From my latest research,it seems"adrenal fatigue"is an out of date concept & what I believe I am experiencing is HPA malfunction.
I have been listening to Dr Carrie Jones on YT as a result of a member's post.
I don't have the kind of money to spend on Dutch tests & functional medical practitioners.I am going to start with an adrenal saliva test.My last one was in 2012 at the start of this journey out of T4 monotherapy.
Please recommend the best value saliva adrenal test.
I have just done Medichecks Advanced Thyroid test.
I am 71.I was on thyroxine for 16 years,then T3-only for 2.Now been on NDT for over 3 years .Been on LDN 6 years.
My theory is my HPA is malfunctioning because I am ageing with Hashimotos,& have experienced chronic anxiety with periods of acute anxiety for over 60 years.
I was diagnosed auto-immune underactive in 1997 but not as a direct result of symptoms.I'd probably had it undiagnosed for quite a while.
I have MTHFR & D102 from both parents.
I am so tired....
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Naomi8
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If you do an adrenal test, make sure it tests both cortisol and DHEA, not cortisol alone. This is because testing both helps with determining stages of adrenal fatigue. In the initial stage, both cortisol and DHEA will be high, the more we struggle to produce stress hormones then DHEA will lower, and more advanced adrenal fatigue then cortisol will lower too (my simple explantation, more info out there to research if you want to).
I use Regenerus because they email you direct when the results are ready. With Genova they send results to ThyroidUK who then send them on to you when they have received your consent form. Regenerus are also more helpful if you have any questions, Genova tend to say "ask your practioner".
From my latest research,it seems"adrenal fatigue"is an out of date concept & what I believe I am experiencing is HPA malfunction.
"Adrenal fatigue" is not exactly an out of date concept. The problem is that if you mention those words to a doctor they will dismiss you out of hand and tell you there is nothing wrong with you.
Doctors "believe in" adrenal insufficiency but not adrenal fatigue. Patients "believe in" both - and I think the patients are right to be honest - but then I'm not a doctor.
Adrenal insufficiency is caused by disease - autoimmune or otherwise - or damage or failure or tumours affecting one or more of the following : the hypothalamus (H) and/or the pituitary (P) and/or the adrenal glands (A), giving you the HPA you refer to.
Just as an example, one type of Adrenal Insufficiency is Addison's Disease - a dangerous, potentially fatal condition if it is left undiagnosed and untreated. In this particular case the adrenal glands have failed and the patient can't produce cortisol in amounts compatible with staying alive.
There are various types of adrenal insufficiency - Addison's Disease is just one of them.
In cases of adrenal insufficiency the standard treatment is steroids. It isn't optional and the sick/damaged organs (the H or the P or the A) can never recover.
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Adrenal fatigue is not due to the failure of the hypothalamus, the pituitary or the adrenals.
In people with hypothyroidism, for example, the adrenal glands try to take up the slack when there are insufficient thyroid hormones in the body by producing more cortisol. People can spend many years with too low a level of thyroid hormones, and in some cases the adrenal glands get less and less capable of producing sufficient cortisol to keep people going.
Another issue is that hypothyroidism usually leads to low levels of vitamins and minerals. This also makes it difficult for the adrenal glands to keep going.
In the above scenario, if the thyroid hormone levels are fixed, nutrients are optimised, diet is optimised etc, the under-performing adrenal glands can be repaired and start producing healthy levels of cortisol again. And steroids are never an appropriate treatment for adrenal fatigue because they can stop the adrenals from functioning altogether.
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This link shows the kind of results of a saliva cortisol test you would expect to see in adrenal fatigue :
In sample 1 the result is 39% of the way through the range but optimally it should be at the top of the range.
In sample 2 the result is only 9% of the way through the range but optimally should be 75% of the way through the range.
And so on....
In earlier stages of adrenal fatigue you can see extremely high levels of cortisol and DHEA, but both of them drop as the adrenals start to suffer.
If you read the whole of link 3 you can see there are quite a lot of self-help things that people can do to improve their adrenal health - but only if they truly have adrenal fatigue and not adrenal insufficiency.
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This is a thread with results from someone who did turn out to have Addison's Disease :
From my latest research,it seems"adrenal fatigue"is an out of date concept & what I believe I am experiencing is HPA malfunction.
You’re totally right on this. If you watched the specific video by Dr Carrie Jones on YouTube she explains that yes the symptoms are real and sit somewhere between the range of Addison’s and Cushings. However, the previously thought theory that the adrenal glands just run out of steam or give up has now been disproven. It’s a case of HPA axis dysfunction. In other words a person could either be producing cortisol at the wrong time or producing an abnormal cortisol curve - too high or too low but not at the extremes that a medical doctor would diagnose as either Addisons or Cushings. I wanted to clarify this for anybody in doubt with a link to her video.
Yes,thank you,you've saved me having to do that.I wasn't referring to the medical establishment's refusal to believe that unless you have Addisons your symptoms cannot be linked to the adrenals. I was referring to functional medicine gaining a better understanding of the mechanisms involved that lead to the incapacitating symptoms formerly labelled "adrenal fatigue"by those who are trying to help those experiencing this incapacitating syndrome.
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