I am sick for five years now. It started with brain fog and tiredness after a very stressful period, where i got weird adrenal spikes. In this five years i have visited tons of doctors and did tons of tests. The local doctors did not help and the tests did not uncover anything, the only constant result is the high reverse T3 and high Tryptophan.
After five years of reading about these symptoms and diseases, i think my HPA axis is wrecked due to being activated too much, because of the too much stress. Now my stress response is very bad (even the smallest stress makes pain in my left chest and i begin to burn first in the chest and head and then everywhere, and after some hours i become very tired) and i need help more than ever. But the biggest problem is that i am almost out of money...
I read that adrenal fatigue is debated if it is a real disease, but HPA axis dysfunction/dysregulation is accepted as a diagnosis, but i don't know how to diagnose these and i have no medical help.
I am in a dire need of help. If anybody knows a doctor who is willing to give advices for free, or knows cheap tests which i can use to diagnose these, then please share it...
Thanks everybody in advance...
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TCH68k
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I don’t know much about what’s available to you in Hungary healthcare wise I’m afraid. But if you’re RT3 is consistently high, it might be that you’re cells aren’t getting the T3 that’s in your bloodstream. FT3 tests can only measure your serum levels, not what’s actually crossing into the cell. There are all sorted of things that can cause this but that might be whats causing your symptoms. I think the usual suggestion is to take a T3 containing medication to saturate the cells.
That perhaps doesn’t help with your immediate situation but might be a bit of a shortcut if you can find a way to get hold of some medication or a doctor.
Yes, i know. Somewhy too much RT3 is produced which blocks the FT3. But i cannot find an endocrinologist, who can handle this; right now one suggested that i have too few thyroid hormones...
As for getting extra T3 as supplement, i'm not sure if that is a good idea. My body produces RT3 for a reason. (Hypercorticolism?) I'd need to uncover the reason.
What about your thyroid status? Have you had any issues ? Are you taking any medication ?
How about other known comorbidities, symptoms (even if they look unrelated - e g hair loss, eczema, whatever...) and treatments you have been following. Nothing?!
Sex hormones have been checked? Electrolites? Any suspect autoimmunity issues ?
I am looking to understand if there are any disturbances on the other axis (HPT, HPG)
How old are you?
RT3 by itself it's not a very reliable conversion indicator. Can you tell us your last thyroid panel results ?
Why are you thinking T3 supplementation would be of help? Incresed RT3 (as unreliable as it is) might point towards a normal/high FT4 but impared periferic conversion. On the other hand, if this would be a conversion enzyme issue, that would probably have plagued you for the entire life.
All my thyroid levels were in the valid interval, except for rT3 which is constantly high (0.40+). I received no treatment or medication.
I had a minor eczema (?) on my right hand which lasted very long (months), but now it's gone. Yes, i have hair loss. Also my skin is so dry, it can be "dusted" off of me...
Sex hormones were checked: Testosteron, Free Testosteron, Progesteron and Estradiol. All were in normal ranges. What about electrolites? You mean Sodium, potassium, magnesium, calcium? All were normal. Zinc and selen too.
To the best of my knowledge: i have no autoimmune problems. This state is stagnating for five years. Not progressing, not healing. Well, more precisely, when i live in a less stressful time, it gets better (lower rT3), but then when another stress avalanche arrives, it gets worse.
I was born in 1986.
I do not think T3 supplementation would be help. The doctors thinks.
I have one recent TSH result: 2.016 mIU/l (2022-09-07)
But here is a little earlier, but more complete one (2022-02-16):
So far I see nothing obvious in your results, but I do within your symptoms. Meanwhile, please do not forget I am far from being a professional.
Few more things to ask, please bear with me
1. has your adrenal function been tested thoroughly?
Cortisol tested only from serum or urine too?
Multi-point saliva cortisol profile has been tested? (4-5 times during the day, to see evolution)
Dexamethasone suppression test has been performed to check adrenal response?
2. have you had an ANA test done, preferably immunofluorescence, to check for potential rogue antibodies? This is a very cheap test, I strongly suggest to do it, if you haven't already (ask for IFA test, not screening) Fatigue, hair loss, eczema and brittle hair/skin, nail splinter hemorrhages, all may point in the direction of connective tissue disease area, may worth to be checked, but please do not worry about it too much, it's just a wild guess.
3. Hypertryptophanemia might be more of a pointer than the RT3.
Causes of it might be genetic, but it would probably recruit other metabolic issues. How is your insulin levels/glycemia? Did you ever confronted with PCOS? High lipids/cholesterol?
Another cause might be excessive protein intake, but i've noticed you said it's not the case.
and again, using SSRIs (e.g. for depression) might increase the tryptophan levels. Is this the case? A level of depression would be quite normal in someone battling for five years with an undiagnosed condition, but could be also a symptom. Have you had it and/or have you been treated for it?
1. I don't know if it was an adequate test, but multipoint cortisol profile was done, the results were 11.8, 8.2, 1.5, 1.5 and 1.5 nmol/L at 6, 10, 14, 18 and 22 o'clock. DHEA-S was also tested then, with the result of 7.74 umol/L. ACTH was 5.09 pmol/L. SHBG was 32.3 nmol/L.
2. Yes, i've done ANA and ENA. Both were negative, with the ANA being 20 U/ml. RT3 can cause all these symptoms from the nails to the hair.
3. Well, i've had two tryptophane test and when i did the first, i ate a lot of turkey (0.25 kg to 0.5 kg per day), because i can eat boiled chicken and turkey, but for the second i did not. However, i eat a lot of rice and rice contains a lot of tryptophan. So it is explainable, however it might worth to test it. How can i do that? (Also, if i'd have it, should not i suffer from it in my entire life? I don't know, i'm just asking.)
Edit: I've just checked the symptoms of Hypertryptophanemia in Wikipedia: none of them fits me. (Well, i have mood swings sometimes, but who has not?) Also, it says, that the levels of Tryptophan are 650% of the normal levels (25-73) and i had only slightly higher than the normal values (71, 78).
As for insulin, glucose, cholesterol: they are always good; routine lab test always check them and i did insulin resistance test, serveral times.
I don't think i have depression. Anxiety, panic, PTSD yes, but not depression. I don't feel depressed. Also, i don't take SSRI-s. Once i got them for panic roughly 10 years ago, but i put them down shortly.
it seems you have been thoroughly checked, but a clear diagnostic remains ellusive.
Still, I need to point out that ANA screening can be unreliable. Personally i've had e few, all negative, whike ANA IFA is consistently positive, at a high titre. As it's not an expensive test it might be worth repeating it.
On one hand, the RT3, as i understood from you, was not very high and was only tested twice. There are several functional but not morbidity related reasons that could yield a higher RT3 result. Dieting, for example....
On the other hand, though not really consensus exists, there seems to be a Rt3 dominance condition under discussion.
In all honesty, I give you credit and my compassion, this issue is a complicated, exhausting one.
I noticed a good idea in your previous posts - try adhering to a longer cure with cannabidiol, it might help from the other end , decreasing stress and incresing the quality of your sleep and rest. It works!
Paired with a high quality, nutrient dense diet, it might make wonders for you.
If it would be autoimmun, then would it not cause more painful symptoms? I don't know, just asking.
As for rT3, no, it was not checked twice. It was checked six times since 2017, with results of 0.44, 0.39, 0.41, 0.38, 0.41, 0.41. (And once in 2016, that time it was only 0.24, which is normal.) Considering this article i've found yesterday (healthrising.org/blog/2019/..., it might be, that stress and starvation together does this.
When the brain fog and POTS(?) started in 2017, i went to a lot of doctors and one of them gave me wide-spectrum antibiotics which devastated my gut biome. I ate nothing but rice, potato and carrots for several month (and even those caused me cramps), i lost 25 kg. Since then, i again-and-again was forced to restart dieting. A Stool Genomic Test revealed recently, that 87% of my gut biome has been destroyed.
Thanks for the link (i've already found it earlier) and your compassion.
So, rT3 dominance in me i think is caused by three things:
And the main problem is stress, because now my body gives obvious signs, that it cannot tolerate stress anymore. (Like i feel burning, even on the least amount of stress i encounter. Edit: And these sudden thought, or situation-triggered adrenaline spikes/surges/bursts become worse, than they usually are.) But the stress is persisting.
As for cannabidiol, i'd rather avoid anything what contains THC. That stuff coats the cortex with some destructive layer.
Hello, I’ve had problems for years with an overactive adrenal system/overly sensitive HPA axis I think. Like you I have been to so many doctors and had lots of tests and was told my thyroid is normal. I have found now that the best thing for me is to be strict with when and what I eat. Eat plenty of good food. Have a protein rich breakfast (no carbs), have a tiny amount of carbs with lunch and a meal with most carbs in the evening (obvs with other foods too). Have good carbs though like sweet potato and whole grains. Cut out caffeine, sugar and alcohol. Avoid stress. Take calming supplements like valarian root and ashwagandha. Stay hydrated and practice breathing exercises and have cold showers. All these things calm your nervous system and help you feel better. Good luck.
Thank you for your kind words and useful tips. Unfortunately i cannot avoid stress and i barely can eat anything else than rice, because doctors destroyed my gutflora... I now try to restore it with raw vegetables/fruits, but with little results.
Also, i don't drink caffeine or alcohol and i had not ate any sugar in years.
As for breathing exercises, i'll soon go to a CBT/mindfulness psychoterapist, so i'll do that.
What good cold showers do? Stimulating the vagus nerve?
About your thyroid tests: was your reverse T3 high?
yes it stimulates the parasympathetic nervous system - so it calms you down. No my thyroid is fine I’ve been told. Mine is a problem that my HPA axis was triggered too much and it’s stayed in overdrive. Best of luck.
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I now try to restore it with raw vegetables/fruits, but with little results.
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