Adrenal Thread

[john456]

Another case study for you guys, if any care to comment:

I've been treated for hypogonadism for two years now with Androgel and HCG, following a protocol suggested by SWALE. Testosterone levels have been 700-1000 ng/dL on a 200-800 scale, and I've mostly felt a lot better. I've also been treated for mild hypothyroidism with 50 mcg T4 and 1/2 grain Armour for equally long. Mostly I've felt quite good, but, lately especially I've begun to realize I'm not feeling as good as I'd like to.

Symptoms: Mild fatigue, significant loss of libido, slow metabolism, constipation, irritability, and joint issues (specifically tendon issues - longstanding full-body issues with tendonitis), tendency towards central obesity (ALL of my fat is in/on my stomach)

Tests:

TSH - 0.4 (.4 - 4)
Free T4 - 1.0 (0.7-1.4) ng/dl
T3 - [Didn't get actual number, but just slightly below the normal range.]
DHEA-S - 273 ug/dl (240-480, I think)
Testosterone - 798 ng/dl (300-1000)
Cortisol - 19 (3-18) (8:30 AM, fasting, no caffeine)

Results:

My doctor thinks I might have hypercortisolism, so is having me do a urine collection. I also am doing a saliva testing. Furtherrmore, to correct the thyroid issues, I asked to be switched to 2 grains of Armour (and no T4), which should boost the out-of-refernce-range-low T3.


First of all, are there any more tests I should look into? Strangely enough, I can't figure out if my symptoms and tests align more with hypercortisolism or hypocortisolism. The thyroid issues are a little weird, since TSH is low but T3 is really low too; though I have secondary hypogonadism, so I figure my pituitary might just be screwed. Furthermore, the low DHEA is puzzling, but treatable. So:

-Should I get more tests?
-Does this look like hypercortisolism or hypocortisolism?
-Is there anything else I should do besides supplement T3 and DHEA for now/is there anything else I should look for?
-What (if any of these) could cause lack of libido in a 20 year old male?

Thanks guys; this thread has been really enlightening.

 

[pmgamer18]

Another case study for you guys, if any care to comment:

I've been treated for hypogonadism for two years now with Androgel and HCG, following a protocol suggested by SWALE. Testosterone levels have been 700-1000 ng/dL on a 200-800 scale, and I've mostly felt a lot better. I've also been treated for mild hypothyroidism with 50 mcg T4 and 1/2 grain Armour for equally long. Mostly I've felt quite good, but, lately especially I've begun to realize I'm not feeling as good as I'd like to..

I don't see your Estradiol tested here this is a must test if high it effects your Testosterone, Thyroid and Cortisol levels just for starters not to mention your sex life.

Symptoms: Mild fatigue, significant loss of libido, slow metabolism, constipation, irritability, and joint issues (specifically tendon issues - longstanding full-body issues with tendonitis), tendency towards central obesity (ALL of my fat is in/on my stomach).

A lot of these syptomes sound like Thyroid read Dr. Lowes FAQ's.
http://www.drlowe.com/index.htm

Tests:

TSH - 0.4 (.4 - 4)
Free T4 - 1.0 (0.7-1.4) ng/dl
T3 - [Didn't get actual number, but just slightly below the normal range.]
DHEA-S - 273 ug/dl (240-480, I think)
Testosterone - 798 ng/dl (300-1000)
Cortisol - 19 (3-18) (8:30 AM, fasting, no caffeine


Results:

My doctor thinks I might have hypercortisolism, so is having me do a urine collection. I also am doing a saliva testing. Furtherrmore, to correct the thyroid issues, I asked to be switched to 2 grains of Armour (and no T4), which should boost the out-of-refernce-range-low T3. )..

You can't go by TSH when your on thyroid meds the TSH is sent by your brain and like testosterone when you take meds your brain sees this and stops sending the messages to make more as in Testosterone it stops sending LH in your Thyroid your brain stops sending TSH.
I would drop the T4 med and do just Armour but if you do this go up on armour slow starting with 30mgs 2's a day. Then go up 15mgs every 2 weeks.

First of all, are there any more tests I should look into? Strangely enough, I can't figure out if my symptoms and tests align more with hypercortisolism or hypocortisolism. The thyroid issues are a little weird, since TSH is low but T3 is really low too; though I have secondary hypogonadism, so I figure my pituitary might just be screwed. Furthermore, the low DHEA is puzzling, but treatable. So:

-Should I get more tests?
-Does this look like hypercortisolism or hypocortisolism?
-Is there anything else I should do besides supplement T3 and DHEA for now/is there anything else I should look for?
-What (if any of these) could cause lack of libido in a 20 year old male?

Thanks guys; this thread has been really enlightening.

Yes you can't tell by doing a blood test on Cortisol best to do a saliva test one the checks 4 x's in a day. I would add in a ACTH Stim. test to tell if your Primary or Secondary.
http://www.stopthethyroidmadness.com/community/viewtopic.php?t=288
Also the following.

Thyroid Antibodies (anti-TPO and TgAb. YOU NEED BOTH.)
* Ferritin (and do stress FERRITIN, not just RBC)
* Adrenals Cortisol levels (but we strongly recommend saliva tests, not the one time blood test your doctor will do. See below, because you dont need a prescription)
LAB WORK from Canary Club for special prices. The saliva test is for a full spectrum: thyroid (TSH, free T3, free T4), adrenals (cortisol and DHEA), estrogen, progesterone, testosterone. You can choose from two lab facilitiesDiagnos Tech (saliva test for $144.50) or ZRT (saliva plus blood spot test for $199).
thecanaryclub.org/

* B-12
Reverse T3
Estradiol
SHBG

 

[blondambition]

Re: Adrenal Thread WOW

Although this is a mens forum and I am a woman, Thank God it was recommended to me. I now can put a name to the way I have been feeling. I had blood work done and Dr. office called me this morning and said all my tests came back normal except for thyroid, (hyperthyroid). I have another appt. for a follow up test in a week. I have read up on hyperthyroid and adrenal fatigue. They seem similar and related to me. When I read the symptoms of both...WOW! It is exactly how I have been feeling. Especially the adrenal fatigue symptoms right down to the swollen ankles (or kankles as I like to call them) that started about 3 weeks ago. Can't say that I am not scared. Never had anything really wrong with me before. Have been under a great deal of stress for years now so I guess it really shouldn't surprise me. Your thread here is great. I am open to suggestions and advice. I want to be in charge of my care and not just leave it soley to a Dr.

Thanks so much!

 

[pmgamer18]

It's great that it helped you but you still have a long way to go and will need more help. Go to this site and post to Val she helpe me a lot and will help you.
NaturalThyroidHormonesADRENALS : Natural Thyroid Hormone ADRENALS
She was the mod at STTM's site for a long time most of the mods were so busy they had to quit posting because they were burned out. But the site is still there full of good info.
Stop The Thyroid Madness Index Page
Most of the mods moved to this site you can check it out also.
Real Thyroid Help Forums :: Index
This link is a must read Bob and Val put this together at STTM a FAQ's on Adrenals.
Stop The Thyroid Madness ADRENALS FAQ–the most frequently asked questions

 

[s0b]

Hey people,

how ve you been doing? Im in a terrible state still.

First of all i have to say that im waiting on the saliva test results and also had the chance to visit a good sports doctor and did some catecholamine testing.

The sports doctor prescribed me some vitamins called Sanuzella Zym with Q10, Siberian Ginseng and some mood stabilizer/adaptogen spray called Rescue Remedy. i told the guy that i suspect apart from being overtrained and having autonomic nerve failure, that i may have adrenal fatigue but he was more concerned about overtraining i guess. During exercise testing within 5 minutes of moderate running i started having bronchitis, sweaty and cold palms and signs of parasympathetic failure so i had to lie down. Nevertheless neither the cardiologist or the sports doctor could reckon why i was gasping for oxygen while i was on the belt running, they thought i was able to cause this condition on my own! They had probably never seen an overtrained individual before in their lives!

Anyways, i had a good talk with the sports doctor and we are waiting for the results to come back.
Then i drove back home and started on his regime therapy, well as soon as i sprayed twice my tongue with this mood adaptogen (Rescue Remedy- anyone heard of it??) i got same breathing problems, felt like i was suffocating from lack of oxygen and the night i couldnt sleep well. Today i woke up and was feeling so sick that i decided on starting with dr. Wilsons formula.

I took one tablet of Super Adrenal Stress Formula and one of the Adrenal Rebuilder formula but within 20 minutes i starting feeling worse than ever, with the exact same symptoms like the time i was hospitalized >>> deep tremors, shakiness, irritability, weakness, headache and others. I dont know if it is due to the overdose of vitamins (like B6 and B5) or it is the effect of last nights Rescue Remedy spray but if i was ok i guess these symptoms would not be exaggerated so much.

Last weeks i was on 2.5 mg of diazepam day after day and was trying to cut off of it slowly due to slight memory problems and lethargy, i guess now i may need to keep on it, since this irritability wont let me sleep for the following nights.

So now my questions and conclusions.

a) What the hell is this Rescue Remedy supposed to do?? If it was supposed to fix my mood why did it make me gasp for air (exactly like the bronchitis one develops during a bad cold). I m thinking that maybe this rescue remedy needs healthy adrenals to work and since mine are 99% messed up it caused me all these problems.

b) Should i keep on taking Wilsons adrenal fatigue formula?

c) Does adrenal fatigue cause medullary instability (hyper/hypo excretion of catecholamines) or just cortical problems and if it does, would hydrocortisone help with my adrenal medulla rest and recover by destresing the cortex? Why do people prefer hydrocortisone from cortef?

d) Should i just jump onto hydrocortisone or cortef rather than experimenting with uknown amount of vitamins and herbs which have rather none positive impact on me but rather toxic?

I ordered a sports neuroendocrinology book and the adrenal fatigue book, i hope they come fast because i need answers, im tired of being sick and not being treated for.

Thanks for reading (and answering) in advance

 

[s0b]

By the way, where is a safe place to order hydrocortisone from the internet? Here in pharmacies they only have 20 mg minimal dose. If i want to start on 2.5 mg or 5mg i will be having a difficult time cutting those pills right. Is there a 10mg or 5mg hydrocortisone tablet?

Or should i start on isocort?

 

[pmgamer18]

Before I went on Cortef my breathing was very bad now that I have my adrenals supported my breathing is much better. You could have low Aldosterone levels read this link.
http://www.stopthethyroidmadness.com/community/viewtopic.php?t=581
and this one.
Adrenal Glands
Try to find a Better Dr. Endo's are not good for this. Here is a list.
American Academy of Osteopathy
Find an osteopath in US and some other countries
http://www.academyofosteopathy.org/findphys.cfm

Find an osteopath
http://www.osteopathic.org/index.cfm?PageID=findado_main

General Osteopathic Council
Find an osteopath in almost any country
Find an Osteopath : General Osteopathic Council

Healthfinder
Find an osteopath near you in the US. Also links to site to explain what an osteopath is.
http://www.healthfinder.gov/Scripts/SearchContext.asp?topic=3786

*I recommend avoiding osteopathic endos. They seem to be the same as regular endos.
Or if you can fly out and see Dr. John www.alltingsmale.com.

Stop taking any supplements they can be stressing your adrenals even more you don't know whats in them some have adrenaline in them.

I don't know If I gve you this FAQ's on Adrenals from STTM so here it is this will help you understand more.
Stop The Thyroid Madness ADRENALS FAQ–the most frequently asked questions

 

[s0b]

Thanks for the osteopath link but i live in Greece. No osteopaths around, i still have an internal medicine doctor who ordered the saliva tests for me and he sais he is going to help me with treatment.

I ve been reading loads in the thyroid madness forum, its very good and explicit.

Still, would you suggest going through the internet to order hydrocortisone? Is there some safe and reliable internet store to order? Here most pharmacies have 20mgs of hydrocortisone only

By the way, most important, what am i supposed to expect when starting on hydrocortisone? Will i feel some rapid improvement (meaning same day) or how will i know that the dosing is appropriate? Is there some abrupt feeling like relaxation, or increasing of well being or what is there to say that dosage is right for me? Or should i just go ahead and keep taking till i end up seeing some results (like a month or two later)?

 

[pmgamer18]

I had a feeling of well being when I started and it was Isocort Sheep glands the first pill I did was 2.5 mgs and this feeling was strong. But I got the same feeling doing HCG shots that act like LH and make my testis make testosterone. You could try Pregnenolone it's at the top of the hormone tree a lot of guys feel better on this you can do a search on it and read some of the posts here is a link to a tree I just use the picture of the tree forget about the rest.
CERI Q&A: Androstenedione vs Androstenediol?

Your saliva test should show if it checks you 4 x's in a day when your the lowest. I am very low first thing in the morning so I take 10mgs with some milk or food. Then I do 5 mgs at noon and dinner time If I take near bed time it keeps me up. If you start on this go slow and do a low dose read about it at STTM adrenals.
Stop The Thyroid Madness How to treat adrenals–for the patient and their doctors

 

[s0b]

So, you reckon i should go ahead try to increase my testo levels along with administering hydrocortisone. Is it fundamental that i try to increase and stabilize my low to low normal testo levels or would hydrocortisone provide a good adrenal fatigue recovery on its own.

And if i had to do some testosterone replacement, when should i try to enhance it with hydrocortisone administration, i mean at which point during my adrenal fatigue therapy and restoration? Right away, after one, two three months? or wait till my adrenals feel better ?

 

[HeadDoc]

The practice of starting with the adrenals vs. total hormonal replacment all at once varies from doctor to doctor. Given all the complexites of HRT, it may take months, at least, to rebalance the whole system regardless of which approach is taken at the start.

 

[pmgamer18]

Yes I go along with this Dr. M will treat Cortisol and Thyroid get them balanced and then retest Testosteone to see if it come back up if not then he would put them on TRT as per some of his posts. Dr. John belives in treating everything that is low or low normol so your not suffering. I was on TRT 23 yrs before finding out my pituitary was bad yet treating my low cortisol and thyroid has helped me to feel much better and as time is going by my Testosterone and Estradiol are getting better. Soon I am thinking I will drop the testosterone shots and just try HCG then later try coming off to see if my levels stay up. So this is on your how you want to do this.

The practice of starting with the adrenals vs. total hormonal replacment all at once varies from doctor to doctor. Given all the complexites of HRT, it may take months, at least, to rebalance the whole system regardless of which approach is taken at the start.

 

[s0b]

Well, its been months for me (almost 8) sitting at home and not being able to walk outside or enjoy normal everyday aspects of life, so i have had enough patience till now.
What is my greatest worry though is whether hydrocortisone will be my next and last resort, since with those adaptogenic herbs i ve tried and the enormous amounts of vitamins i dont really feel how i should feel, - i dont even feel any positive effect to say that i could be on the way back to finding my track - and whether in order to stabilize the effects of hydrocortisone i would need to take some testosterone enhancement remedy, since from all these info i have read i guess testosterone is a key player in the whole process at some point.

I remember few months ago, i really felt extremely well for a couple of days when i took some capsules of tribulus terrestris, i thought i had found the magic bullet at that point, but then it turned out that it was just another stimulant which on one hand may have increased my LH and testo slightly, and gave me the false impression that i was gonna recover, but on the other made my adrenals suffer even more and i developed more blood sugar handling problems and more stressful reactions.

If the effect of hydrocortisone on me resembles in any case that of Tribulus Terrestris action, regarding my energy boosting and well being that is, i will at least know that it is what i need to be on.
Nevertheless I still am in a last dilemma of spending this week supplementing with the Adrenal Rebuilder formula (containing Gonadal, Adrenal, Hypothalamus, Pituitary concentrates from Porcine sources as it claims) or whether i should just wait until next week to start on hydrocortisone and forget all about those remedies i have bought till now - since most people say its for very mild cases, and mine is definately not a mild one-. I just feel guilts for the several hundreds of euros i have spent till now ordering and reordering all those products and not trying them out to a definate end point.

 

[s0b]

By the way i have found some few articles which are very interesting to me regarding the correlation between adrenaline and cortisol, and i would like someone who knows more to commend on them.

http://www.usdoctor.com/cortisol.htm

From this link i m interested in this simplified first paragraph

"The problem with insomnia is that the individual suffers all day long with adrenaline (epinephrine) overload, which is related to cortisol deficiency, so he/she is unable to sleep at night" states Edward M. Lichten, M.D., clinician and researcher in Birmingham, Michigan

and offcourse this paragraph

"The adrenal cortex releases CORTISOL (prescription CORTEF™) in response to the pituitary hormone ACTH's signal. The problem is that ACTH can only be turned down by Cortisol yet it triggers increased release of adrenaline. The absence of the Vitamin B's and C's that are necessary for the adrenal cortex to manufacture Cortisol from being produced, aggravate and accelerate the problem of adrenaline (epinephrine) overload. The cycle continues until intervention breaks the cycle. That break can be a 3-month hiatus (vacation or mental breakdown)"

Ive been looking extensively over the internet for articles regarding adrenaline and cortisol action and what could their correlation be and what changes do they evoke during a prolonged stressful event (for example in sympathetic overtraining) and how possible could reestablishing to normal cortisol levels(and adjusting from adrenal fatigue) bring to normal an increased sympathetic activity, (i have been found to suffer from parasympatheticotonia* meaning excessive sympathetic activity which overlaps the ability of the parasympathetic system to relax my organism, from training too much for yrs) but i havent found any articles whatsoever since the very few i come across are research papers which i have to pay to be able to download.

Is there anyone who knows a bit of neuroendocrinology comment on that or point me to some of mariancos notes or other links, if there are any regarding this issue?

 

[s0b]

Yes I go along with this Dr. M will treat Cortisol and Thyroid get them balanced and then retest Testosteone to see if it come back up if not then he would put them on TRT as per some of his posts. Dr. John belives in treating everything that is low or low normol so your not suffering. I was on TRT 23 yrs before finding out my pituitary was bad yet treating my low cortisol and thyroid has helped me to feel much better and as time is going by my Testosterone and Estradiol are getting better. Soon I am thinking I will drop the testosterone shots and just try HCG then later try coming off to see if my levels stay up. So this is on your how you want to do this.

Thanks again for reinforming me. I just hope i dont need to get into testosterone replacements, i hope getting over adrenal fatigue will be enough for me, but who knows !

 

[pmgamer18]

Let me say this If I were you having read all this info and knowing what is wrong I would be trying everything I could to feel better and get back to a normal like. So I would have started on TRT but knowing what I know now I would do HCG starting at 100 IU's everyday this will keep your testis makeing your testosteone and not shut down your pituitary anymore then it is. When you get your saliva test back if it shows you low on cortiosl then I was start on it going up on the dose slow. If your problem is do to pituitary your adrenals work fine they just don't get the messages to work so you don't need all kinds of supplements to help your adrenals just the messages. So all you would need is to just add in HC. If your thyroid is low get on enough HC to support what your adrenals are not doing the add in some armour or a med like it.
I took my temps to do this. In this link all the info on how to do this is there and you can print out a chary to keep track of your temps.
http://www.drrind.com/tempgraph.asp#directions
After you start this then do blood work to keep track of your progress with thyroid and testosterone alos testing Estradiol levels.

Well, its been months for me (almost 8) sitting at home and not being able to walk outside or enjoy normal everyday aspects of life, so i have had enough patience till now.
What is my greatest worry though is whether hydrocortisone will be my next and last resort, since with those adaptogenic herbs i ve tried and the enormous amounts of vitamins i dont really feel how i should feel, - i dont even feel any positive effect to say that i could be on the way back to finding my track - and whether in order to stabilize the effects of hydrocortisone i would need to take some testosterone enhancement remedy, since from all these info i have read i guess testosterone is a key player in the whole process at some point.

I remember few months ago, i really felt extremely well for a couple of days when i took some capsules of tribulus terrestris, i thought i had found the magic bullet at that point, but then it turned out that it was just another stimulant which on one hand may have increased my LH and testo slightly, and gave me the false impression that i was gonna recover, but on the other made my adrenals suffer even more and i developed more blood sugar handling problems and more stressful reactions.

If the effect of hydrocortisone on me resembles in any case that of Tribulus Terrestris action, regarding my energy boosting and well being that is, i will at least know that it is what i need to be on.
Nevertheless I still am in a last dilemma of spending this week supplementing with the Adrenal Rebuilder formula (containing Gonadal, Adrenal, Hypothalamus, Pituitary concentrates from Porcine sources as it claims) or whether i should just wait until next week to start on hydrocortisone and forget all about those remedies i have bought till now - since most people say its for very mild cases, and mine is definately not a mild one-. I just feel guilts for the several hundreds of euros i have spent till now ordering and reordering all those products and not trying them out to a definate end point.

 

[s0b]

I understand your point, im thinking of doing it the other way round though, start on hc next week some time, when my saliva tests come back, and then in about a month or so, if i dont get at least to the point of walking around without having neck strains, difficulties breathing, sweaty palms, and dizziness, jump to some thyroid enhancement or some testosterone therapy as a last help, even yet i dont really believe that my testosterone levels are that low ( i mean i know people are sprinting with levels like 500) but for the sake of stabilizing and destressing further more my adrenals i might consider doing it.

Anyways, what makes it so complicated for me, and thats why im writing and rewriting here and some times it may seem that i talk for the same things over and over again, is the fact that the mechanism of sympathetic overtraining that brought me to adrenal fatigue is to some extend still skewed in my brain. I have tried to put down each and every piece of this puzzle, understand all the neurotransmitters actions, hormones, and cytokines involved and symptoms caused, but there are still pieces that i have failed to understand and so many unexplained symptoms, thats why i kept trying herbs and vitamins to avoid jumping into something with more permanent results that could mess me up even more before knowing exactly everything behind the whole problem.
In Mariancos writings i have found several useful aspects and i am trying to pick as much valuable info to enhance it with other findings and embedd it to doctors to help me since here in Greece most doctors are so astonished when i talk to them about my problems(overtraining+af).
One should have seen the look in their eyes when i was tested 4 days ago for blood catecholamines, cortisol and some other hormones during rest and exercise - man i barely managed to run 6 minutes and 40 some seconds before almost collapsing and that way they looked at each other puzzled like they were seeing a ghost was all i needed to see to understand the lack of their experience/knowledge and understanding of my problem. And guess what, those where some of the best sports doctors i managed to find in this helpless country. Oh well, i guess i have to just keep going and doing more and more reading and experimenting by my self since trying to find help from doctors here sometimes sounds as a joke.
I remember somebodys word from this forum i think it was, "welcome to the club of people that are trying to cure themselves on their own" - that was definately the most hilarious but on the same time realistic thing i had read so far believe im gonna go like this all the way

 

[pmgamer18]

Yes after all is said an done we get dam sick of seeing Dr.'s that tell us are labs are in range I mean WTF one can't have 80% of all the tests done in the low range this says your levels are in the 1% of all the people tested. Then to tell you it's all in your head and want to put you on drugs for Depression that only makes you feel worse. We tend to start looking in to treating are self. It's to bad you can't get a Dr. that will work with Dr. John over the phone to test and treat you he does this all you need is one that specks English. If you need to look into this go to All Things Male - Center for Men's Health.

 

[blondambition]

My bloodwork came back, I am hyperthyroid. I have an appt with an endocrinologist in 2 weeks. Any info for hyperthyroid?

 

[love_en]

It was me who said welcome to the club of people who are forced to treat themselves. I did not go through a complete puberty, my adrenals have been bad since age 5, and I have probably been hypothyroid all of my life as well. There is nothing psychological about how 200 mg per week of test enanthate and 35 mg of hydrocortisone per day enables me to live like a normal person. Unfortunately, I have not met any doctors who will think past my low, but within reference range test results. I also had what, I consider a very poor response to an ACTH stim test. So I am an undiagnosed adrenal insufficient patient. Hope I never need surgery or get injured. Many doctors have told me they have never seen a case of adrenal insufficiency in their entire medical career. Of course not. You do never find what you have decided does not exist.