T3 or NDT with poor adrenals?: Just to recap. TT... - Thyroid UK

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T3 or NDT with poor adrenals?

Sally56
Sally56

Just to recap. TT 18months ago. Levo till April this year and straight onto T3 only, after returning a poor conversion of t4 to t3. Having adrenaline rushes which I believe are due to low cortisol (haven't tested yet as I'm on Hyrocortisone for another 2 1/2 weeks) . Was unable to get past 15mcgs of t3 because of rushes. As a result I returned a TSH if 78 and for the last 11 days been on hydrocortisone and doubled my dally dose of t3 to 30mcgs. I am in a struggle I can't cope with. I have elevated BP. I feel agitated, brain fog and stressed out. I have the option of struggling on with t3 plus hydrocortisone. Or going onto NDT. I need my brain back. I am not coping. Has the t3 set of my struggling adrenals for good? Should I try NDT? So fogged up. Can't make a decision to save my life. Thanks. I see my GP in 2 hours. She feels out of her depth and my Endo goes on extended leave today grrrrrrrrrrr!!

33 Replies
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Well I've seen my GP who spoke to my Endo. The plan is increased Hydrocortisone to 30mgs so 10mgs x 3. Taken 30mins before T3 which remains the same at 30mcgs so 10mcgs x 3. Both Endo and GP are at a load as to how bad I feel. I see GP again next week. Endo is away for 4 weeks holidays. (Sigh) . I explained low cortisol and adrenaline rush response on T3 but they both thought it all a bit weird??? That's me! I am going to post a question on whether I can take adrenaline support (zinc, Vitc adaptogens) whilst on Hydrocortisone. But would love to hear anyone's wisdoms on my current. 'situation'.

Look for adrenal cocktail recipes online. I use V8 vegetable juice which has lots of Vit C sodium and potassium.

T3 is hard on the adrenal to start with but it does get better as they get used to it.

When I first started NDT I would get very dark circles under my eyes an hour after each dose. This doesn’t happened anymore and I’m on a much higher dose now.

Hi Missimal,

I shall google that, I love V8 Veg juice, so will get some straight away. I have an adrenal disorder called Primary Aldosteronism and I have to be careful of sodium dosing as it can cause my potassium to fall. But I used to get a low salt V8. I shall buy that one.

What happened to you at the beginning and what dose did you start, increment and end up with?

The black eye thing, my son has. I am getting him to test for adrenal fatigue with a saliva test tomorrow and also thyroid bloods. He also has high anxiety (as does my other son, my mother, grandfather etc.) I do believe that undiagnosed thyroid issues are at the bottom of our familial anxiety and brain fog.

I'd love to hear about your journey. I'll see if it is documented on here first! Thank you so much for replying.

No wondered your adrenals are struggling - I don’t know about primary aldosteronism so you’ll have to check the sodium levels

I was told my dark circles were from my adrenals releasing a lot of aldosterone in response to the T3 and that was on 0.5 grain doses 3 times a day. I now can take 2 grain at once with no dark circles and im on 4.25 a day. I would say it took 4 months of gradual increases to improve my adrenal response.

Thanks Missimal. Yes it's a bit of a ticking time bomb. I have been hospitalised a fair bit with it. Not in recent years since I'm medicated.

Very interesting that you were told black eyes were aldosterone. I wonder if my sons have inherited that pearler from me as well! I have no thyroid (TT) as well which is all about not being diagnosed in time.

I have been reading your posts. It's great to have a record of everything to look at. You've had your battles too!!! But a happy ending I am predicting.......shall read on!

Another symptom I used to get when I first started NDT was an internal tremor/vibration throughout by body which felt like I was sitting in a car with the engine running - I was told that was adrenal related as well.

Good news is I don’t get that anymore either - so I think it just takes time for your body to get used to the medication

Missimal,

Those internal shakes are my constant companion. Especially when I stop and lay in bed. Horrible things. They have gone away a few times, especially when I first started T3, 3 months ago. I thought I'd hot the jackpot! They are disgusting and wake me up sometimes. I used to get out of bed to see if something was shaking it! I had them before I was medicated (before the TT). But I agree they are adrenal. If only the Doctors would listen to us? Thank goodness for this forum!

I wonder if you are still under medicated... when did you last have your FT3 levels tested?

Oh Missimal,

This is my journal entry for today!

Last T4 20th. April 2018

Results: 31/7/18

Reference range

Free T4. <5.2 (9.0-19.0)

Free T3 4.0 (2.6--6.0)

TSH 17.7 (0.3-4.0)

In 12 days because of doubling my T3 T3 is.4.0 and TSH 17.7 (results from 19/7/18)

Results: 19/7/18

Reference range

Free T4. <5.2 (9.0-19.0)

Free T3 2.7 (2.6--6.0)

TSH 71 (0.3-4.0)

Reverse T3 <40 (140-540)

Fasting Glucose 4.5 (3.6-6.0)

Iron 20 (5-30)

Magnesium 0.86 (70-1.10)

S-Insulin 8 (3-15)

Peroxidase Ab <1 (<6)

Thyroglobulin Ab 2 (<4)

Caeruloplasmin .21 (.20-.45)

Copper serum 15.6 (13.0-25.0)

Zinc plasma 11.3 (9.0-`9.0)

Hydroxycalciferol VitD 158. (50-`150) Have stopped supplements now

Iron 20 (5-30)

Transferrin 2.3 (1.9-3.1)

Ferritin 90 (30-300) Been supplementing Ferritin

Active B12 >128 (>35)

Folate Serum 34 (>7.0) Ben supplementing B12 with Folate

So yes I am undermedicated. I was unable to get the T3 up over 15mcgs in the last 3 months resulting in the horrendous TSH of 71! That's when my Endo put me on double the dose, T3 @ 30mcgs (yes not a high dose normally). I couldn't have done this without the Hydrocortisone. I started having the adrenanline rushes 2 weeks ago before the rise and during when I was trying that CT3M Method. I am wondering if T3 only is for me. It is so hard on the adrenals. But my Endo went away for a months holiday today, so he didn't want to change my regime. I'm stuck here hoping these rushes will stop. Today bloods showed my TSH was down to 17.7! OMG!

Sally56
Sally56
in reply to Sally56

Gosh, stress really is our number one enemy isn't it?

hi there. So sorry to hear you feel so bad. I notice your active b12 is above range but that can happen with supplementing or fortified food. Do you take any vitamins containing b12, fortified foods and drinks, or on b12 injections? Or spirulina? Have you had your mma, homocysteine, intrinsic factor and parietal cell antibodies checked?

Sally56
Sally56
in reply to moomoo17

Gosh Moomoo17, Yes I have been taking B12 with Folic Acid for about 2 months orally. Is it over? I'll check that out.

I have no idea what mma, homocysteine, intrinsic factor or cell antibodies are?

moomoo17
moomoo17
in reply to Sally56

hi there its no problem at all to be over range with b12, its a water soluble vitamin. My worry with supplementing without having all the tests beforehand is that it will skew all b12 results now and you might not absorb the oral as well as you would injections but that becomes difficult to find out once supplementing. Did you start supplementing because you were deficient?

moomoo17
moomoo17
in reply to moomoo17

although you can have intrinsic factor and parietal cells tested even when supplementing. You can get them all tested while supplementing but some will be skewed and perhaps show false normal because of the supplementation.

Sally56
Sally56
in reply to moomoo17

Hi Moomoo17, No I wasn't deficient in B12. I just saw it as one of the things in here I should have for better thyroid meds absorbtion. Also being a non converter t4 to t3.

ALlo I have no idea what mma, homocysteine, intrinsic factor or cell antibodies are?

Sally, I think it's a really, really bad idea to increase the HC when you've never even had a cortisol test. Why doesn't your doctor do a 9 am serum cortisol test, at least? Did I mention to you that you should only take HC in the morning with Adrenal Fatigue? Never after 1 pm. So, how are you supposed to fit in three doses? I really think you ought to see another endo urgently. This is not something that can be handled by a GP, they don't have the knowledge.

Sally56
Sally56
in reply to greygoose

Hi Greygoose,

I have a cortisol test here, I can do it myself. I thought it would be compromised by my valium use and now HC use? What do you think? Shall I just do it before it's too late. I'm on Day 11 of HC @ 20mgs. Okay, so I was taking the HC 30mins before the T3 to dull down the adrenaline rush of taking T3. So just once in the morning? If I have Adrenal Fatigue? Will do. My Endo is the Endo's Endo in Brisbane, if you know what I mean. I am so scared of getting a quack. He was from the site here. (Yeah I know). I have an adrenal Professor for my Aldosteronism but I recall him scratching his head when I asked about my high cortisol reading? (5 years ago now). I see him yearly. If I didn't have brain fog, I might be able to make a simple decision. But the truth is no one knows, your not meant to have two adrenal disorders, the Professors just can't deal with with each others arenas. I've been to a very costly Physician twice and he did and knew nothing. I honestly believe my best bet is here.

greygoose
greygoose
in reply to Sally56

So, 5 years ago you had high cortisol? Even more reason why the 'endo's endo' should have tested your cortisol before putting you on HC. Can't you just ask your GP to do an early morning serum cortisol test? That would give you an idea, rather than wasting the saliva test. And, if you don't have adrenal fatigue, you shouldn't be taking HC.

Also, if you already have a known adrenal problem, how do you know that it's not that problem causing the symptoms? Why automatically suspect cortisol?

Taking your HC just 30 mins before your T3 is probably affecting the absorption of your T3, which won't help.

Sally56
Sally56
in reply to greygoose

Yes I have Primary Aldosteronism and it is controlled by Aldactone medication. My Adrenals make too much Aldoserone. It is very hard to get diagnosed and treated. I insisted many times that I be investigated for it, before it finally gave a glimmer of a maybe in the results. Diagnosis involved 5 hospital stays, one for almost 2 weeks of laying flat. Then venous sample from the vein that goes into the adrenal gland whilst awake on an operating table. Excruciating pain and had to do it twice. Last time 5 ours on the operating table. All this, plus offering my body up for research for this 'rare' illness and my Endo's Endo (quite like that) finally admitted on the phone to my GP this morning that he had no idea how the Aldosteonism would be impacting my thyroid meds. The two Profs are in the same buidling at the hospital! GP at least didn't pretend to understand any of it. I'll be stuffed Greygoose, honest, I have kicked and gouged for my health for many years but I am so running out of steam.

Aldosteronism, deals with the adrenal gland not the cortex. Yes two different specialties. The Endos Endo would have done Aldosteronism 101, you'll never see it. My Professor for the Aldosteronism is a world wide expert. But is not an Endo! Adosteronism has a specific set of symptoms, none of which include cortisol or adrenaline production, low or high. It causes hypokalemia, and very high BP. I don't know where to turn.

I am the exception and I was when I went through the adrenaline and subsequent anxiety and ill health, it caused 5 years ago. I know now that it was undiagnosed hypothyroidism and Primary Aldosteronism, a double feature. I managed with time to heal myself and when they took my thyroid and I went on T4, I felt a glimpse of health for the first time in years.

T3 seemed like a miracle to me, until I crashed 2 weeks ago, with some very wonky Thyroid levels. Aldosteronism is perfect. Okay got that out of my system, excuse me please.

Now, no I can't ask my GP to do a cortisol test. She has declared herself Switzerland. (I don't blame her) Can I just do this saliva test myself tomorrow? I will investigate an Endo.

Sorry I am so verbose, I seem to be crying now as well.

greygoose
greygoose
in reply to Sally56

Oh, don't cry. Well, yes, do cry, get it out of your system. You've been dealt a very rough hand in life, and have had a lot of suffering. Which is why I want to try and avoid further suffering for you. Yes, do the cortisol test. It seems to be the only way to get any sense out of all this.

Both your GP and your endo have behaved most reprehensibly. The endo for not testing your cortisol before putting you on HC, I imagine he wanted to save time, with his holidays coming up! And, also for increasing your T3 by 15 mcg in one go! I can't imagine that's made you feel good. And your GP for abandoning you. Even if she doesn't know anything about it, it wouldn't hurt her to do a test!

I'm not sure how valium is likely to affect cortisol. I've been googling but can't find anything that says much about it. Vit C seems to reduce cortisol in people with high cortisol, but doesn't say anything about people with normal cortisol. I think the only way you're going to find out anything is to do the test. :)

Take care. x

Sally56
Sally56
in reply to greygoose

Greygoose,

Thank you for your kind words. I shall do the test tomorrow. And yes, I have been shafted by my Holidaying Endo and my politically immune GP. I'm going to bed.

greygoose
greygoose
in reply to Sally56

Have a good sleep. Best thing you can do. I look forward to seeing the results of your saliva test. x

nutritionalmagnesium.org/bl...

I believe in taking extra Magnesium having been a somewhat poor converter with poor adrenals to prevent 'crashes'... and have been put off believing the serum levels to be of much help (see above link). We have seriously underestimated it's importance in helping overcoming autoimmune issues. However, if you've reached a 'crash' state then you'll need to replenish electrolytes in general including sodium before taking additional magnesium. Coconut water is a good electrolyte source.

adrenaladvice.com/magnesium...

Sally56
Sally56
in reply to HLAB35

Hi HLAB35,

Thanks for your reply, I don't know where I am in the adrenal stage process. I was high cortisol for a long time, then never tested again. I was really well until 2 weeks ago. Sleeping, waking refreshed, no big anxiety, a bit stressed, but I am doing my PHD, working part time and have one son at home in final year uni. I love life.

Until wanting a bit more than what T4 was offering, and finding out I was not converting well. The Endo suggested T3 ONLY. Why not? I have been getting muscle cramps at night recently though? I have begun taking magnesium but I shall check if it is the right one. I have ti be careful with electrolytes as I have a serious Sodium/potassium issue with Aldosteronism. I shall look further into this though as I think the link was very insightful. So thanks so much.

HLAB35
HLAB35
in reply to Sally56

I recommend 'The Magnesium Miracle' - may be able to get it from your library, but the latest edition has more content. Magnesium has helped me immensely deal with lots of stress etc. The only thing you have to watch out for is kidney function - Magnesium requires lots of extra fluids. One that may help you could be Magnesium Taurate as both help with GABA and support adrenal health.

Sorry, forgot the link..

ncbi.nlm.nih.gov/pubmed/6814

Sally56
Sally56
in reply to HLAB35

Hi there HLAB35,

Thanks for your reply. The link took me to something on Taurine?

HLAB35
HLAB35
in reply to Sally56

Yes, it works well with Magnesium. If you read Carolyn Dean's book on Magnesium she mentions how taurine also protects the heart and prevents atrial fib / arryhthmia. (She also mentions the need for more Magnesium when you're on thyroid replacement.)

livestrong.com/article/4712...

Sally56
Sally56
in reply to HLAB35

Oh I see! Do you take or would you recommend Magnesium taurate? I have the ingredients of my magnesium:

Mag amino acid chelate 75mg

Mag citrate 291mg

Heavy mag oxide 423mg (equiv Magnesium 305mg)

CHromium 50pg

B6 50mg

D3 2.5pg

Manganese 4mg

calcium ascorbate Vit C 50mg

Is this any good? Thanks for helping me.

HLAB35
HLAB35
in reply to Sally56

I would recommend magnesium taurate - started taking it in the evenings and it's somewhat more effective than citrate at making one feel rested. It's expensive, but it does seem good if you've had any wired / tachycardia symptoms from hormone imbalances (especially in the summer it seems). Would definitely not recommend oxide - it's just really hard to absorb and almost just a 'filler'. I've also tried malate which is very good for muscle and nerve pain - perfect for fibromyalgia - which I seem to suffer with more in the winter... trying to prevent RA which is in the family.

Strength and Sympathy for you Sally56 . I could not raise or even dose with synthetic T3 /NDT till I supported my adrenals first . You need to make sure your on a very good B-Complex I take extra B-5 and Vitamin C . I found that Sea Salt first thing in the AM helped to calm my adrenals . I take 1/2 lemon in warm water with 1/4tsp of Sea Salt . If there is some discomfort in the adrenal area just take a pinch of Sea Salt to calm the area . Eliminate sugar make sure to keep good sleeping hours . Try to relax more . Try to read Dr Wilson's book "Adrenal Fatigue: The 21st Century Stress Syndrome" .

Wishing You Better Days Ahead .

amazon.com/Adrenal-Fatigue-...

Sally56
Sally56
in reply to jgelliss

Thanks Jgelliss,

I am not on any B vitamins at all. So I shall get some. I can't take the sea salt because of my Aldosteronism unfortunately. I have to avoid all salt. I am on the Michael Mosley low carbs/sugar diet. I have been for over 12 months and have lost 13 kilos. I, like so many on this forum, oput on a stack of weight around the tummy area very quickly. Yuk! I have been re-thinking my very stressful life. There are plenty of changes to be done i the relaxing area. It's not something I do well. Thanks for your supportive words.

Just as a PS. I did the Saliva Test yesterday. Thanks for all your support. I still feel blah, but I am not freaking out and that's down to you guys.

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