Adrenal or Thyroid treatment, which to do first?

[slimecity]

Hi there - please see my test results attached. I have finally found a decent doctor a d she prescribed me pregnenolone (100mg, which seemed very high, so I have reduced to 50mg), 15mg DHEA, 20mg levoxy and also 1IU HGH per day.

Levels are:

Free T4: 16.8 pmol/L

TSH: 2.4 mIU/L

Free T3 5.7 pmol/L

RT3 - very low

Urine cortisol: 127 mmol/collection

Thyroid antibodies (anti-TPO): <1 IU/ml

Plasma Aldosterone: 123 pmol/L

Serum cortisol: 512 nmol/L

CRP: <3 mg/L

Ferritin: 205 ug/L

Total billirubin: 14umol/L

Alk phosphatase: 63 U/L

CGT: 19 U/L

ALT: 19 U/L

Total protein: 70 g/L

Albumin: 40 g/L

Globulin: 30 g/L

Plasma IGF-1: 119 ug/L

DHEA: 4.7 umol/L

B12 and folate: 605 pmol/L & 35.2 nmol/L

I am starting to think however she "threw the lot at me" with a bit of scattergun approach - I beleive (based on reading on the net) that you need to get your adrenals fixed first, then thyroid, then boost your HGH. I felt I was getting too many blood sugar issues with HGH, so I stopped it. I also want to see if I can boost my own bodies production of this too.

I am GF and have dropped allergic food, I am taking B6, 12 + folate, mag, D3, selen, fish oil and others. I read that taking levoxy could be contraindicated in Adrenal Fatigue sufferers. I also felt like I was "racing" on the levoxy, so I stopped taking that too. I felt like my cortisol production was also out of control (no problems with producing cortisol it seems, and my blood tests seem to reflect this).

I read that treating yourself with T4 like this gets your thyroid to put your body in a "racing" state, when the adrenals on the other hand are trying to slow your body down, so that they can recover.

So I am after some advice on the following - will I be OK (based on the blood tests) just supplementing with the preg and DHEA, plus the B and C vitamins, to get my adrenals back on track, and THEN look at taking the levoxy to get the thyroid back on track? After my thyroid readings improve, at that point, I could then look to restart HGH injections to try to get growth hormone back on track? Should I also be looking at ways to boost iron absorption, ie: with B2?

Any advice appreciated, thanks

[silverfox7]

Please can you add your ranges. Ranges are very important as they different from lab to lab so can be very different from what we are familiar with.

I'm not familiar with adrenal problems but from seeing other posts I think it's adrenals first.

[StarFlower2]

Adrenals first. It's often difficult for the body to utilise thyroid meds if adrenals aren't functioning correctly.

[Lozzer66]

I've been told told fix adrenals first then the body's going utilise thyroid medication properly and may end up needing less of it.I'm currently working on this myself .

[OldC]

Thyroid should be treated first. To quote from Roderick Lane's Tired All The Time lecture 'thyroid sets the metabolic rate for all cells and healing'. While you need to treat the adrenals the thyroid provides the motive force for cellular repair. So thyroid and piggyback on the adrenals.

You can read his stuff on Thyroid Care Group in facebook. have a good day, chin up you can get better, i did

C

[cat69]

Dr P advised to get your Adrenals up to scratch first and then treat thyroid and it will help thyroid uptake.

[elaine2447]

I tend to agree adrenals first, not that I have much experience but what I do know is that I reacted badly to just a quarter of a grain of NDT and was told to check cortisol levels which are high and that was probably the reason. Apart from being told this by two large forums, here and one on Facebook, I started investigating why I felt okay for one day out of the five awful days. Cutting a long story short, in desperation I had dug out an old mirtazapine, only 15mg, and took it one night just to get a bit of sleep. I was puzzled and googled and found a study had been done on healthy volunteers and mirtazapine was at that time the only anti depressant that greatly reduced cortisol.

[Howard39]

Hi

I agree with silverfox7.

Without the ranges it's impossible to give you anything but general info.

Usually you have cortisol saliva tested 5 times over the course of the day together with the dhea and it's pretty easy to see where and when you have problems. You can have high normal or low in both ranges so there are only so many combinations you can have.( if you read drmyhill.co.uk and search under adrenal glands it's fairly easy to see the combinations)

That said adrenals are vital to get right. Very low dhea and v high cortisol levels are life threatening so naturally they must be fixed asap.

Yes as someone whose dhea levels were nearly 0 that must be fixed first. You used to be given dhea- now pregnenelone is the Med as it's better absorbed and less artificial. 100 mg is high and there is no reason to take both dhea and pregnenelone- they are ' related drugs' rather like asprin and nurofen. Taking pregnenelone will help your high cortisol ( as you say - I just can't tell from a figure with no ranges)

Other things include tulsi tea and holy basil that will help the racing feeling that you can have from high cortisol- if you had a breakdown ( Geneva do it) I could help more. How do you sleep and do you take anything- there is a reason I ask this.

Your tsh is too high in my opinion and the level of free t4 a little low. If you have high cortisol I doubt without a breakdown of the results you can definitely say the Levo was to blame.

I would suggest you take the pregnenelone sublingualy and any thyroid meds an hour away in which ever direction is best for you.

If you feel levo is definitely an issue you could consider a small amount of ndt but you have healthy levels of free t3.

I have not got all your vitamin ranges so again it's not easy to be definitive. Did you have a red cell magnesium test?

At least you found some one who has heard of pregnenelone that's a start. Yes the results are a little random - but it's a start. Just be careful you don't be influenced too much by reading the internet- can be misleading and confusing. Also why did your doctor not guide you more?

I will help more when I have more information.

Best wishes

[Howard39]

Just an after thought 50mgs of pregnenelone and 15 dhea - equals 80 mg of pregnenelone so I'd suggest just taking the one.

Kind regards

H

[slimecity]

Thanks a lot for the comprehensive replies! I think based on the above I will reduce preg dosage to 25mg twice per day, along with the 15mg DHEA once per day. Just some comments, ranges are reproduced below:

Free T4: 16.8 pmol/L (12.8-20.4)

TSH: 2.4 mIU/L (0.4-3.8)

Free T3 5.7 pmol/L (4-6.8)

RT3 - very low (these results are at work)

Urine cortisol: 127 mmol/collection (50-250)

Thyroid antibodies (anti-TPO): <1 IU/ml (>10)

Plasma Aldosterone: 123 pmol/L (103-1100)

Serum cortisol: 512 nmol/L (170-500)

CRP: <3 mg/L (>6)

Ferritin: 205 ug/L (30-500)

Total billirubin: 14umol/L (2-20)

Alk phosphatase: 63 U/L (20-110)

CGT: 19 U/L (10-50)

ALT: 19 U/L (5-40)

Total protein: 70 g/L (65-80)

Albumin: 40 g/L (34-48)

Globulin: 30 g/L (25-41)

Plasma IGF-1: 119 ug/L (69-212)

DHEA: 4.7 umol/L (2.4-11.6)

B12 and folate: 605 pmol/L (170-800) & 35.2 nmol/L (9-45)

I stopped taking the 10mg levoxy as I felt that I was "racing" and cortisol output seemed high - I was feeling constantly "wired." Last night the last of it left my system and I crashed pretty hard. Now have chest tension and difficulty breathing - basically the "asthma" I have been told all my life that I have. But something that I think will probably improve in a few days once my own thyroids' production re-starts? Not sure what to do about that now. I stopped as I felt there was a metabolic imbalance between what my thyroid was doing and what my adrenals were doing - basically - the thyroid is trying to boost the metabolism of the body while the tired adrenals cannot sustain that output. If people think its a good idea - I may restart the levoxy at say 5mg.

My doctor did say that if I felt "hyper" - to reduce the levoxy dose, so thats what I did initially.

I am supplementing daily with mag and D3 (however too much can offset the fragile sodium balance in the adrenals) so I dont think mag is the problem. Its a high quality complex that I can feel the benefits of. However I had some mineral tests done as part of a full work up in October last year and they were:

Sodium: 140 mmol/L (135-145),

Potassium: 4.5 mmol/L (3.5-5.2).

The higher K result I suspect may indicate adrenal fatigue and the above readings may offset mag blood content - Im not sure on this one.

To add to the above confusion is the HGH. I dont like risking taking it due to blood sugar issues. Plus - higher carb intake (and sugar) benefits the adrenals - however it is contraindicated for HGH. so the proper approach for one is not the same for the other. I was given HGH to take at night for organ/cell repair. I am taking 1IU.

Thanks for your replies and yes I note the cautions - I am taking all advice into account and considering it carefully.

[slimecity]

RT3 results are actually 154 pmol/L (range 230-540)