Hello All
When I last attempted to have my hypo treated the accepted thinking (by enlightened private doctors) was that you never started to treat the thyroid first if there was adrenal insufficiency present.
So I was proscribed Adrenal supplements to take first.
Is this still the accepted route to starting treatment? And what do knowledgeable doctors proscribe for adrenals; is it still adrenal supplements?
Sorry you haven't had any replies. I'll try and say a little. I think you're asking quite a duffel icily question!
Within the NHS, they currently don't acknowledge adrenal fatigue, and you will only be treated if it's at the extreme, Cushings or Addisons.
Going private it depends how enlightened you can find, and I know less about this. Of course the danger is that you'll get one who follows the NHS line.
I've heard it said quite recently to treat the adrenals first, but I'm sure it depends how bad the thyroid condition is. I've had functional doctors mutter to me that they might do that, but because I've had a thyroidectomy they won't take me off my hormone replacement.
The treatments available are quite wide. Definitely adrenal extracts, but also adaptogens, and there are a lot of different tablet formulations that offer packages of adaptogens, vitamins, and maybe extracts as well.
Unfortunately this doesn't get discussed in detail on the forum very much!
Hello SilverAvocado
Thanks for responding; your answer is helpful. Why is it, do you think, that treatment for adrenals doesn't get discussed much on here?
Is it because most people (including those who self diagnose and treat) aren't having any specific treatment for their adrenalsl?
I also feel it is such shame this is not frequently discussed as there is a clear link between all hormone systems (thyroid/adrenal/sexual) and once one is off balance a chain reaction often follows. I suppose the knowledge is still limited in this area and it’s quite controversial too. I’ve been reading up quite a lot on the subject but by no means expert. For me, the key fact is that T3 cannot go into cells without optimal cortisol which is an issue for those low. Too much cortisol steals progesterone and inhibits T4 to T3 conversion.
Hello AnnSo
I'm going to try posing my question more simply; to see if I can get more responses from the salient people.
I wonder that a lot, and its been a struggle for me. I've treated my adrenals on and off since I first got ill 5 years ago. I'm now trying to get more serious, and its all going off and reading alone. I'd love to get great quality references and advice like there are for thyroid hormones and vitamins.
One reason might be that its all a lot more complicated 
Even many of the references most clearly describing adrenal fatigue are vague about how to treat it!
I bought James Wilson's book, Adrenal Fatigue, which may be one of the main books about it - although I still don't know much about its reputation, because there isn't much discussion! This is a novel-length book, and there's still only a couple of pages about treatment with adaptogens, and he doesn't mention glandular extracts at all. Most of his book is about sleep, meditation, etc, but I already work on all of that because I've been disabled a long time!
In another book they recommended going straight to hydrocortisone!
I think if you've had advice from Dr P in the past you probably can't do better than repeat what he advices you as best you can.
I believe he used to advise Nutri-Adrenal eXtra (often abbreviated to NAX on the forum), but that may not be available anymore. I think Adrenovive is a very similar product, and there may be a second brand. If you search on the forum you can hopefully find more detail.
Hello again SA
I'm going to post about the Medical Medium - have you heard of him? He recommends several supplements to take to help with adrenal insufficiency. I can say that they can definitely help but like everything; not for all of the people all of the time....
Worth researching though; you've got nothing to lose (I would start by reading the reviews - UK and USA - on Amazon) to get an idea of how many people he has helped.
No, I haven't heard of him, although I think I've heard the name but haven't taken notice. I will look it up.
I completely agree, there seem to be quite a bit of contradiction on how best approach it. I only have a mild case of raised cortisol only mid day and while some say to take adaptogens to lower it some say adaptogens will lower it too much throughout the day. 🤷🏼♀️
Hello AnnSo
That is a dilemma isn't it? You'd have to have a test done daily to see how you were affected; or you could have a go at taking one of the supps/adaptogens and see if you have any more energy at the times you normally feel you are lacking (I started off with 2 drops at a time; I always have to take any changes slowly).
The thing with MM's protocol: is that he is saying our thyroid/adrenals/you name it; don't work properly because we are so full of germs and viruses; left behind from colds/flu's etc that you have had all your life. He tells you the supps/adaptogens that will help to rid you of those germs which may allow your thyroid and other organs to work better.
Whatever you/we do; it's an uphill, mighty tough struggle....
Hi Moonbeam
I saw Dr Peatfield nearly 3 years ago and he advised on the importance of treating adrenals before treating thyroid.
I took an initial dose of adrenal treatment for 7-10 days before then introducing thyroid treatment & upped the dose of both by way of checking symptoms, taking pulse & temps & then checking in with Dr P again.
I got an Adrenal stress index test done through Genova Diagnostics, to also check levels.
Hope this of some help to you 🙂
Hello Paula
Thanks for responding. It was Dr P who proscribed Nutri Adrenal Extra for me too (he wasn't able to help me with my hypo but I think that that was due to just trying too hard to help too many people and stretching himself too thin. Despite that, I still think he is a wonderful man who cares deeply about unnecessary suffering; especially from hypo).
Dr P is pretty clued up so I wonder if adrenal supplements are still the treatment of choice for those doctors who actually know that adrenals can be treated and improved.
Hi Moonbeam. Your welcome. I too was on Nutri Adrenal Extra. You can just get basic Nutri Adrenal, this has none of the vitamins or minerals that the Extra has.
When Nutri Adrenal Extra & Nutri Thyroid were out of stock for a year, Dr P recommended Adrenavive & Metavive, for adrenals & thyroid respectively. I did feel that both products did make improvements but when I look back I didn't give them my full attention & focus & had not known of this forum. However, having been on this life saving forum for a while now, I need to give my adrenal & thyroid the full attention they deserve. I'll read Dr P's book again & re-read STTM.
Supplementing with vitamins & minerals has made a huge difference & these have had my full attention, so can say for sure that they have made a difference to me. But I still need more help & now I've had new blood tests done, I'd would like to try NDT alongside any adrenal treatment I take.
Hello All
I'm a bit surprised at the low number of responses; I know how helpful you can be so it can't be lack of interest.
Can I ask if anyone on here is taking something specifically to treat their adrenals? And would you mind telling me what it is please?
I think very few people will see this second question, now. It might be that the reason you didn't get many replies was because the question you asked was a bit complicated.
You could maybe ask this new question as a new post, or ask a super simple question like what do people suggest for adrenal fatigue? Or do people have any references. Or quote your 24 he saliva test if you have them. Test results often get more responses.
If you don't have any results, you might as well start by getting those done. You won't really know where you're going until you do that.
Hello SilverAdvocado
Thanks for your advice; I thought it might help to be specific but perhaps not!
I too bought James Wilson's book on Adrenal Fatigue and I found it to be not very helpful at all.
If people are going to self treat; then the best book I would recommend would be Stop The Thyroid Madness.
I've got Stop the Thyroid Madness, but haven't looked at it for age or ploughed through for adrenal stuff! Do you recommend it specifically for that?
My sense is that being specific can put people off. Particularly with adrenals where no one really knows much
Whenever I make posts I feel like there isn't much response, so I'm not the best to give advice 
I haven't read if for a while but I remember the information and advice given on adrenals was in the easiest format for hypo brains to take on board (and I have read a lot of books on the subject over the years; forgotten most of what was said but that goes with the territory).
Also unlike Dr P's book on Thyroid; Janie Bowthorpe explains how to get tested for your adrenals and how to start treating them (I'm fairly sure she was suggesting Nutri Adrenal Extracts or NAX as you said).
The reason I posed my initial question was to find out whether there was anything different being proscribed.....
Thanks, I will take another look at that.
My impression is that nothing different is being discused, though there may be different brands that are more available.
It will focus you if nothing else - please take time to research the MM (medical medium).
Don't be put off by his story; the main thing is that his protocol has helped thousands of people from all over the world and we KNOW it can make a difference because my husband had some improvement with a bladder problem.
The supplements also don't cost the earth unlike most things we have to buy to try to treat our hypo....
Anecdote :
When I took the plunge a few years ago and started treating my own thyroid, my reading up to that point had suggested I probably had low cortisol levels because almost everyone with untreated thyroid issues appeared to have low cortisol. On that assumption, a couple of months after I started taking Levo I bought some adrenal supplements (NAX - Nutri Adrenal Extra). I did a saliva cortisol test, sent it off, went on holiday, and started taking the NAX after doing the test. I found they perked me up a little bit while on holiday, but I was very, very ill at the time for non-thyroidal reasons, so I still felt awful. I also had a dreadful temper on that holiday, sweated gallons, and couldn't sleep. When I got home the results of the saliva test were waiting for me, and it turned out my cortisol levels were high (over the reference range) at all four points in the day that I had produced a sample. It clearly wasn't high enough for Cushing's though.
So, the moral of this tale?
Always test cortisol levels before deciding to treat with adrenal supplements, because otherwise you could find yourself treating the wrong problem. Saliva cortisol levels tested throughout the day are more reliable than a morning serum test for cortisol.
Hi humanbean
Thanks for that valuable and cautionary tale. That's what makes me so angry about having to consider self-treating; it can be like pinning the tail on the donkey in the dark!
Just the other day; I read a link put on here about the importance of zinc.
A woman had all the usual hypo symptoms and eventually was given some Levo; it didn't help her hypo problems at all. But she must have had a good GP who tested her vitamin/mineral levels and found she was seriously lacking in zinc; this was treated and her symptoms subsided - especially her moon shaped face and thinning hair.
If she hadn't of had that vit/min test; she could have been ill for the rest of her life.....scary isn't it?
Indeed it is. I always feel worse when I have to give up any of my supplements prior to testing.
Sorry to pop in, but I was taking zinc in am, 2hr after my thryoid, and it created horrible stomach pains for me. I take it, with caution attempts right now at night. So be careful taking zinc🌴
Humanbean, good advice I think to test!
Did you end up doing anything specifically for your high cortisol? Mine was low a few years ago, I treated it with a functional doctor I don't recommend, and it ended up very high.
At the time I thought that was an improvement, so left it for a while. I'm now planning to retest (my last high test was a year ago) and self treat.
But almost everything I find is about low adrenals. I wonder if the implication is that high cortisol is just low cortisol before the crash (high cortisol is often seen as 'stage 1' of adrenal fatigue as the adrenals struggle to keep it high, which leads to an inevitable crash into 'stage 2'). I believe mine has been high for about 3 years, and last year was higher than ever.
I'm actually planning to push for another NHS cortisol test this month. I've had over range results in the past, and my 24hr results last year were much higher than when I had the blood test.
Do you have any advice for where to turn?
After I first found out that I had high cortisol I tried Seriphos. It's five years ago now, so I don't remember the details very well. I started with one capsule a day and increased it to three over about a month. I was very ill at that time with a severe non-thyroidal problem, so my experiences are probably not a good indication of what might help other people. I found the Seriphos made me feel worse than ever - like I was suffering from full-blown flu. But I also know from feedback I've read on the web that many people swear by it and think it is wonderful stuff.
I also tried Rhodiola Rosea. I found this very helpful for a couple of years, before I finally (and quite suddenly) found I couldn't tolerate it any more - I never worked out why. It gave me a little boost of energy that was very welcome. I wish I could still take it.
I had a saliva cortisol test done about a year after the first, and it showed the pattern of my cortisol had changed. Now my first sample result was sky-high, and the next three had dropped into the reference range (although they were still high in range). My total cortisol for the day had actually increased slightly. I have never tested saliva cortisol again since. (I'm a cheapskate.)
I tried Ashwaghanda - it makes me feel sick, but is another thing that others swear by. I ditched that after a few days.
I plodded on, never really being able to get my thyroid hormone levels up high enough to feel well. Often when I tried to raise dose I got jittery and anxious, sweaty, and with dreadful insomnia - all symptoms I associate with high cortisol.
Then I tried Holy Basil about 18 months ago. I tried the dose suggested on the bottle - 2 capsules a day - but it seemed to do nothing. I increased to 2 x 2 capsules. That was a little bit better. Then I went up to 3 doses of 2 capsules, then 4 doses of 2 capsules. In the end I settled at 3 doses of 2 capsules for a few weeks, then reduced to 2 doses of 2 capsules a day for a few months, and then reduced to 2 capsules a day almost permanently.
I stopped taking them for about a month quite recently and ended up with the symptoms I associate with high cortisol again, so I am currently taking 4 capsules, and plan to reduce to 2 at the weekend, which I will stay on.
I really, really should do another saliva test. One of these days I may do it. But I would do the test while taking 2 capsules of Holy Basil. Because it is then that I feel about as good as I get, in terms of cortisol issues.
I should mention, that soon after taking Holy Basil I was able to double my dose of thyroid meds.
The one I've been taking is this one :
healthmonthly.co.uk/swanson...
Hi
What prompted you to try Holy Basil?
I found loads of articles similar to this one :
mindbodygreen.com/0-23289/7...
and was desperate enough to try it.
I just struck lucky in the end, because I find most articles about adaptogens very unconvincing. They don't explain anything very much.
Thanks humanbean
I've just looked at the article and it mentions most of the supplements that the Medical Medium recommends for treating the adrenals and he has had some bad press on here.
It's exciting because Holy Basil is an extract of a leaf of Basil; it's not a drug nor a steroid. So much better for your body overall if of course, it works for you.
I also noticed that it's supposed to be anti-aging! Are you looking any younger yet?!
Am I looking any younger? Sadly not. I'm convinced I'm galloping to the grave at twice the speed my husband is. But then I have other health problems besides a dodgy thyroid and high cortisol. 
Thank you so much Humanbean, that's really really useful. You've mentioned all the adaptogens I was seriously considering, and its great to have a real life example of taking them for highly cortisol. As I mentioned before, almost everywhere they talk about low cortisol only.
Do you also recommend this buying site?
If you don't mind me asking, was there a particular reason you tried them in the order you mention? Its hard to choose which way to turn first!
I use HealthMonthly quite a lot and have usually found them to be reliable but slow. I think a lot of their prices are reasonable too, if bought in multiples. Their head office is in Gibralter I think, but where they keep their actual stock? I have no idea. I do remember one thing I bought came from Jersey. I like the fact that they give discounts when buying several bottles of something.
If you don't mind me asking, was there a particular reason you tried them in the order you mention? Its hard to choose which way to turn first!
I started trying to fix my cortisol about 5 years ago, and at that time I was still a novice in everything to do with self-treatment. I think the order probably depended on what articles I'd read most recently - there was no rhyme or reason to it.
Thank you for taking the time Humanbean! This has been a great help to me.
I think it doesn't get talked about much because no one really knows how to treat it and get decent results. It annoys me a lot that so many people constantly repeat the importance of saliva cortisol testing. But no one can really tell you what to do with the results! I've swallowed so many adrenal supportive supplements for many years and not felt a jot of difference. It costs a fortune and doesn't seem to help.
Dr P. diagnosed me with a thyroid issue around 5 years ago and also said I had adrenal fatigue. My pattern was very high morning cortisol (off the top of the range) and then varying patterns throughout the day over time. He put me on glandular products, even though my cortisol level over the day was quite high. Initially they gave me a focus and energy but it didn't last long. So I was told to increase. I ended up taking several a day, spread over the day and then I crashed. I was in a right state then. He was in hospital so I couldn't get advise. I felt so awful I just stopped taking Armour and the adrenal glandulars. That was a dark time. I'm not sure I'm ever going to attempt to mess with adrenals on my own again.
It bothers me that doctors don't recognise adrenal fatigue. Not because I think they should, I mean it bothers me that they don't see it as an issue. Are we imagining things? Not the symptoms, obviously most of us on here have issues of one kind or another. But are we imagining that our problems are something different to what they actually are. Every private doctor I've seen apart from Dr P. has said that saliva is not a reliable way to test cortisol. My GP would not even look at my Genova test results. And some of them have been adamant saying "no glandulars". Again, I'd like to know why, perhaps we can make things worse by using them. We all notice how thyroid meds might make us feel a bit better at first and then we need more. Perhaps it's the same with glandular products and we are helping vital glands to lower their own production.
I do have to have a new morning cortisol test carried out by my GP because a new doctor has spotted that my test 2 summers ago was ignored and pushed into a file despite very low results. She wants me to get it done again and so that's what I'm going to do. And then perhaps she will be able to help me interpret the results in relation to my thyroid needs.
I struggle to raise my Levo dose. It's been a 4 week battle so far to get from 50mcg to 75mcg a day. But I have just completed my first full week on 75. I think, for me, every dose increase will have to be done very, very slowly and carefully.
Hi FancyPants54
Thanks for giving us your experience. I've read about endo's who have never treated adrenals so don't be surprised when GP's look blank if you dare to mention them; or they might have heard of them but have diddly squat to give you to treat them.
You ask 'are we imagining things?' I would say not; the only thing that ever had a definite affect on my adrenals was NAX. I was hyper anxious, my body shook and my head felt as if it couldn't support my neck; I started off real slow (as I do with all things) and slowly they started to reduce my symptoms.
I stopped taking them when I heard that they are actually a steroid but not sure now if I did the right thing...…
How do any of us know if we are doing the right thing? It's back to pinning the tail on the donkey in the dark again.....
I did quantify the "imagining things" quote by saying are we attributing the symptoms we have to adrenal fatigue when it might be something else.
I suspect a lot of us have been running on empty for a long time and need to go really slow with Levo. But we try to rush things. 6 weeks seems like eternity but perhaps it's still too quick for those of us who have been ill for a long time and we should take our increases even slower.
Just guessing because there is nothing concrete out there to pin the tail on in my view. Adrenal glandular contain adrenaline, which most of us don't need.
Fancypants54, I've read that what you are doing with slow increases is the right thing to do. I think this was in an Autoimmune Protocol book, she said it could take up to 12 weeks between teensy increases.
It seems to be the only way I can do it. I started on 25 every other day. When it came to move up to 50 I tried it in one go and felt bad. So had to do it every other day with 25. Then I got to the point where I felt really depressed within 1/2hr of taking the medication and got worse. I then realised that I needed to go to 50 per day and all that went away! I tried going from 50 to 75 in one go and after 3 days I felt more hypo than I've ever felt with some horrible symptoms so I backed off to 50/75. After a week I tried 75 every day again for 3 days, still felt bad. Back to alternate days. After 3 weeks of that I was able to go up to 75 with no problem and although the first week was hard (tired and miserable) I'm now into the second week and although my back is aching I've actually swept and hoovered my small warehouse and office this afternoon as well as working! I feel ready to stop now, but I've not swept or hoovered here at work since before Christmas so I'm taking that as a good sign!
That sounds to me like exactly the right thing to do Good luck with it.
Which med are you talking about Levo ? Those adrenal glands at least mine I'm sure are due to severe fight/flight survival stressful situations. This is noted as fact, however there really isn't any documented "real" fix for them once they burn out. My dr., appt is coming up, she is head of women's dept, to a hospital, #1 in state, #3 in USA. I'll ask/post ANY info if it could be eye opening🌺
This was a few days ago, but I believe we're talking about Levothyroxine.
This is in the situation where a person gets a speeded up, overmedicated feeling when trying to increase thyroid hormone. This is most common with T3, but can happen with Levi, too.
There are a few things to try, but one is to go super slow in increasing.
So sorry in reply, sick.....im on armour 50mg, been told I'm severely under medicated, my dr., is gp current blood test, i asked for a full list (as shown to include b12, t3, follate, etc) she sent blood test for the, t4 only? Next appt asking to be referred into thyroid clinic, im shocked after length of treating this illness, adrenal r not included? Let alone a patient isn't listened to?
Adrenal fatigue is not often accepted by conventional doctors. In the UK you won't get any help with it on the NHS 
Its self treatment only, unless you can find a naturopath or functional doctor to help you.
Ok, I'm using a local bioidentical pharmacy for my armour, also for hormone replacement (estrogen,progesterone) they also have naturopath info. I'm in USA. Next go appt is mid July, to review this current blood test I'll ask for another, to include full list, I'll ask armour increase. Do you know of site for info, I can bring to show my gp (follow as a guide) me asking/telling isn't as educated, but I'll write along document how I feel, and how it's led to other medical problems. Thank you, very much, I'll make a new post for other ?, the you
Hello
'Stop The Thyroid Madness' by Janie Bowthorpe has detailed info on adrenals and how to test them and self treat (though really this is best done with professional guidance).
Her website will be well worth looking at too.
Thank you, very very much! Be well💐
My saliva test showed I had 4 very lows. I had all of the symptoms of severe adrenal fatigue. Even my baseline cortisol on the ATCH test was below range but because I'm guessing my cortisol rose sufficiently during the test the nhs declared me to have no problem with my adrenals!
This obviously wasn't true as my thyroid levels were optimal yet I still felt like death. I saw Dr P and took Adrenanvive for some time.. I worked my way up to 2 of the iii in the morning and 1 at lunch. This gave me a bit of energy initially but over time i felt I wasn't progressing. Next I saw Dr W in London. He said I must be feeling pretty awful with results like that.. (I was) and suggested I try Pregnenalone for my adrenals (on top of the adrenanvive). This gave me severe heart flutters and breathlessness so I stopped it.
I have now taken things into my own hands and following advice from a good adrenal related Facebook group i have been on for a while i have started Hydrocortisone, 25mg a day. They also advise how to dose with glandular extract (like NAX, ACE and adrenavive). It does worry me that I am taking HC but I am literally at the end of my options so to speak. My adrenals are bad and need some serious intervention. I am hoping this will help. I Have also started the auto immune paleo diet which I am hoping with help with some of my symptoms.
Cheers
Chloe
Thanks for responding SeaVee79; the thing that seems to be coming through loud and clear is that most of us are out there suffering and searching for products/medications/supplements that will significantly help us.
You could do worse than read the other post I have just started; it couldn't harm to get more informed.
Do you mind saying what the FB group is called? It's great that you have support on there and are taking things into your own hands.
I'll have a look thanks moonbeam. I'll PM you the name of the group as not sure if I'm allowed to mention here.
Thanks
HC always best for treating adrenal fatigue?
Adrenal ignorance
Thyroid, Adrenal Fatigue & Supplements
What is the maximum limit for B12?
How to split T3 from 2 to 3 dosages, and withdraw from adrenal support?
