What Happens if I Take Thyroxine with Adrenal P... - Thyroid UK

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What Happens if I Take Thyroxine with Adrenal Problems?

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What Happens if I Take Thyroxine with Adrenal Problems?

Even if the adrenal insufficiency is slight, it will adversely affect thyroid conversion, tissue uptake, and thyroid response.

If the T4–T3 conversion doesn’t happen as it should, the body can become toxic through unused T4. If it is converted, but the T3 cannot enter the cell walls due to adrenal insufficiency, the T3 cannot be used, and may reach toxic levels. In either case, T4 and TSH blood tests will appear normal, but the patient may feel really unwell. (6) If a physician raises the thyroxine dose in this scenario, the situation worsens still further.

The reaction varies with degrees of adrenal insufficiency. Symptoms may include: a sudden feeling of exhaustion, nausea, headache, inability to concentrate, trembling, muscle weakness, loss of peripheral circulation leading to numbness, lack of muscle control, giddiness, slurred speech, and cognitive impairment.

And as the literature included with this drug points out, the result can be extremely serious in anyone suffering from severe adrenal insufficiency:

“Levothyroxine is contraindicated in patients with uncorrected adrenal insufficiency since thyroid hormones may precipitate an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids [a too-rapid withdrawal of cortisol]. Patients known to suffer from adrenal insufficiency should therefore be treated with replacement glucocorticoids before starting any Levothyroxine sodium treatment. Failure to do so may precipitate an acute adrenal crisis when thyroid hormone therapy is initiated.(2)

Adrenal insufficiency must always be addressed before starting any thyroxine treatment.

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Clutter profile image
Clutter

CC, It kind of begs the question why GPs and endocrinologists don't seem to believe in adrenal insufficiency when the Levothyroxine PIL is so specific about the contraindications.

cc120 profile image
cc120 in reply to Clutter

I did take Nutri Adrenal Extra for approx 2 months before starting NDT but wonder if lack of progress means my adrenal needs more work. Just started 2 grains/140mg of Naturethroid.

Clutter profile image
Clutter in reply to cc120

CC, it can take a few months to adjust to NDT so it may be that you need more time.

cc120 profile image
cc120 in reply to Clutter

Hi Clutter, thank you.

flatfeet1 profile image
flatfeet1

A really good find cc120, I always wondered how one would feel if this happened. thanks

cc120 profile image
cc120 in reply to flatfeet1

You're welcome, the adrenal - thyroid connection is a tricky one, what comes first the chicken or the egg. According to Dr Lam: drlam.com/articles/adrenalf... - (here he includes a chart comparing adrenal fatigue and hypothyroidism symptoms) then talks about how hypothyroidism can be primary or secondary and this effects your treatment.

On the following link he talks about Anxiety and Adrenal Fatigue Syndrome: drlam.com/blog/anxiety-and-...

flatfeet1 profile image
flatfeet1 in reply to cc120

thanks, definitely the egg in my case :-)

cc120 profile image
cc120 in reply to flatfeet1

I was trying the Circadian T3 Method (CT3M or T3CM) for Adrenals stopthethyroidmadness.com/t... - a great way to treat your low cortisol! Using only NDT, but it was so difficult not eating for 4 hours so I could take my iron, then in an hour my calcium. Now more often than not I take the NDT just before I going bed. I am planning to buy some licorice tincture and multi-vits and mins, to help adrenal. Not sure if I should try cortisone as did: galathea

'I did a saliva test with Genova, looked at where my levels were low and then took cortisone. 90 mins before a drop was due, so, where I saw my 1 pm level was low,I took the cortisone at. 11.30 am, and so on. I took cortisone for two years, gradually tapering off as I felt I needed to. It worked, results were fast and I would do it all again if I needed to. However, since getting on to the correct meds ( for me) My adrenals no longer have to compensate, so all my levels are fine.'

healthunlocked.com/thyroidu...

flatfeet1 profile image
flatfeet1 in reply to cc120

My problem is high cortisol, I'm hoping as Jackie (below) says, that getting thyroid straight will improve cortisol. glad CT3M worked for you

cc120 profile image
cc120 in reply to flatfeet1

Hi Flatfeet1, I believe my cortisol or is it andrenaline, high evening and night. Don't know if the CT3M would have worked for me as didn't try it for long enough.

Here is an interesting article explaining how adrenaline and cortisol work together/effect each other:

en.wikibooks.org/wiki/Demys...

Jackie profile image
Jackie in reply to cc120

My Endo says that the only good tests is through a doc. 24 hour urine collection, cortione prescribed for mid night and then a blood test 9am.It could be done by your doc with written permission from a private hospital, it is also done nHS. iron needs to be taken with food.

Jackie

cc120 profile image
cc120 in reply to Jackie

I miss lovely Jackie x

marvalrus profile image
marvalrus in reply to flatfeet1

Sure is. I read this label and wonder why they don't explain further reasons for it. Probably because they would expose the need for doctors to address adrenal glands. Something most don't want to do, nor do they even quite understand how individual this is, or they do, and that's why they just don't seem to go there.

Jackie profile image
Jackie

Hi My Endo believes in treting Adrenal but not until thyroid OK as it does alter.On T4 she reduces it and gives t3 as well.I had before and after tests, the adrenals were improved when thyroid right.

It can take up to a year to have the thyroid right for you.

Jackie

cc120 profile image
cc120 in reply to Jackie

Hi Jackie - thank you, I'm still perplexed about this and wonder if it differs for each person depending on the primary cause. I have a strong suspicion that in my case it was my adrenal exhaustion that caused thyroid problem, mainly cause I've always been very anxious and worried, but not always so lacking in energy as I am now. In the article drlam.com/articles/adrenalf... mentions how adrenal issues are indicated if initial improvement on NDT, followed by no improvement until NDT is increased to required levels. I don't seem to be improving along the lines of the initial energy boost.

Jackie profile image
Jackie

Hi I think in reality not much known about thyroid so if you think it helps no harm in trying it, so long as not taking huge doses of cortisone.I cannot take any cortisone, heart.

Jackie

Jackie profile image
Jackie

Hi I think in reality not much known about thyroid so if you think it helps no harm in trying it, so long as not taking huge doses of cortisone.I cannot take any cortisone, heart.

Jackie

cc120 profile image
cc120

Does adrenal insufficiency mean no cortisol is produced?

marvalrus profile image
marvalrus in reply to cc120

If no cortisol is produced, a person would die. It is a vital to our life. When this glucocorticoid is low, we are basically running on empty. Docs will Rx prednisone at the drop of a hat, but ask for Cortef and their eyes go blank or they shudder at the thought. It's bizarre and evil! So many people benefit greatly from allowing adrenals to rest, and recuperate.

cc120 profile image
cc120 in reply to marvalrus

Thank you marvalrus. I run out of energy in a couple of hours of mental or physical effort. I also keep breaking out in cold sweats. What is wrong with me?

marvalrus profile image
marvalrus in reply to cc120

First of all you need to do another ACTH/amCortisol test. Same day do a diurnal 4-tube saliva test for cortisol and DHEAS and you might as well do an aldosterone test as well. These are the most basic adrenal hormones. Can you buy your own labs privately?

cc120 profile image
cc120 in reply to marvalrus

Thank you marvalrus. Financially difficult to buy own labs. I did ask a for a 24 hour urine cortisol test from consultants assistant but he said no. How much would the tests you mentioned cost altogether approximately?

marvalrus profile image
marvalrus in reply to cc120

Where are you located? If UK, I don't know where to get them. Others here might. In the very least you need the ACTH/Cortisol am blood test. Terrible doctors don't comply with the wishes of their patients. Find another doctor if possible.

cc120 profile image
cc120 in reply to marvalrus

Thank you marvalrus. I am in the UK. Here is listed a discounted 24 Hour Adrenal Stress Profile - tpauk.com/main/article/disc...

ALL About Adrenals and How to Treat

- tpauk.com/main/article/all-...

marvalrus profile image
marvalrus in reply to cc120

I don't see anything on these links. : \

cc120 profile image
cc120 in reply to marvalrus

If you register with tpauk.com first then the links will be active. :-)

marvalrus profile image
marvalrus in reply to cc120

says I now have to wait for an admin to approve me.

helvella profile image
helvellaAdministratorThyroid UK in reply to marvalrus

It's a pain, isn't it?

I prefer sites which are not restricted and, for that matter, the documents I have produced which are freely available.

cc120 profile image
cc120 in reply to marvalrus

Have you been approved yet marvalrus?

marvalrus profile image
marvalrus in reply to cc120

Yes, but I'm not seeing any tests that you can buy. Can you give me a direct link?

marvalrus profile image
marvalrus in reply to marvalrus

I do see a list of a few tests but only saliva Cortisol. You need ACTH/Cortisol a.m. blood test.

millefleur40 profile image
millefleur40

I was diagnosed as having Hashimotos 21 years ago. Have been on Levo 100mcg per day ever since. Have suffered from a list of symptoms though and never felt well. GP and Endo (saw Endo two years ago) think that I am 'in range' so no action required! I have all the symptoms of adrenal fatigue, but when GP or Endo did Adrenal tests - had bloods (cortisole, I think) and also 24 or 48 hr wee tests (buckets). They did not think my Adrenals were bad, so again no action. Bloods were in Feb this year, wee tests were a couple of years ago. Any help?

marvalrus profile image
marvalrus in reply to millefleur40

It's is so individual, and that is the problem. Doctors say "but you're in range". I'm here to tell you it doesn't matter. The only time it matters is when the cortisol is high. In range is very ambiguous depending on the symptoms of the person.

Russellb73 profile image
Russellb73

Why is it the gps doctors and consultants prescribe levothyroxine before checking adrenals in on 100mg of Levo and now 15-20 mg of cortisol even though to function as I "normally would" I need 30-35 mg but endo doesn't listen !! Typical so I'm told !!

Just listen to your body !! I'm learning slowly !!

McPammy profile image
McPammy

Hi. In reply to your comments on Levo and cortisol.

I have an under active thyroid. I have been on Levothyroxine for 23 years, with difficulty at times rushing and causing overactive.

Recently my cortisol dropped as I’d been under a long period of stress. I went to see my GP. He said I need to increase my Levo by 25mcg. I took my first increase the following morning. 2 hours later my body went into a crazy like explosion state. Like I’d blown a fuse. I took myself to A&E they said nothing wrong and see your GP. I continued to take the increased dose. Over time I was getting tired. My legs very heavy. I was nearly falling asleep driving hone from work. My legs buckling my walking became effected. My strength was getting lower and lower. I ended up in A&E with cortisol at 68. My ACTH was 0.5. Too low. I still cannot walk properly. I decided to stop taking Levo as I thought it had sometime to do with my condition. Yo my amazement within 3 days I was so much better. This continued. By day 8 off Levo I was getting concerned so I took just 25mcg. I had s bad reaction with upset stomach. I did feel good with my strength tho. Then the following day I couldn’t hardly walk again. Back to square one.

My Endo says I have no cortisol issue. And wants to send me down neurologist muscular route. This is so frustrating I know it’s Levo and cortisol not being aligned and balanced. As

cc120 profile image
cc120 in reply to McPammy

Thank you McPammy. I hope you get some feedback from the more informed. Have you ever tried NDT or T3 alone?

marvalrus profile image
marvalrus in reply to McPammy

ACTH is very low, and that is why your cortisol is low. Your pituitary (gland responsible for ACTH) should be yelling at your adrenals to get busy, but it's not, it's barely putting anything out. You may have to have an MRI of your pituitary. You say 68 for cortisol. What is the range for this result?

McPammy profile image
McPammy

Hi. No I’ve never tried it. I have just responded to a letter from my consultant who has advised that I should not take it. Where can you get it from and how much does it cost. Also how can you transfer fro levothyroxine to T3.

Many thanks, Pam

cc120 profile image
cc120 in reply to McPammy

Interesting article: 'T3 to heal adrenals, Selenium, Liver Health–all important info for thyroid patients!'

stopthethyroidmadness.com/2...

Which shouldn't you take NDT or T3?

PM'd T3 prices.

Another interesting article: 'Tests for Adrenal Fatigue you can do at home

'

tpauk.com/main/article/test...

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