Early Hypo/Hashi's Complicated By Adrenal/Low Cortisol

[ASkepticalConsumer]

Greetings everyone:

Finally got fed up with my family doctor who knows nothing and went two routes - endocrinologist (my doctor reluctantly gave a referral) and naturopath.

Symptoms

I have just about every symptom of hypothyroidism I have ever read and I am confirmed Hashi's by antibodies and ultrasound. Particularly distressing is the new body shaking and feeling of rapid, pronounced heart beat - despite the pulse rate being under 90. I am very tense and want to scream. Moderate high blood pressure. Muscles are tense. Have IBS it seems - bad tummy and a lot of diarrhea. Sleep is broken up a lot with many dreams. I have sleep apnea but use a CPAP. Breathing is shallow (doing stairs winds me) and massive fatigue and brain fog. Pins and needles in feet and toes and many leg and calf cramps. Poor appetite. Tinnitus in both ears. TMJ. Want to sleep all day, sleepy all the time. Cholesterol is high but not alarming. Osteoporosis. A bit over weight with the belly fat, classic Hashi face. Very dry skin, lost 1/3 eyebrows, on and on.

When I wake up I am exhausted, but gain energy throughout the day.

Mother had Hashi's and died of CHF, I believe because of poorly treated thyroid, which is implicated in CHF.

Do not want this to happen to me, so to avoid my mother's fate, I am learning as much as I can about the thyroid and adrenal systems.

Food

Decaf coffee, 2 glasses wine per day, very limited to no gluten and minimal dairy. I notice that after even the decaf coffee or wine, my heart beat goes up.

Medicines

I am NOT on any thyroid medications.

I am trying a bit of sea salt during periods where my heart is beating loudly and I am shaking, it seems to help?!?!?!?!?!?

I also use a small amount of metroperol when shaking etc - slows down the pronounced heart beat. Use 5mg of BP med per day.

I take a small amount of bioidentical testosterone, estrogen, progesterone. I had to stop the hormones during the urine testing, boy I felt awful.

Re-starting the estrogen makes me feel better for sure. I wonder about the testosterone causing some body revving ........even though the testosterone blood work indicates I am about 60% along the normal range, so not over medicated.

Supplements

I take a bit of calcium, B12, iron, B family, vit D via light machine, magnesium

Life Context

Last 3 years have been major, major, major stress

My Thoughts

What I suspect is early hypothyroidism, Hashi's combined with moderate adrenal fatigue. The free cortisol 24 hr test had the cortisol low normal.

I also wonder if the little bit of testosterone is too much for me.

The Encrinologist said - I am fine. Of course she did.

I am not feeling fine.

What do you all think?

I would greatly appreciate your analysis.

This site is the BEST in the world.

Thanks to all who volunteer and people who share.

Blessings all

________________________________

Here is the latest blood (all done early morning and fasting) and urine work

CBC - All normal

Thyroid Peroxidase Antibodies - 45 (<35) High

Transglutaminase IGA Antibodies - <0.5 (<15)

TSH - 2.06 (0.35-5.0) - Has been as high as 3.65

Free T4 - 15 (12-22)

Free T3 - 4.8 (3.4-5.9)

Parathyroid Hormone PTH - 3.3 (1.6-6.9)

ACTH - 6.9 (<10)

C Reactive Protein High Sensitivity - 3 (<=3) Inflammation somewheres High

Follicle Stimulating Hormone FSH - 96 (post menopausal 16-157 international units)

B12 - 1,136 (>220)

Ferritin - 110 (12-289)

Iron Plasma - 20 (6-27)

Total Iron Binding Capacity (TIBC) - 58 (45-77)

Transferrin Saturation - 0.34 (0.20-0.50)

Sodium - 139 (136-146) - Has been below normal before

Potassium - 4.4 (3.7-5.4)

Vit D - 191 (76-250)

Folate - >3,000 (>=1,200)

Calcium - 2.48 (2.15 - 2.60)

ALT - 23 (<26)

ALP - 50 (35-122)

Aldosterone - 672 (118-946)

DHEA - 6.5 (0.51-5.56) High, has been as high as 8 two years ago

Cortisol Morning Fasting - 458 (130-540) - Please note 24 hr urine test below

Testosterone Free - <20 (<30)

Estrogen - 59 (post menopausal <202, I assume this level is with no bio - so even using bioidenticals I am still very low vs a post menopausal female not using

Progesterone - 2.2 (post menopausal <0.7 which is essentially 0 as you produce none, but the bioidentical progesterone counteracts the estrogen)

_____________________________________

24 Hour Urine Tests

Free Cortisol - 24 Hr - 60 (0-193) - Low normal - I wonder about this

Creatinine - 24 Hr - 9.2 (4.2-15.3)

Epineprerine - 24 Hr - 24 - (<100) - Bottom 1/4 - seems low to me given the stress I have been under, but I am not as stressed as I have been in the past

Norepinephrine - 24 Hr - 312 (<500)

Dopamine - 24 Hr - 1,893 (<2,600)

Normetanephrines - 24 Hr - 1.8 (<3.3)

Metanephrines - 24 Hr - 0.5 (<1.7) Very low normal

[Tuscansun]

I cannot comment on your blood tests, however, it seems to me that your IBS and menopause are causing this health havoc.

- IBS means you consume food your body rejects. It causes body inflammation - and when the body inflamed, immune system can start attacking organs triggering autoimmune. Read this drhyman.com/blog/2012/01/27... and you can find other Dr Hyman videos/books and other functional medicine doctors videos/books to find out more.

- Do you take Omega-3 and Omega-6?

- Your estrogen is still deficient.

It seems bizarre that you noticed you react badly on coffee and wine and you still continue to drink coffee and wine!????

I don't know if there are any functional medicine doctors in the UK, but some US functional medicine doctors offer consultations via Skype - you can try it if you want.

[SlowDragon Administrator]

See you are in Canada

Suggest you contact Canadian Thyroid group

thyroidpatients.ca

[SilverAvocado]

In terms of thyroid hormone, your current thyroid panel looks basically okay, but its a tiny bit wobbly. Your numbers are all within the limits I would suggest from a healthy thyroid, but are not quite perfect looking. A TSH of 3.65 on the other hand is above my own personal threshold for saying there is a thyroid problem.

Your TPO antibodies are raised. This is only a touch over range, and I don't know enough to tell you if that makes a difference, but theoretically this shows you have Hashimotos autoimmune thyroid disease. This is a progressive illness, so your thyroid will be nibbled away over time reducing its function.

In terms of adrenal problems, have you considered a 24hr saliva cortisol test? This gives 4 measures throughout the day and is very sensitive to showing adrenal fatigue.

[bookish]

Can I recommend 'Why do I still have thyroid symptoms when my lab tests are normal' by Datis Kharrazian. Lots about Hashi's and other reasons for thyroid being affected eg blood sugar, gut health, hormones, adrenals. Very useful read. I too would choose 24 hr saliva cortisol (Regenerus/Labrix has been good for me) but I'd read the book before you do anything else. Best wishes

[ASkepticalConsumer]

Thank you everyone!

I will indeed contact the Canadian Thyroid group.

My philosophy is treat to the elimination of symptoms because that is how doctors had to do it before all the fancy blood tests.

Q - I am wondering why my free T4 is so much on the very low end of normal but the free T3 is more mid range?

Q - Does it appear that I am converting the T3 to T4 ok?

I think the adrenals are part of the problem, cause when I stand up or bend down and stand up, I get dizzy and lightheaded.

I have contacted the natropath and have secured a 24 hr saliva test, so that will give more information.

I can get my hands on some Synthroid, so thinking of a trial of say 15mg and monitor body reaction.

Thoughts?

[Icast]

Do you eat seafood regularly? I ask this because if sea salt seems to help, maybe iodine is the issue (although there isn't a whole lot in sea salt). Maybe you're iodine deficient. I would never suggest you mega dose, however, it seems to be very popular. I am deficient but I think it's been such a long time of that, that when I've tried to fix it, I overeact. So I must do a little at a time and through diet. It helps so much, but one day of slacking, and I feel terrible the next day. Check your selenium as well. Mine is good, so I just keep my diet.

I'm also early hypo/hashis and suspect low cortisol. Ashwagandha helps so much.

Another suggestion is discontinuing your b vitamins for a few days and see how you feel. Maybe taking a break from it.

I had similar symptoms a few months ago, now feeling much better. But it is a work in progress.

I also had an episode of high blood pressure and that's very rare, now low pressure which is not all pleasant either, but I prefer it over high because it would spike suddenly. Magnesium *glycinate* 2-3 times per day was key to lowering it in the meantime. But don't stop taking your meds.

[ASkepticalConsumer]

Icast, thanks so much.

The low iodine angle is interesting, I have most of the symptoms, but not the slower heart rate which is listed as a symptom.

My heart rate is usually 86 or so, but I feel the heart pounding in my chest.

Up to now, I have avoided salt. But recently I have added in some sea salt and I have noticed I calm down and my heart rate slows.

The salt helps the adrenals perform I understand, so that makes sense to me.

The 24 hr urine test noted a 60 for cortisol (range 0-193) - so my 24 hr cortisol seems awfully low - ie not optimized.

I just drag myself around, barely can do stairs. Breathing is shallow. Constantly want to sleep. Brain fog.

Things bothering me cause I do not have answers..............

Question - my free T4 is low normal 15 (12-22). Why is this when my TSH is 2.06 considered ok here on this board. Also, the free T3 is ok, but still not in top 1/3 as desired.

Question - the low estrogen - interesting - if my adrenals are fatigued, then I understand that the adrenals can not adequately make the sex hormones. The estrogen is 59 (<202), and this using bioidentical estrogen!!

Does this mean my body is not making estrogen from the adrenals?

___________________

Gosh, this is difficult.

Sigh