[saltimbanc0]

To try and answer the questions, yes taking low doses that surpress your own acth output and therefore cortisol levels but dont fully replace your needs can cause a relative AI situation.

It is quite likely by increasing your metabolic rate with the cytomel you pushed your adrenal capacity beyond what it wa capable of, ideally it would be better to be more careful with the cytomel than have to use the hc again – its not as simple as a few days to rest the adrenals or anything like that and you are risking complications and further problems taking thyroid meds, especially cytomel (t3).

I would really recommend getting a proper adrenal work up so you know what your body is capable of.

I have been on high dose steroids (pred and hc) in the past and not gained any weight, and then another time gone very cushingoid. Likewise before i was diagnosed but had symptoms of addisons i gained weight being hypoadrenal so both extremes CAN cause both changes in weight.

Often its forgotten/overlooked that without adequate cortisol your body doesnt/wont convert t4 to the active t3 which would also explain why you had good results with supplementing t3 directly but you would be much better long term and healthier to get the adrenals functioning right and not taking thyroid meds rather than having to take both which can eventually cause dependance and further problems.

[saltimbanc0]

Questionng – if troubleis HIGH NE then why are you not trying to reduce this rather than raise Serotonin – altho the hae opposing effects you will just be cuasing a second high level to mask the problems of the first. Also NE has many systemic effects tht raising serotnin wont cancel out.

Have you tried GABA supplements?

[saltimbanc0]

Try L-Dopa/Mucuna Pruriens. Dopamine is still a precursor to NE and will be broken down to that if required.

[saltimbanc0]

The bloods that took forever…..Here they are:

Free T4: 16.9 (10.5-25)
Free T3: 3.4 (2.3-6.5)
TSH: <0.01 (ive been on levothyroxine for a few years so no big suprise – but a highish t4 intake is not making a difference or pushing t3 up…)

Testosterone: 10.5 nmol/l (8-30)
Oestradiol: 83 pmol/l (0-150)
Progesterone: 0.8 nmol/l (0.7-4.3)

DHEA: 1.5 umol/l (0.45-13.4)

Seems to me some pretty obviousl things to address and the way to fix them but wanted to get your opinions without pushing for answers i think i want to hear first.

As mentioned earlier, meds are:
HC – 30/40 mg daily
Synthroid – 200mcg daily (time to change?)
Azathioprine: 100mg daily (also humira 40mg every 2 weeks subQ)

5htp: 200mg daily, L-dopa: 100mg daily, Melatonin some nights. Vit D – 5000iu, Multivit with zinc.

Came off venlefaxine 2/3 weeks ago hence the 5htp and ldopa to help as i withdrew.

Current issues: Fatigue, imsomnia (broken sleep no more than an hour at a time and 4 hours a night) severe brain fog, joint pain, slow healing, NO libido, low temp, depression/apathy, hypoglycemia and intense hunger at night only.

Hope someone can offer some ideas 🙂

Cheers

[saltimbanc0]

As with most people and threads here, more info is required. Have you checked your thyroid ranges lately? Cortisol levels need to be known too.

“Brain fog” is one of my biggest problems without enough cortisol but sometimes its not just cloudy its just im not able to concentrate (when NE is too high).

IF high NE is the problem its quite likely to be a result of low cortisol, you would also be noticing other symptoms such as fatigue, blood sugar instability etc but these are very similar to hypothyroid symptoms.

I would recommend blood work if you are not stuck in the dark ages (UK) and can get them done. Never a good idea to play with things if you dont know whats broken.

With regards to reducing high NE if that is the case, make sure the A/D meds you are on do not have any other interactions – it its an exclusive ssri (i would try to avoid that before i even started on it as its not going to treat underlying issues and will most likely cause more problems long term).

GABA is the inhibitory neurotransmitter which effectively quietens the stimulatory effects of NE and Dopamine in the brain, i found taking this at night really made a difference in letting me switch off but hadnt solved the problems entirely. (i still havent slept through a night for over 4 years and dont get more than an hour or 2 at a time and about 6 hours a night – not good for a 23 yr old). GABA can be bought as a dietary supplement and i use 1000-1500mg at night.

See if you can get any more bloods to help pinpoint potential causes first though.

[saltimbanc0]

Good old doctor – your anxiety is high so without looking into the cause of that and potentially the high blood pressure etc he just whacks a plaster on it to over it up (the lorazopam).

Anxiety, high blood pressure, lack of concentration (feeling “wired but tired”) feeling warm even when body temp is not too high, trouble maintaining good sleep – ALL symptoms of HIGH NORADRENALINE.

[saltimbanc0]

Alas despite several messages and hasing no contat from Dr Peatfield (he is hard to track down!)

Fortunately though i HAVE found a good endo it seems who i met on Friday, he seemed to be able to comprehend things and said first of all we need to do a day curve on meds to see what my cortisol is doing and how im absorbing meds. Then we can start ruling things off from there- some words of sanity! (albeit it will cost me a fortune as its all privately funded – insurance wotn cover it and i will have to book a funeral before i get any NHS appointments)

My MLM preg arrived today and il try that and see if it helps anything, i know first we have to get the cortisol and thryoid meds balanced and then we will have to look into tuning the other bits (im sure there is a lot to do there). I will do anything, go annywhere, try or take anything to get myself back. Cant stand being this fat bloated wreck who cant get out of bed half the days of the week to even work, the mental anguish of seeing this all slip away despite fighting tooth and nail and wondering what happened to the athlete who could push himself through anything reach any goal and was in really great shape physically.

For anyone in england there was a real eye opener in the daily mail health section where a junior doctor spoke out about what really happens in nhs hospitals now and why the system is such a pile of ****.

[saltimbanc0]

Hopefully he will update and give us his views.

Im doing much better on nothing overall than when i was on the SNRI. BUT i dont feel sharp like i used to during the day. Working with tyrosine supplmentation (precursoer for dopamine and then NE) and then taking 5htp in the evenings (precursor to serotonin).

If you re feeling too stimmed at night then GABA is extremely effective – this was the only thing able to turn me off when the NE was too high but it wore out halfway through the night when i was on the SNRI due to the NE levels staying chronically elevtated. Now rather than blocking excess NE with the GABA i am working my way up from the other end of the spectrum – too low NE during the day but i think better this way for now so i can get some sleep and avoid the antidepressant type meds throwing me more off balance.

Getting rid of the sweats and feeling hot all the time is a plus too but it hasnt actually effected my body temp which is still stupidly low (waking temp was 35.6 today). I think i need to keep tweaking my thyroid (have been on HC and t4 for a long time due to addisons) and i know hypothyroidism can also cause big problems with depression/mood/lethargy….

[saltimbanc0]

Sounds lke you want something that is exclusively focused on the dopamine and not the NE.

I think you’ll be looking more towards Parkinson type drugs – bromocriptine, cabergoline. You mention you have tried selegeline in the past though… I think thats the same family of drugs.

Have you tried supplementation with prescursors? Tyrosine or L-Dopa. The problem with reuptake inhibitors is that take a while to work and just elevate the levels of what you have too long sometimes. With increasing the raw product there is at least the opportunity for it to degrade naturally and levels to drop – you can then increase the supplementation whereas with blocking reuptake of them you have less control.

Generally speaking antid-depressants are worth avoiding if you can find relief another way but that said they are extremely effective and useful IF there are no other methods and the patient is aware of the long term risk/benefit profile of the drug they are prescribed.

[saltimbanc0]

Thanks – firstly for reaffiriming my “impossible” revelation to the endo i was with that i might need more cortisol at night.

I had read a lot about Dr Peatfield and trie to get in touch but he seemed to be moving or not fixed to a location at the time and i never got a reply. From his blogs etc i could see he was proactive and open mined and definitely someone i wanted to bounce ideas with and have some advice. I will try again to contact him as soon as these bloods are back an idea have an idea where im at. Also was lucky enough to find a private GP who kind of gets it – he has a sport background and can relate to an elite athlete suddenly being bedridden, jobless and worse (for me) unable to train and do the sport they dedicated their life to. He is referring me to a speicialist he can ork with and im happy to do that if it yields results. He was pretty off the radar i think for the same reason Peatfield and Dr Carhill are/were – they get ostracised for actually doing their jobs and being proactive!

Il keep posting here in the hope more people can offer their experience and advice as it really does help and hopefully i can add to the “good news” stories on this board in the future 🙂

[saltimbanc0]

Thanks for the post and ideas,
I take a high dose vit D supplement now (for the last 2 months or so) or exactly those reasons. I also check all my salt intakes because of the addisons and need to keep blood pressure stable.
B12 i can only keep up by either sublingual drops or injections, i know you cant overdose as its water soluble so generally take this enough to keep levels in range.
The problem with the diet, even things for the Crohns, at the moment is these night time problems that were only alleviated by the carb consumption (having qualifications in psyh and nutrition it was tough feeling it was a mental thing and also knowing what i should be puttting in me realistically but this was the only way i was managing to avoid adrenal crisis).
If things stabalise enough for me to sleep through the night without problems im sure gluten free will be easy enough to try – i have been able to cut any food group before or even do liquid fasts when it was just the crohns and addisons (taing hc) that were the problem. now with all this other stuff, well i can be fine in the day but im a different beast at night.
Hoping to learn from the bloods im doing this week if there are any BIG imbalances ith hormones. From there i can track back and look at dietary influences that could alleviate this.

[saltimbanc0]

Last night was hopeless again, by 7pm i was wasted but couldnt switch off. By 10pm the joint pain, carb craving and other problems came back and i also had a toothache (often inicator of low cortisol in me). I also had a hell of a lot of cramp last night in mall my muscles and kept taking on extra fluids and salts, it as still there this morning but again ive had another night of no/poor sleep and a lot of eating and have gotten up feeling naff and unrested.

The t3 dosing sounds very frequent, i am suprised its that often but i guess i can just do 3/4 doses at the same time as my cortisol seeng as i dont/cant forget that (i know about it within 30 mins if im late).

Hoping the T3/temp/metabolism/weight loss does work but i know for sure if i had energy to be up and about and was able to sleep i could drop it (when i was training food was just fuel and i could manipulate my weight no problem through diet and exercise to be in the shape i needed to be for competition – that was about 30kg ago now though).

Would it be likely that low test and high e2 could also make a big difference to this?

Results from Friday:

FBC – fine:
WBC – 9.65
RBC – 4.96
HB – 149
MCV – 95.6
MCH – 30.1
Platelets – 356
Neutrophils: 5
Lympocytes – 3.4
Monocytes -0.9
Eosinophil – 0.1
Basophil – 0

Just not sure how this reflects ongoing infection in light of the immunosupressants etc…

ESR – 11 (>10)
b12 – 489 (been taking sublingual b vits)
Sefum folate – 8.5

Na – 141
K – 4
Creatinine – 97
Urea – 6.4
GFR – >60 (range starts at 60?)

ALT – 44 – high
Alk Phos – 134 – high

FSH -6
LH -3.7

TSH – 0.03
Free T4 – 11.7

9am cortisol – 69 (range starts something like 260-800)- HOLY ****! I am suprised i managed to walk in and out before taking my meds and i know i literally swallowed them as i walked out of the clinic as i knew i was low.

So its on to the private bloods to see what IS the problem:

Testostorone, Estrogen, Progesterone, DHEAS, Pregenolone (if they test it here) Free T3, RT3 (if they test it here).

ANy others? :confused:

Kind of trying to keep my head up by telling myself it IS possible to get things balanced and find a day i can bounce out of bed having slept, workout and work as usual and get my physique and life back even if im not still going to the olympics. The idea of climbing out of this hole yet again is tough when its been a 3 year history of fighting my hardest only to slip back worse than before. 🙁

[saltimbanc0]

Having dropped the SNRI completely a week ago (its been a hellish week) I am now sleeping better but very up an down emotionally in the day, am taking 5htp throughout the day and Ldopa in the morning to try and boost the flagging neurotransmitters – seems to be working. Just the fact i am getting a few hours or more sleep is HUGE! Also the sweating has pretty much gone (some clever sausage said this was prob due to high NE and this would confirm that).

I finally got a confirmation of the infection and have targetted antibiotics (yep another one!) an am on aciclovir to clear any reactivation of shingles. Am debating whether to counter with something for candida/yeast after the antibiotics with having had so many but otherwise will just stick to high dose probiotics. Finally getting on top of the infection and getting the sleep to improve are pretty huge steps forward but now i have a HUGE climb ahead…

Have stacked the weight on from being stuck in bed with crashing blood sugars etc and am desperate to shed this quick, knowing the sex hormones and thyroid numbers will give me a clue if anything is holding me back with that as i sure dont have any pep or drive at the moment and seeing a fat bloated wreck in the mirror doesnt help.

Have followed recommendation on other sups- digestive aids etc. Only thing outstanding is the ******* pregenenolone (typical post delays). I will prob get an idea from the bloods if lots of hormones are low just how important the preg is but i cant get to any labs that will test pregnenolone at the moment.

[saltimbanc0]

What were the initial reasons for taking clomid to increase things? Your FHS, LH and test were all pretty good prior to that. Now just seems you have built up the test only to have it negated by problems caused by high estrogen?

[saltimbanc0]

@DrMariano 3271 wrote:

This is a reason I prefer medications that have a single mechanism of action. I can more easily control the signaling process and reduce complications. For example, if I wanted to increase norepinephrine while increasing serotonin, I can simply add a stimulant to the treatment and can control dose – rather than have a one-size fits all treatment as with the combination medications.

Thyroid hormone deficiency or inadequate thyroid signaling, is one of the exceptions in that it can be observed on physical exam. However, at which level of signaling does the problem exist is more difficult to determine. For example, is thyroid signaling impaired by impaired production of thyroid hormone, by impaired transport into cells, by impaired cofactors such as vitamin A and iron and the b-vitamins, etc. etc. Lab testing helps clarify the issues. Otherwise, adding thyroid hormone would still be a clinical trial or trial and error treatment.
—

Hydrocortisone alone is an incomplete treatment, which also can cause deficiencies in the other adrenal hormones when given alone. Many people can tolerate these problems (e.g. reductions in progesterone, DHEA, estrogen, testosterone, pregnenolone, etc.). But many cannot and need replacement of one or more of these other hormones to have a more complete and adverse-effect free treatment. The minimum would be to pair hydrocortisone with an androgen (such as DHEA), if tolerated – which in some women and men is not.

Are you saying you would use an SSRI and then IF necessary add a stimulant during the day? Would a similar benefit be possible with 5htp for the serotonin and if not what SSRI do you recommend with weight gain being a worry?

I intend to retry LDN when i am able to sleep again and a seeking supplementation of pregnenolone but it seems there are very few products that are absorbed and bio-available.

My testosterone has tested low before and DHEA was non existant but since adding it i have had so many other problems countering i all that i have no idea if it helped.

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