Preparing for endocrinology assessment - adrenaline rushes

[whisperit]

I was diagnosed with Undifferentiated Connetive Tissue Disease 18 months ago and have been taking hydroxychloroquine and low dose prednisolone ever since. This has cleared up my initial problems of joint pain and lung inflammation, but left me with long term extreme fatigue, very poor sleep and daily episodes of extreme sweats, nausea and shaking. This has been so severe that, from working full time and spending my weekends mountain biking, I have had to take ill health retirement and struggle to walk to the end of the road.

My concern is that my rheumatologist has diagnosed these problems as fibromyalgia. I have managed to persuade him to make a referral to endocrinology, but won't be seen until March. Meanwhile, I have daily episodes where I feel a sudden "rush" of flushing and a burning face, with sweating, racing heart, nausea and shaking. I also tend to wake in the small hours of the morning with similar symptoms. I believe these are due to some problem with my adrenal/cortisol regulation.

I have had only a couple of one-off thyroid (FSH, T3 and T4) and a single cortisol level, which are all reported as "within normal range". I appreciate these are unsatisfactory for diagnostic purposes, but this isn't my main question for now.

I'd be grateful if anyone could suggest anything that my GP could do to provide useful information prior to my endocrinology assessment. Also, how I can make sure that assessment goes well and fully addresses my worries about adrenal function.

As a bonus, if anyone has tips on dealing with these "adrenal surges", that would be great! Thanks

[shaws]

I am not medically qualified but I think you should have a 'Full Thyroid Function Test' i.e. TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. Your GP or Endo may not as they seem to only do TSH and T4 and diagnose or not by the results.

We have two private labs which will do all of the above and I'll give a link below. Both Blue Horizon and Medichecks are good.

You could have thyroid antibodies, and if you do you would have an Autoimmune Thyroid Disease, commonly called Hashimoto's and the antibodies wax and wane. Sometimes people feel hyper and at other times hypo. You'd eventually become hypo due to the attack of the antibodies on your gland and it is the commonest cause of hypothyroidism.

thyroiduk.org.uk/tuk/testin...

All blood tests for thyroid hormones have to be at the very earliest, fasting (you can drink water) and if taking replacement hormones (levothyroxine) you'd allow a gap of 24 hours between the last dose and test and take it afterwards. This helps the TSH to be at its highest as it drops throughout the day.

Levothyroxine should be taken first thing on an empty stomach with one full glass of water and wait about an hour before eating. Food interferes with the uptake of levo.

[whisperit in reply to shaws]

Thanks for that. I will definitely look into doing that.

I am unclear what the relationship between thyroid and adrenal systems is in this context. The symptoms I have are exactly what I would expect from a huge surge of adrenaline; does thyroid function govern this, or does thyroid dysfunction simply have similar effects...?

[shaws in reply to whisperit]

Sorry for delay in responding. Hope the following will be helpful:

holtorfmed.com/understandin...

[whisperit in reply to shaws]

thanks

[SlowDragon Administrator]

When thyroid is not working correctly, the adrenal system has to stem in to compensate. This is why it's always essential for medics to consider adrenals before starting thyroid medication

Adrenal glands need plenty of vitamin C for support, and salt to

Read about adrenals

Drlam.com

Endocrinologists will not recognise adrenal fatigue. They only acknowledge Addison's or Cushings.

But many thyroid patients before diagnosis well recognise adrenal fatigue as very real and challenging to deal with

stopthethyroidmadness.com/a...

For full Thyroid evaluation you need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

Link about antibodies

thyroiduk.org.uk/tuk/about_...

You are unlikely to get full thyroid and vitamin testing from GP

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

[whisperit in reply to SlowDragon]

That's really helpful, thank you. I've just ordered those tests, and now I've got plenty of reading to do while I wait! x