Adrenal Fatigue - Hypothyroid - Low T complications

EverSinceMono

New Member
My first post asking for help here, so I will try to include as much info as possible here, will upload my labs in excel, hope that will work. I hope this isn't too long.

Basically been to several docs and not much is working, what is the missing link?

My Chronic Fatigue History

For the last 18 years or so (around 1991) after being diagnosed with Mononucleosis, I suddenly found my self constantly tired, extreme fatigue, brain fog, frequent morning headaches, and chronic malaise. Sometimes extra sleep would work, but never felt totally refreshed, just a little better. However, spending your weekends in bed, just to struggle through the week did not seem right to me, so I went to seek medical help.

I’ve been to several Doctors over the years (being told lab tests are normal), I have tired B12 injections, vitamins and Herb concoctions by the dozens, Colon Cleansing, Fasting, Diets and juicing. Back in the 90's there was a lot of talk of the “Yuppie Disease“ or Mono - Epstein-Barr Virus (EBV), which is linked to Chronic Fatigue Syndrome (CFS) and even Fibromyalgia. Since there is not a cure for any of these, you are left with trying to treat the symptoms, which I tried for 18 years! Unfortunately I ended up having to sell my business, as I no longer had the energy or mind to cope.

Now in 2009, I am still going to medical doctors and with a change in health providers, I am now part of the Kaiser plan. I seek advice and have the doctors order blood tests, e.g. thyroid disorders, hormone imbalances, HGH, Lyme disease, etc. All tests came back “normal”. I even had testing done at a sleep center for sleep apnea and that came back "normal".

Fatigue, exhaustion
Weakness, feeling run down and sluggish
Brain Fog
Occasional Muscle cramps & aches
Impaired concentration
Hair Loss – Slow Hair Growth & dry
Decreased libido
Intolerance to cold, especially in the extremities
Night sweats (used to have, not so much any more)
Temporary morning headaches
Unexplained Lower back pain
Occasional sore throat
Occasional light headed when standing up
Depression / Suicidal - Negative thoughts
Occasional canker sores
Occasional constipation
Sensitivity to bright lights
Sensitivity to some perfumes or chemicals
Blood pressure 105/65 - Pulse rate 56

Other
Buzzing in ears, ears may plug up with strenuous exercising
Varying eyesight problems (due to age?) Starbursts around lights at night.

Symptoms seem to go in cycles and may take 4-5 days to go from severe back to normal/mild. My wife claims I must be Bi-polar. Also I may experience constipation for no apparent reason, energy levels and mood will swing from positive to negative. Moderate morning headaches (which dissipates within 20 minutes of waking) usually accompany a lower backache & stiffness for no explained reason, which will last 3-4 days. My energy level are horrible upon waking, it never seems like I get enough rest, EVER. It may not be until 10am or so that I start to feel a bit better, and energy may get better as day goes on (sometimes), however, for the most part I have increase energy in the evening, almost like my biorhythms are swapped.

Lyme Protocol
August 2006 – Thinking I might have Lyme (as I was born & raised in Upper Michigan, many ticks) I started the 100 day Lyme Borreliosis Treatment Protocol. Using Nutamedix products of SAMENTO, CUMANDA, BURBUR, & QUINA. During this time I also took another herb for 30 days called SHEOGI (Larrea Tridentata).
*While on this protocol I got tested for the Epstein-Barr virus and showed an OLD infection only.
* Tested for Borrelia Burgdorferi Antibody (Lyme) with a value of 49 range <120.
* Also tested for Erytrocyte Sedimentation rate (ESR), Westergren method, which appears normal.

I also had a HAIR analysis done around this time as well. I took supplements to help offset deficiencies.

Results: Lyme protocol had no apparent physiological effect.

Other
Even in adolescence I would occasionally have painful bowel movements resulting in diarrhea (strong peristalsis process of the intestines), which would come usually in two waves, usually during the middle of the night. Taking Alka-Seltzer seems to help alleviate, however usually within 30 minutes it is all over, and the next day all is well, no more diarrhea or pains. I may not experience this again for a year or more, when younger it seemed to happen more frequently (6months or so).

I have noticed that when I go through a bad cycle and crash I seem to have sinus congestion and or mild post nasal drip, as well as some mild constipation. Have more energy in the evenings that during day.

In regards to stimulants like coffee or soda, I tried coffee when younger and never liked the hyper feeling I got and the cotton mouth, as well as urinary effects, so I have always avoided it. Sodas, I gave up long ago as they are just sugar water and not healthy ;). Sweets I avoid, as I had acne problems in my teens and was told sweets caused it, so I still avoid them to this day, also anything to sweet or rich doesn’t appeal to me anyway;). So I do not know how my body reacts to sweets. However I do like fruits.

Alcohol: Normally I do not consume alcohol. However I MAY have a glass of wine once in a great while with dinner or special occasions. However, when I do over overindulge in alcohol for special occasions, it REALLY drains me for days, more than just your usual hangover. I will feel miserable for several days or longer… I crash, no energy and the usual fatigue symptoms.

Perfumes/Odors: Certain perfumes I will have severe reactions, runny nose, sneezing and itchy eyes. I will have to leave the room. While managing my automotive shop, I was always subject to exhaust fumes, various chemicals and solvents, exhaust fumes (carbon monoxide) seem to bother me the most.

Tongue: I have been told I have a Geographic tongue, which is more common in people who are sensitive to the environment -- those with allergies, eczema, and/or asthma.

TMJ: while not chronic, I have had several occurrences of TMJ over the years, I attribute this to stress and grinding of my teeth at night.

Hemorrhoids: Minor flare-ups from time to time usually aggravated by spicy foods and/or constipation.
…….

I do believe I have primary Adrenal Fatigue (insufficiency) with secondary pituitary issues and Hypothyroid. Low T is something that has occurred either due to age and possibly these complications?

I started an exercise program of mainly walking then working up to running about 2 years ago, and for the last 9 months I also started weight or resistance type training as well (crossfit). I was always active earlier in my life until I started having problems, which prevented me from being active, I now FORCE myself to do it. Not easy.

I feel I have always had a pretty good diet, I don’t drink coffee or sodas, don’t smoke, and aside from special events I rarely consume alcohol. It wasn’t until recently that I started to eat more green veggies, coconut oil, avocados & sweet potatoes. As far as supplemental pills, I have always taken a multivitamin, anti-oxidants, & glucosamine. It wasn’t until recently that I added fish oil, CoQ10, vitamin D, L-Glutamine, protein powder, etc. (see supplement list).

In regards to hormone therapy, I feel that nothing has helped. I pretty much still feel the same, and actually I feel my libido got WORSE! regardless of the amount of Testosterone (up to 125mg topical), DHEA (up to 50mg) & cortisol (up to 15mg). As such I left my current physician and tapering of cortisol and stopped T and DHEA. I noticed since I stopped the T & DHEA that I am dizzy and lightheaded. I have suspicions that I may me Androgen resistant. When we tried porcine thyroid I got worse, however this was during an elimination diet, so there is some confusion as to what was the cause. Looking back, it is obvious that I should not be doing an elimination diet and diagnostic replacement therapy at the same time.

I am currently trying to decipher if I have some sort of intolerance either to gluten or lactose. Order lab work from EnteroLab for gluten and casein intolerance, just trying to find answers to the primary cause and these are probably secondary to Adrenal Fatigue? Celiac disease profile lab results from Kaiser came back Negative.

I notice on my lab work that my Total T levels went down while Estradiol levels rose. My Saliva Free T levels may not have had not enough time to come down (14 days) from last supplementation.

Vitamin B12 practically doubled from last time, possibly due to change in diet?
Vitamin D levels are low, considering supplementation of 5,000IU daily.
Ferritin values came down into normal range, while Iron rose. I am not supplementing Iron, must be diet.

MCV (red blood cell size) values are high, associated with Hypothyroidism (as well as other possibilities)
Platelet count is gradually decreasing over time. Is this due to previous infectious mono (EBV).
Lipid Panel values appear normal.

PSA level did go down from previous results.
DHEA levels rose slightly, considering supplementation.
SHBG values did drop, however still high
IGF-1 value doubled, maybe due to additional exercise and diet (L-Glutamine).
Estradiol values rose, indicating aromatase converting Testosterone to Estradiol or Estrone.
Pregnenolone is within range but on high side. FSH is on the low side.
Total T levels are much lower than previous results. Blood test taken during supplementation 2/16/10.
TSH is still high, T4 free is still in low range. T3 is lower. Free T3 is low. Indicating a Hypothyroid situation is this secondary to Adrenal is the question. Reverse T3 is normal, actually right at optimal.
TgAb is on the high side for Thyroglobulin.

Saliva test: Progestorone is low, Testosterone Free is low, DHEA is low, cortisol is low

Low morning and daily average temperatures, low blood pressure 104/66

……….
Dr. Kedy Ying Jao, D.O. F.A.A.F.P
through saliva testing found my morning cortisol levels very low and my Testosterone levels below normal, noticed my Thyroid lab results, but she wanted to treat the Adrenals first. Here is the timeline:

First Initial visit 10-2-2009
Testosterone injection: 1cc (initial boost) 10-2-2009
Testosterone Cream: 10% 10mg/.01ml .5ml - .50mg once daily in AM - DHEA: 25mg daily in AM
Adrenal Rebuilder Formula (AR) (Dr. James Wilson’s Formula): 2,1,1,2 capsule, 4 times daily
Super Adrenal Stress Formula (F1) (Dr. James Wilson’s Formula): 2,1,1,1 capsule, 4 times daily

10-29-09
Testosterone Cream: 15% 15mg/.01ml .5ml - .75mg dose apply once daily in AM
DHEA: 50mg daily in AM
Adrenal Rebuilder Formula (AR) (Dr. James Wilson’s Formula): 2,1,1,2 capsule, 4 times daily
Super Adrenal Stress Formula (F1) (Dr. James Wilson’s Formula): 2,1,1,1 capsule, 4 times daily
NOTES: Poor response to previous T injection and cream,( libido seemed worse)so topical T cream & DHEA was increased.

11-24-09
Testosterone Cream: 15% 15mg/.01ml .5ml - .75mg dose apply once daily in AM
DHEA: 50mg daily in AM
Cortef (Hydrocortisone): 5mg daily in AM
Adrenal Rebuilder Formula (AR) (Dr. James Wilson’s Formula): 2,1,1,2 capsule, 4 times daily
Super Adrenal Stress Formula (F1) (Dr. James Wilson’s Formula): 2,1,1,1 capsule, 4 times daily
“New Vitality” Super Beta Prostate Formula: 2 caplets daily
NOTES: Still no increase in energy or Libido so Cortef was added. (Am I androgen resistant?)

1-5-2010
Testosterone injection: 1cc (2nd boost)
Testosterone Cream: .5ml - .75mg dose in AM .50 in PM (125mg total)
DHEA: 25mg daily (reduced to 25mg)
Cortef (Hydrocortisone): 7.5mg in AM & 2.5mg Lunch time
Adrenal Rebuilder Formula (AR) (Dr. James Wilson’s Formula): 2,1,1,2 capsule, 4 times daily
Super Adrenal Stress Formula (F1) (Dr. James Wilson’s Formula): 2,1,1,1 capsule, 4 times daily
“New Vitality” Super Beta Prostate Formula: 2 caplets daily
NOTES: since still no improvement in symptoms Cortef was increase to 7.5mg and 2.5mg noon. I increased this to 10mg AM & 5mg at noon and while not optimum I have better results.(energy still seems to cycle day to day but better). Still low Libido.

1-28-2010 She had me start an Elimination/Provocation Diet using Metagenics Ultra Clear Plus Medical food powder.

2-4-2010
Testosterone Cream: .5ml - .75mg dose in AM .50 in PM (125mg total)
DHEA: 25mg daily
Cortef (Hydrocortisone): 10mg in AM & 5mg Lunch time
Adrenal Rebuilder Formula (AR) (Dr. James Wilson’s Formula): 2,1,1,2 capsule, 4 times daily
Super Adrenal Stress Formula (F1) (Dr. James Wilson’s Formula): 2,1,1,1 capsule, 4 times daily
“New Vitality” Super Beta Prostate Formula: 2 caplets daily
Added: 2-10-10 started Porcine Thyroid 30mg (½ grain) (T4-T3-T2-T1 trace formula) compound pharmacy
NOTES: Since libido was still low, Porcine Thyroid was added and was told this should give more energy & Libido.
*** However after ONE day on this I gradually started to CRASH, eventually after6 days(2-15-10) I stopped taking it. It took me several days to recover! Unfortunately since I was on a elimination diet I thought it was due to dairy, as I added dairy the 2nd day(2-11-10) after the thyroid meds were taken. So I stopped the dairy then the wheat, however it took a few days to figure out it was the thyroid med. 2-15-10 Took last Porcine Thyroid dose. Apparently I am not converting T4 to T3 due to adrenals?

2-15-10 Stopped 25mg DHEA capsules.
2-19-10 Stopped Testosterone Cream.
2-23-10 Due to confusion with Thyroid meds and food intolerances, I restarted the Elimination/Provocation diet over, however this was inconclusive.

I stopped seeing this doctor and thorough a friend of a friend heard about Holtorf medical group and sought them out.

Holtorf Medical Group – Dr. Laufer

3-25-10 (first consult + supp) $726.87
Initial Diagnosis prior to labs: Chronic Fatigue
Order lab work from Quest Diagnostics (specialty tests Kaiser not able to do) Also Igenex test.
Supplements: Sleep Tight #90 $36, MitoNT #190 $52.50 (don’t take in pm), Adrenal Repair #120 $76, Immuno-Stim #180 $52, Flex Plus Powder #60 $54.
Medications/Injections: none at this time.

4-22-10 (2nd visit Lab review) $1,388.08 + $66pharm = $1,454.08
Diagnosis: Chronic Fatigue / Hypothyroid / Testosterone Deficiency
Supplements: MitoNT #190 $52.50 (don’t take in pm), Adrenal Repair #120 $76, Flex Plus Powder #60 $54. Fibrinex #120 $89, Transfer Factor Multi-Immune #60 72x2=$144, Immuno-Stim #180 $52,
Medications/Injections: Gammagobulin 2cc-Injection 4x120=$480, Valtrex (Acyclovir) 400mg 3x daily, Lunesta (Zolpidem) 10mg nightly as needed for sleep. Testosterone Cream my existing supply 200gm daily. Thyroid meds, start titrate #10 T3@2.5mcg, #10 T3@5mcg, #30 T3@7.5mcg capsule.

6-3-10 (3rd visit) $1,373.69 + 203.75pharm = $1,577.44
Diagnosis: Chronic Fatigue – Testosterone Deficiency
Supplements: MitoNT #190 $52.50 (don’t take in pm), Adrenal Repair #120 $76, Flex Plus Powder #60 2x54=$108. Fibrinex #120 $89, Transfer Factor Multi-Immune #60 2x72=$144, Immuno-Stim not needed with Gammagobulin.
Medications/Injections: Gammagobulin 2cc-Injection 4x120=$480, Valtrex (Acyclovir) 400mg 3x daily, Lunesta (Zolpidem) 10mg nightly as needed for sleep. (NEW) Testosterone/Progesterone (2x30gm) Cream 200/2.5mg/gm daily. Thyroid meds, still titrate #10 T3@10mcg, #50 T3@50mcg capsule final.

8-5-10 (4th visit) $1,438.70 + $178.43 = $1,617.13
Diagnosis: Chronic Fatigue – Hypothyroid - Testosterone Deficiency
Supplements: MitoNT #190 $52.50 (don’t take in pm), Adrenal Repair #120 $76, Flex Plus Powder #60 $54. Boluoke (in place of Fibrinex) mailed Fibrinex #120 $89, Transfer Factor Multi-Immune #60 $72, Immuno-Stim not needed with Gammagobulin.
Medications/Injections: Gammagobulin 2cc-Injection 3x120=$360, Valtrex (Acyclovir) 400mg 3x daily, Lunesta (Zolpidem) 10mg nightly as needed for sleep. (NEW) Cypionate/Progesterone 200mg/2.5mg per ML 10ML Vial (IM EOW). (NEW) HCG 11,000 Vial 275iu .25cc 2x weekly, Thyroid meds, change (NEW) T4 38mcg/T3 10mcg capsule combo .

This last thyroid meds are having me crash, although it was a slow process, now I am feeling worse than ever. I see the doc next week.

The T injections do not seem to work, although my labs show that T is elevated.
My current symptoms include:
• Difficulty falling asleep at night
• Waking frequently during the night
• Difficulty waking in the morning, not feeling refreshed
• Bright lights bothered me more than others
• Startled easily due to noise, intolerant of noises
• Dizzy/lightheaded when standing from sitting or from lying down
• Take things too seriously, stressed, anxious
• Difficulty coping with certain people or events
• Extreme Fatigue, constantly wiped out
• Taking days to recover from even minor stress
• Severe fatigue, no energy, falling asleep at my work desk.
• Feel like I have the flu, been in a boxing match
• Get winded easily, poor lung capacity
• Muscle and joint pains, more now than ever
• Lightheaded – headaches
• Depression, Malaise
From my labs it appears my cortisol levels are improving with just the 5mg of Cortef. All labs tests are done WITHOUT on meds that morning ;)
Here is what I am taking from Holtorf:

These two items are suppose to help out with my autoimmune system,
Gammagobulin 2cc every 2 weeks (anti viral) as natural killer cells, etc were low
Acyclovir 400mg 3times daily (due to HHV6 antibody Titers ) so my immune system won’t have to work at keeping this at bay?
Supplements to help support Mitochondria and alleviate fibrin, as well as build up the immune and adrenals:
MitoNT
Adrenal Repair
Flex Plus Powder
Fibrinex
Transfer Factor Multi-Immune
Testosterone: 1cc every two weeks
HCG: 275mg (.25cc) twice weekly
Thyroid med: T4 38mcg/T3 10mcg capsule combo in the morning
Cortisol: Cortef 5mg in the morning
Lunesta for sleep
Other supplements on my own:
Multivitamin & Mineral Supplement
Vitamin C
N-Acetyl Cysteine (NAC
Protein Powder (Optimum Nutrition or Designer Whey)
Glucosamine & MSM
Super B Complex
Zinc
Selenium
Jarrow’s Bone-up
Acetyl-L-Carnitine:
Alpha Lipoic Acid (ALA
NAC N-Acetyl-Cysteine:
L-Arginine:
CoQ10
Magnesium
Omega 3 fish oil

I asked about DHEA supplement and the doc said “we never know what this will get converted to” so not prescribed.

So my main complaint is joint and muscle ache/pain, low or nonexistent libido, no energy, poor sleep, depression, pretty much all the same, like all this is a waist of time. Something is being missed. He told me last time that it takes time, there is now magic pill and that the cell die off from the Acyclovir may be causing the way I feel too. Aahhh.

I was losing my hair and since there was no diagnosis on my condition I had a hair transplant done two years ago and that doc had my on Finestride which I took for about a year. I stopped this once I read up more about it and the possible side effects, so maybe the Finestride has something to do with the transdermal cream not working? Maybe other complications? Low Libido?

So what do you guys here think?
Give them more time?
What adjustments do you see in the protocol should I make?
 

Attachments

Christ!

This is the longest intro post I have ever seen.

The most helpful thing to do is to start linking symptoms to lab results.

So post your recent lab results with reference ranges and the symptoms that you were experiencing while at those levels.

I couldn't even find any labs in all of that.

As far as Holtorf medical group, they look better than your standard doctor for this kind of stuff, but the supplement stuff seems like a bunch of woo. I don't think you can supp your way out of this one, unfortunately.

My theory on this stuff is to introduce one variable at a time and then stabilize on it for at least a few months to see how you react and then measure labs and look for other imbalances and then go after that. It's slower than the shotgun approach but maybe safer and easier to understand where your problems and results are coming from.
 
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Labs

I removed the possible confusing field that had "opt" in it, as those are the middle ranges i was told you would like to be at..;)

the dates of the labs are across the top. hope this helps

Also some tests where done at Kaiser and others from Quest. So you may see a "K" or a "Q" in the date ;)

I should add that I do get morning wood sometimes, but it is difficult to maintain an erection. ED.. as well as non-existent Libido... I understand the difference between ED and Libido. I have BOTH problems, at least mechanically it functions, just not well.
 

Attachments

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I should clarify the amount of T taken, as I wrote only 1cc.. ha!

Testosterone: Cypionate 200mg/ Progesterone 2.5mg per 1ml - 1cc every two weeks on Thursday. - HCG: 275IU (.25cc) twice weekly, Thursday and Sunday

As far as how I feel with each med change, I have felt the same no matter what was done, except for the last two times. which follow:

6/3/10 office visit
T3 only, 50mcg: made me have heart palpitations at times, still no energy/fatigue. very minor, however Libido and ED was still getting worse. was on Transdermal T at the time in which my T levels actually went DOWN! my body is not absorbing the T cream for some reason....

8/5/10 office visit
T4 38mcg/T3 10mcg: made me slowly crash over the last 7 weeks, and ED libido is worse than ever. First round of consistent T Cypionate IM 200mg every 2 weeks (which has 2.5mg of progesterone in it as well). I can see from my most recent labs that the T IM is working as far as levels, but I still feel crappy. may due to the Thyroid med. I think I need more T3 as it seems my body is not converting T4 to T3 like it should for some reason... Adrenal issue??

This also makes me think that something in my diet maybe causing this. So I am currently on a strict no gluten diet and avoid dairy products. I have been doing this for the last 3 weeks and doesn't seem to make a difference, but maybe need more time?

Next office visit is in a few days.
I think an increase in T3 is needed.
Possibly a increase in T cypionate?
How about support of the Adrenals? More Cortisol support? I know Thyroid meds need Cortisol.
Modify the HCG schedule so that I inject HCG on Mon & Tue, then the Cypionate on Thursday? or current way ok? Is 275IU each time enough?

Thanks!
 
Just a heads up: Even T cyp injections 1x/week do not keep levels stable enough for many. I personally inject 30mg EOD [every other day] with a small insulin needle. It is painless and keeps levels dead steady. Steady levels is the goal of HRT. And if you have been low on T for a while, it may take [many] months to fully realize the benefits of higher testosterone levels. Some take as long as a few years to really get back up to speed.

As far as thyroid, I don't know much about that, but my speculation would be that you haven't ramped up to a full replacement dose yet or that maybe you do not have enough cortisol for proper metabolism of the thyroid hormones.But as I said, not my specialty. I know more about androgens.:D
 
Holy fuck. Longest introduction post I've ever seen. As I am tired, drunk, and angry from reading "Massalman's" posts I can't even begin to look at this right now. I promise i will spend some time on this tomorrow.
 
Fatigue, exhaustion
Weakness, feeling run down and sluggish
Brain Fog
Occasional Muscle cramps & aches
Impaired concentration
Hair Loss – Slow Hair Growth & dry
Decreased libido
The above are your only real problems

Unexplained Lower back pain
Normal
Occasional sore throat
Normal
Occasional light headed when standing up
Normal
Depression / Suicidal - Negative thoughts
Depression/anxiety
Occasional canker sores
Normal
Occasional constipation
Normal

Blood pressure 105/65 - Pulse rate 56
Normal

Other
Buzzing in ears, ears may plug up with strenuous exercising
Varying eyesight problems (due to age?) Starbursts around lights at night.
All completely normal


Lyme Protocol
August 2006 – Thinking I might have Lyme (as I was born & raised in Upper Michigan, many ticks) I started the 100 day Lyme Borreliosis Treatment Protocol. Using Nutamedix products of SAMENTO, CUMANDA, BURBUR, & QUINA. During this time I also took another herb for 30 days called SHEOGI (Larrea Tridentata).
*While on this protocol I got tested for the Epstein-Barr virus and showed an OLD infection only.
* Tested for Borrelia Burgdorferi Antibody (Lyme) with a value of 49 range <120.
* Also tested for Erytrocyte Sedimentation rate (ESR), Westergren method, which appears normal.

Wasted a lot of money/time on this stuff.
I also had a HAIR analysis done around this time as well. I took supplements to help offset deficiencies.
Yep, another scam you fell into.

Results: Lyme protocol had no apparent physiological effect.

Because you don't have lyme disease.


Alcohol: Normally I do not consume alcohol. However I MAY have a glass of wine once in a great while with dinner or special occasions. However, when I do over overindulge in alcohol for special occasions, it REALLY drains me for days, more than just your usual hangover. I will feel miserable for several days or longer… I crash, no energy and the usual fatigue symptoms
.

Many people have this reaction.

TMJ: while not chronic, I have had several occurrences of TMJ over the years, I attribute this to stress and grinding of my teeth at night.

Interesting

Hemorrhoids: Minor flare-ups from time to time usually aggravated by spicy foods and/or constipation.

Interesting
…….

I do believe I have primary Adrenal Fatigue (insufficiency) with secondary pituitary issues and Hypothyroid. Low T is something that has occurred either due to age and possibly these complications?
Invalid diagnosis.

I started an exercise program of mainly walking then working up to running about 2 years ago, and for the last 9 months I also started weight or resistance type training as well (crossfit). I was always active earlier in my life until I started having problems, which prevented me from being active, I now FORCE myself to do it. Not easy.

Good. Keep going.

I feel I have always had a pretty good diet, I don’t drink coffee or sodas, don’t smoke, and aside from special events I rarely consume alcohol. It wasn’t until recently that I started to eat more green veggies, coconut oil, avocados & sweet potatoes. As far as supplemental pills, I have always taken a multivitamin, anti-oxidants, & glucosamine. It wasn’t until recently that I added fish oil, CoQ10, vitamin D, L-Glutamine, protein powder, etc. (see supplement list).

Good, take it easy on the supplements. Most are BS.

In regards to hormone therapy, I feel that nothing has helped. I pretty much still feel the same, and actually I feel my libido got WORSE! regardless of the amount of Testosterone (up to 125mg topical), DHEA (up to 50mg) & cortisol (up to 15mg). As such I left my current physician and tapering of cortisol and stopped T and DHEA. I noticed since I stopped the T & DHEA that I am dizzy and lightheaded. I have suspicions that I may me Androgen resistant. When we tried porcine thyroid I got worse, however this was during an elimination diet, so there is some confusion as to what was the cause. Looking back, it is obvious that I should not be doing an elimination diet and diagnostic replacement therapy at the same time.

Your T levels (in the upper 500's at times) do not warrant TRT (yet).

I
am currently trying to decipher if I have some sort of intolerance either to gluten or lactose. Order lab work from EnteroLab for gluten and casein intolerance, just trying to find answers to the primary cause and these are probably secondary to Adrenal Fatigue? Celiac disease profile lab results from Kaiser came back Negative
.
Elimination diet is much better (and cheaper) than any lab test as far as food allergies go.

I notice on my lab work that my Total T levels went down while Estradiol levels rose. My Saliva Free T levels may not have had not enough time to come down (14 days) from last supplementation.
Why are you doing saliva testing for testosterone?



……….
Dr. Kedy Ying Jao, D.O. F.A.A.F.P
through saliva testing found my morning cortisol levels very low and my Testosterone levels below normal, noticed my Thyroid lab results, but she wanted to treat the Adrenals first. Here is the timeline:


Adrenal Rebuilder Formula (AR) (Dr. James Wilson’s Formula): 2,1,1,2 capsule, 4 times daily
Super Adrenal Stress Formula (F1) (Dr. James Wilson’s Formula): 2,1,1,1 capsule, 4 times daily
Can I have some money? I will use it much more wisely.



1-5-2010
Testosterone injection: 1cc (2nd boost)
Testosterone Cream: .5ml - .75mg dose in AM .50 in PM (125mg total)
DHEA: 25mg daily (reduced to 25mg)
Cortef (Hydrocortisone): 7.5mg in AM & 2.5mg Lunch time
Adrenal Rebuilder Formula (AR) (Dr. James Wilson’s Formula): 2,1,1,2 capsule, 4 times daily
Super Adrenal Stress Formula (F1) (Dr. James Wilson’s Formula): 2,1,1,1 capsule, 4 times daily
“New Vitality” Super Beta Prostate Formula: 2 caplets daily
NOTES: since still no improvement in symptoms Cortef was increase to 7.5mg and 2.5mg noon. I increased this to 10mg AM & 5mg at noon and while not optimum I have better results.(energy still seems to cycle day to day but better). Still low Libido.

1-28-2010 She had me start an Elimination/Provocation Diet using Metagenics Ultra Clear Plus Medical food powder.

2-4-2010
Testosterone Cream: .5ml - .75mg dose in AM .50 in PM (125mg total)
DHEA: 25mg daily
Cortef (Hydrocortisone): 10mg in AM & 5mg Lunch time
Adrenal Rebuilder Formula (AR) (Dr. James Wilson’s Formula): 2,1,1,2 capsule, 4 times daily
Super Adrenal Stress Formula (F1) (Dr. James Wilson’s Formula): 2,1,1,1 capsule, 4 times daily
“New Vitality” Super Beta Prostate Formula: 2 caplets daily
Added: 2-10-10 started Porcine Thyroid 30mg (½ grain) (T4-T3-T2-T1 trace formula) compound pharmacy
NOTES: Since libido was still low, Porcine Thyroid was added and was told this should give more energy & Libido.
*** However after ONE day on this I gradually started to CRASH, eventually after6 days(2-15-10) I stopped taking it. It took me several days to recover! Unfortunately since I was on a elimination diet I thought it was due to dairy, as I added dairy the 2nd day(2-11-10) after the thyroid meds were taken. So I stopped the dairy then the wheat, however it took a few days to figure out it was the thyroid med. 2-15-10 Took last Porcine Thyroid dose. Apparently I am not converting T4 to T3 due to adrenals?

2-15-10 Stopped 25mg DHEA capsules.
2-19-10 Stopped Testosterone Cream.
2-23-10 Due to confusion with Thyroid meds and food intolerances, I restarted the Elimination/Provocation diet over, however this was inconclusive.

I stopped seeing this doctor and thorough a friend of a friend heard about Holtorf medical group and sought them out.

Holtorf Medical Group – Dr. Laufer

3-25-10 (first consult + supp) $726.87
Initial Diagnosis prior to labs: Chronic Fatigue
Order lab work from Quest Diagnostics (specialty tests Kaiser not able to do) Also Igenex test.
Supplements: Sleep Tight #90 $36, MitoNT #190 $52.50 (don’t take in pm), Adrenal Repair #120 $76, Immuno-Stim #180 $52, Flex Plus Powder #60 $54.
Medications/Injections: none at this time.

That sucks. You wasted a lot of money. A lot.

4-22-10 (2nd visit Lab review) $1,388.08 + $66pharm = $1,454.08
Diagnosis: Chronic Fatigue / Hypothyroid / Testosterone Deficiency
Supplements: MitoNT #190 $52.50 (don’t take in pm), Adrenal Repair #120 $76, Flex Plus Powder #60 $54. Fibrinex #120 $89, Transfer Factor Multi-Immune #60 72x2=$144, Immuno-Stim #180 $52,
Medications/Injections: Gammagobulin 2cc-Injection 4x120=$480, Valtrex (Acyclovir) 400mg 3x daily, Lunesta (Zolpidem) 10mg nightly as needed for sleep. Testosterone Cream my existing supply 200gm daily. Thyroid meds, start titrate #10 T3@2.5mcg, #10 T3@5mcg, #30 T3@7.5mcg capsule.

A LOT.

6-3-10 (3rd visit) $1,373.69 + 203.75pharm = $1,577.44
Diagnosis: Chronic Fatigue – Testosterone Deficiency
Supplements: MitoNT #190 $52.50 (don’t take in pm), Adrenal Repair #120 $76, Flex Plus Powder #60 2x54=$108. Fibrinex #120 $89, Transfer Factor Multi-Immune #60 2x72=$144, Immuno-Stim not needed with Gammagobulin.
Medications/Injections: Gammagobulin 2cc-Injection 4x120=$480, Valtrex (Acyclovir) 400mg 3x daily, Lunesta (Zolpidem) 10mg nightly as needed for sleep. (NEW) Testosterone/Progesterone (2x30gm) Cream 200/2.5mg/gm daily. Thyroid meds, still titrate #10 T3@10mcg, #50 T3@50mcg capsule final.

Jesus christ. How can you afford this bullshit?

8-5-10 (4th visit) $1,438.70 + $178.43 = $1,617.13
Diagnosis: Chronic Fatigue – Hypothyroid - Testosterone Deficiency
Supplements: MitoNT #190 $52.50 (don’t take in pm), Adrenal Repair #120 $76, Flex Plus Powder #60 $54. Boluoke (in place of Fibrinex) mailed Fibrinex #120 $89, Transfer Factor Multi-Immune #60 $72, Immuno-Stim not needed with Gammagobulin.
Medications/Injections: Gammagobulin 2cc-Injection 3x120=$360, Valtrex (Acyclovir) 400mg 3x daily, Lunesta (Zolpidem) 10mg nightly as needed for sleep. (NEW) Cypionate/Progesterone 200mg/2.5mg per ML 10ML Vial (IM EOW). (NEW) HCG 11,000 Vial 275iu .25cc 2x weekly, Thyroid meds, change (NEW) T4 38mcg/T3 10mcg capsule combo .
Jesus.Fucking.Christ.

This last thyroid meds are having me crash, although it was a slow process, now I am feeling worse than ever. I see the doc next week.

The T injections do not seem to work, although my labs show that T is elevated.
My current symptoms include:
• Difficulty falling asleep at night
• Waking frequently during the night
• Difficulty waking in the morning, not feeling refreshed
• Bright lights bothered me more than others
• Startled easily due to noise, intolerant of noises
• Dizzy/lightheaded when standing from sitting or from lying down
• Take things too seriously, stressed, anxious
• Difficulty coping with certain people or events
• Extreme Fatigue, constantly wiped out
• Taking days to recover from even minor stress
• Severe fatigue, no energy, falling asleep at my work desk.
• Feel like I have the flu, been in a boxing match
• Get winded easily, poor lung capacity
• Muscle and joint pains, more now than ever
• Lightheaded – headaches
• Depression, Malaise
From my labs it appears my cortisol levels are improving with just the 5mg of Cortef. All labs tests are done WITHOUT on meds that morning ;)
Here is what I am taking from Holtorf:

These two items are suppose to help out with my autoimmune system,
Gammagobulin 2cc every 2 weeks (anti viral) as natural killer cells, etc were low
Acyclovir 400mg 3times daily (due to HHV6 antibody Titers ) so my immune system won’t have to work at keeping this at bay?
Supplements to help support Mitochondria and alleviate fibrin, as well as build up the immune and adrenals:
MitoNT
Adrenal Repair
Flex Plus Powder
Fibrinex
Transfer Factor Multi-Immune
Testosterone: 1cc every two weeks
HCG: 275mg (.25cc) twice weekly
Thyroid med: T4 38mcg/T3 10mcg capsule combo in the morning
Cortisol: Cortef 5mg in the morning
Lunesta for sleep
Other supplements on my own:
Multivitamin & Mineral Supplement
Vitamin C
N-Acetyl Cysteine (NAC
Protein Powder (Optimum Nutrition or Designer Whey)
Glucosamine & MSM
Super B Complex
Zinc
Selenium
Jarrow’s Bone-up
Acetyl-L-Carnitine:
Alpha Lipoic Acid (ALA
NAC N-Acetyl-Cysteine:
L-Arginine:
CoQ10
Magnesium
Omega 3 fish oil

I asked about DHEA supplement and the doc said “we never know what this will get converted to” so not prescribed.

So my main complaint is joint and muscle ache/pain, low or nonexistent libido, no energy, poor sleep, depression, pretty much all the same, like all this is a waist of time. Something is being missed. He told me last time that it takes time, there is now magic pill and that the cell die off from the Acyclovir may be causing the way I feel too. Aahhh.

I was losing my hair and since there was no diagnosis on my condition I had a hair transplant done two years ago and that doc had my on Finestride which I took for about a year. I stopped this once I read up more about it and the possible side effects, so maybe the Finestride has something to do with the transdermal cream not working? Maybe other complications? Low Libido?

AND HERE IS THE FUCKING ANSWER, HIDDEN AT THE BOTTOM.
 
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Sorry for the shitty formatting, but after wading through all of that it seems to me that your problem is your finasteride use. When did that come into the picture?
 
his problems started 19 years ago and he was on finasteride ~2 years ago, hardly a connection.

It sounds to me primarily like a low cortisol problem.

It's not normal to have such a long lasting chronic condition, you could simply be gluten intolerant, or you seriously may have lyme disease or some other chronic infection. You're all over the place you need a completely fresh start, like off all supplements / meds (AS LONG AS ITS SAFE TO DO SO) and go see a COMPEDENT doctor like Dr John or Dr mariano.
 
TBH, I don't think anyone here has the answers. I have somewhat similar problems and have tried taking hormone supplements under the care of the a doctor and didn't really help me one bit. I don't have any solutions I'm afraid, but going broke through buying medications, supplements, tests and doctor visits plus trips is not very wise either if it only leads to minimal improvement.
 
Another thing. The high thyroglogulin levels could be indicative of serious thyroid problems or could be a false reading as a result of the antibodies (Hashimoto`s, which is not all that uncommon) , but T4,3 are normal so there doesnt appear to be a problem. I would look into this further just to be safe.
 
+1 on that Cubbie Blue! It must of taken him freaking days to type that[:o)]

Lots of info!

Thanks, Morris!:D



Holy fuck. Longest introduction post I've ever seen. As I am tired, drunk, and angry from reading "Massalman's" posts I can't even begin to look at this right now. I promise i will spend some time on this tomorrow.
 
I agree with zkt, I don't nearly the knowledge he does, it's better to be safe that sorry, could prevent issue down the road!

Good Luck, Morris:)


Another thing. The high thyroglogulin levels could be indicative of serious thyroid problems or could be a false reading as a result of the antibodies (Hashimoto`s, which is not all that uncommon) , but T4,3 are normal so there doesnt appear to be a problem. I would look into this further just to be safe.
 
CubbieBlue

Why are you doing saliva testing for testosterone?

Sorry for the shitty formatting, but after wading through all of that
it seems to me that your problem is your finasteride use. When did that come into the picture?

Jesus christ. How can you afford this bullshit?

The first doc believed in saliva rather than serum, Holtorf believes in serum rather than saliva. I researched this and found serum is the way to go.

Finasteride did not enter the picture until 2 years ago, so while it may have aggravated my system it is not the reason. But the question is.. how does one reverse any possible damage done from Finasteride?

Cost most differently is a issue, and adds to my depression ;) close to 20 years now and have not found answers. Desperate yeah... I pretty much consider myself dead, as there is no life to my living. It is tough when HMO's tell you year after year that you are "normal" were is one to go? WTF!


sako
his problems started 19 years ago and he was on finasteride ~2 years ago, hardly a connection.

It sounds to me primarily like a low cortisol problem.

It's not normal to have such a long lasting chronic condition, you could simply
be gluten intolerant, or you seriously may have lyme disease or some other chronic infection.
You're all over the place you need a completely fresh start, like off all supplements / meds
(AS LONG AS ITS SAFE TO DO SO) and go see a COMPETENT doctor like Dr John or Dr mariano.

Right, 19 years ago, prior to the Finestride ;0

Yeah Adrenal fatigue was diagnosed and low cortisol levels, I think I am not getting enough Cortef support?

Was tested at Igenex labs (requested from Holtorf) for Lyme, test came back Negative.

Yeah I went of all meds prior to Holtorf, time to do it again, aaaahhh, christ can't anyone get this right? Please point me in a direction of how to contact Dr John and Dr Mariano, I am in Southern California. Thanks!


HeadDoc
have you seen a rheumatologist?

Thanks for asking that one.. good catch/call forgot to mention it as tests were inconclusive.
Yes, Kaiser actually referred me to one of there specialists, had some test done, like for Lupus and no signs of anything abby normal ;)

Did not know what to questions to ask or even expect from a rheumy, just gave him my story and had to wake him up a few times, but since he wasn't drinking he was able make it through :) ha! ha! "CubbieBlue"


zkt
Looked over your labs.
What does the yellow color coding mean?

Another thing. The high thyroglogulin levels could be indicative of serious
thyroid problems or could be a false reading as a result of the antibodies
(Hashimoto`s, which is not all that uncommon) , but T4,3 are normal so there doesn't
appear to be a problem. I would look into this further just to be safe.

Coloring is my own shading for indicating what I THINK is a problem. Yellow is caution/possible problem. Red is either High or Low Levels.

YUP... thyroglogulin antibodies and Hashimotos.... I ask Holtorf about this and he indicated that he didn't think it was a problem.... From my research I tend to disagree, but I am not educated in this stuff and he is suppose to be the specialist.... This is why I am NOW (on my own) doing a gluten free diet and having further testing done from EnteroLabs for this sensitivity. I feel something is being missed, but not sure what it is. Hell maybe toxic mold? but I live in a house with 4 other people and I am the only one that is a zombie. Unless I am the only one sensitive to it? I have changed occupations 7 years ago thinking it would help, as maybe chemicals at work were the cause (automotive field), now I have a desk job in a office.

Anyway Hashi is a possibility, and I am going to push that subject hard at my next office visit, but wont have my EnteroLab results back by then :(

T4-t3 to you are normal? hum... as I started to slowly get worse switching from T3 only to the T4/t3 combo.... May not enough cortisol to support the T4 to T3 conversion, maybe? Adrenal fatigue condition. Treat adrenals along with thyroid right ?

Hashi... hashi... hashi... seems to go through my mind.


sseefried
Our respiratory therapists are members of CSRT (Canadian Society of Respiratory Therapy)
and BCSRT .They are experts in the field of CPAP and sleep apnea.

Was tested overnight at a sleep center, Sleep Apnea isn't a issue.


So it appears to many here that all the supplements are just glorified vitamins?

I was told at Holtorf that we need to build up the Mitochondria and Fibrin build up was a issue and my natural killer cells were low.

Thanks to all the replies, I will keep you posted.
 
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