined salt can be an important part of a healthy diet, there are some situations that do require special consideration.
For example, there are some hypertensive patients who are salt sensitive. Salt sensitivity is defined as an increase in blood pressure due to a high sodium intake. Not all hypertensive patients exhibit salt sensitivity. The only way to tell if an individual with hypertension will respond (via lowered blood pressure) to a low-salt diet is to institute a low-salt diet. The research shows that older individuals with hypertension will have a modest response. A review of 56 trials showed that a low-salt diet had minimal effect on blood pressure in the vast majority of people studied.
Another special concern related to those with kidney problems. Salt is excreted in the kidneys and individuals with renal failure will have a decreased ability to clear salt from their diets. These individuals must watch their salt intake carefully. If you have renal failure, I suggest you speak with your doctor before instituting any dietary change, including a change in salt intake.
Final Thoughts
Although promoted by conventional medicine as part of a healthy diet, my experience has clearly shown the fallacy of low-salt diets. They are not associated with a reduction in blood pressure for the vast majority of the population and also have adverse effects on numerous metabolic markers including elevated insulin levels and insulin resistance. Low sodium diets have been associated with elevating total cholesterol and LDL cholesterol levels, which, in turn, has been associated with cardiovascular events.
Furthermore, it has demonstrated that mineral deficiencies are present in most chronic illnesses and it is impossible to overcome these disorders unless mineral deficits are corrected. What conventional doctors and most mainstream organizations have failed to grasp is the difference between refined and unrefined salt. Unrefined salt contains over 80 minerals in a perfect proportion for our bodies. Our bodies were meant to function optimally with adequate mineral levels and adequate salt intake. Only the use of unrefined salt can provide both of these factors.
For the great majority of people a low-salt diet does not work. Patients do not feel well when sodium levels are lowered. Their energy level drops and they develop hormonal and immune system imbalances. It is refined salt that needs to be avoided – it is a toxic, dangerous substance that fails to provide the body with any benefit. Unrefined salt should be the salt of choice.
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