Adrenal function

[Ginny52]

People, I’d like to ask something.

2 lots of hospital endos (first one and nhs second opinion) refused to test for pituitary damage which I am fairly sure has caused my secondary hypothyroidism. In despair, and very unwell, I went to a private endo who prescribed 75mcg of thyroxine until I had a private mri. Now, I am simply not going to be able to afford this. I have bouts of abdominal pain and nausea which I think are possibly caused by inaquate adrenal function, in the presence of thyroxine.

My question is this: would adrenal insufficiency cause my thyroxine to work less efficiently? I feel sick, which I can endure, but I feel that it is somehow less effective, and that the original hypo symptoms are coming back. I go back to hospital no.2 next Tuesday xxxx

[Hidden]

Adrenal function has to be at a good level for Thyroxine to work well. An initial early morning blood cortisol is a good start to see what your cortisol levels are like. This will show if you need any further testing. ACTH is produced by the pituitary gland sending a message to the adrenal glands to produce cortisol. Damage to the pituitary can stop the adrenal glands responding well or the adrenal themselves can be compromised. Sadly not all Endos have an understanding of pituitary/adrenal issues.

[Ginny52 in reply to Hidden]

Thanks Pauline! My am serum cortisol is about 345 (under the 400 at which I think it can be assumed to be enough without further testing). My saliva test looked adequate. Strange thing- Dr P suggested trying adrenovive and it made me violently sick, the 2 times I tried it, which was odd and I haven’t seen anyone else experience

Hugs

[Kacey12 in reply to Ginny52]

Hi Ginny

Interestingly, a private nutritionist I have been seeing asked me to get my cortisol tested, and my early morning one was lowish at 3.39 nmol/L which is just inside the ref range (2.68-9.30). She explained this as probably past stress, plus, under medication of thyroid meds cause the adrenals to try and make up for it, thereby becoming fatigued. She prescribed a licorice supplement which is delicious! (if you like licorice - I know some people don't!). But, I agree, all this testing etc is expensive, isn't it?

[Ginny52 in reply to Kacey12]

Under medication seems a possibility. I think we had some liquorice in capsules so I couldn’t taste it. I go to the nhs ones one Tuesday so I just have to hope they’ll be a bit more on it- thanks!

[caledoniancat]

Secondary hypothyroidism can be due to undiagnosed Addison's disease, and if you are put on levothyroxine before Addison's is diagnosed it can exacerbate Addison's symptoms because cortsol is being used up more quickly through a quicker functioning thyroid. Vomiting, abdominal pain, tiredness, breathlessness, low blood preasure, hyperpigmentation, joint pains etc are some of the symptoms.

[Ginny52 in reply to caledoniancat]

Yes-I had a bad fall on Thursday, and was concerned this seems to happen with shocks. I don’t make tsh because my pituitary doesn’t function, but I’ll have t3 & 4 levels done on tuesday-i hope they are a bit more alive this time! X

[Hidden in reply to Ginny52]

With cortisol levels of 345 nmol/Ls you wouldn't have Addisons, however if your pituitary doesn't produce TSH then it might be compromised for producing other hormones. To be honest I wouldn't take any supplements until you have had full tests for seeing what your adrenal & pituitary function is as they will mess up any results.

[Ginny52 in reply to Hidden]

Yes- I can see that there’s enough cortisol most of the time, but I think stress like surgery and last weeks fall might push it. Let’s see what Tuesday brings- they offered an acth test at one point and i expect that would show whether your system is functionally capable of dealing with synthetic thyroxine, although some people seem to think there is a grey area where adrenal production is inadequate without being clinically insufficient. I still feel a bit rubbish, but better than yesterday xx warm thanks G

[Hidden in reply to Ginny52]

The ACTH should show if your pituitary is making enough to stimulate the adrenal glands to produce cortisol, so a good one to have done.

[Ginny52 in reply to Hidden]

I have slightly lost faith in mainstream nhs- but on we go! Xx

[satu55555]

I've had low cortisol and the best doctor for this is a functional medical doctor. We're not in the same country so I don't have anyone there to recommend, but it would be a good idea to find one. They are all private. Nausea is one of the low cortisol symptoms. Thyroid and adrenals collaborate and if you have low cortisol, thyroid medications will cause your adrenals to have more issues. So from my experience I'd recommend testing for cortisol and finding a functional medical doctor.

[Ginny52]

Sounds probably not affordable- to the limits of the nhs and then.....thyroid Uk! I suppose dr Peatfield would be what we have, and he’s magnificent, so maybe back to him xx G