Adrenal insufficiency : I have adrenal... - Thyroid UK

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Adrenal insufficiency

friz42 profile image
21 Replies

I have adrenal insufficiency and on liquid prednisolone. I have been on this for quite some time because of other autoimmune problems as well.

I notice that my energy is at rock bottom as I am very weak in myself atm. I am on a reducing regime of prednisolone via my rheumatologist due to long term problems the steroids have caused. However I notice I have tremors in hands weak legs and blurred vision on the slightest use of any energy used. Even just walking because pain is a big problem for me.

I am writing because I don’t believe I should be having these issues if on enough steroids for adrenal insufficiency and autoimmune problems. They still want me to go lower.

Anyone else get these issues? Even eating can cause sweating and worsening blurred vision and weakness in legs. It is worse first hours of the day. By teatime it does not seem as bad. It starts again the next day though.

My autoimmune condition is not under control as still under investigation.

Thanks

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21 Replies
SlowDragon profile image
SlowDragonAdministrator

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

What are your most recent thyroid and vitamin results

What vitamin supplements are you taking

Presumably you have autoimmune thyroid disease

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

 

For full Thyroid evaluation you need TSH, FT4 and FT3 tested 

Also both TPO and TG thyroid antibodies tested at least once 

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Just Thyroid includes BOTH TPO and TG antibodies -£49

randoxhealth.com/at-home/Th...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£32 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

friz42 profile image
friz42 in reply to SlowDragon

Sorry I did not give enough information. 75mg Levothyroxine. My tsh has been checked numerous times and always pretty good. On the lower side of range but good. I am from the time of Dr skinner and saw him many years ago now. (Those that remember him) . I have progressed to perforated bowel adrenal insufficiency lung ild of some kind mobility issues Sjogrens a lot going on and possibly vasculitis.

Lots going on. No herbal stuff . Vitamins iron b12 all ok on Adcal and had b12 injections.

I guess long term if on this change permanently will get tsh tested again.

I am fairly complex patient so lots going on .

Thanks

SlowDragon profile image
SlowDragonAdministrator in reply to friz42

Just testing TSH is completely inadequate

Do you always get testing early morning?

Has GP tested anything else

Please add most recent vitamin D, folate, ferritin and B12 results

Suggest you get FULL Thyroid and vitamin testing done and come back with new post once you get results

As you have autoimmune diseases are you on strictly gluten free and/or dairy free diet

75mcg is a low dose levothyroxine, unless you’re extremely petite

Teva brand upsets many people.

Teva is the only brand that makes 75mcg tablets

Which brand of levothyroxine are you taking

friz42 profile image
friz42 in reply to SlowDragon

Hello no I am going down the adrenal insufficiency side really. Many years ago I did all of what you suggest and nothing came from it. My symptoms progressed to much more serious problems. Hence long term steroids and adrenaline insufficiency.

I have done everything in the past and my problems are complex. I am under Addenbrookes and good people there. I am still proving difficult to manage.

Yes Vit d all good. I have had years of this so this site was my starting point. Little did I know what was to come .

Thanks anyway.

SlowDragon profile image
SlowDragonAdministrator in reply to friz42

Steroids lower TSH often significantly

It’s always absolutely essential to test TSH, Ft4 and Ft3 …..but especially for anyone on any steroids

Test early morning and last dose levothyroxine 24 hours before test

Adrenals become exhausted if left on inadequate dose levothyroxine as they try to compensate for lack of thyroid hormones

Lalatoot profile image
Lalatoot in reply to friz42

Friz getting just tsh tested to gauge your thyroid status is not good enough. By looking only at TSH you are assuming that your body is working perfectly and you know that is not the case.In a healthy person the thyroid hormone levels in the blood, ft4 and ft3, are part of a feedback loop that determines the level of tsh to keep everything at ideal levels.

However, for us folks, this feedback loop is distorted or broken. Just because tsh is within normal levels, you cannot assume that your thyroid hormones are also at normal levels or at normal levels that are adequate for you .

This is why we need to monitor our ft4 and ft3 and find where within their normal levels or ranges we feel at our best .

daniel55 profile image
daniel55 in reply to friz42

frizz 42 have you ever had your sugar levels tested I have had adrenal insufficiency for years and sometimes my glucose levels would drop my legs weak sweating blurred vision all that you mention , it's just an idea and may not be connected to your thyroid problem or as you say your complex like me!!! best of luck xx

friz42 profile image
friz42

hi yes I do think they go low sometimes. I have the distinctive brown markings on my hands which never go so think it’s to do with cortisol levels etc . The blurred vision etc can be made worse after I have eaten and weak legs are even weaker. Like digestion affects me as I feel my body is really weak atm. I have so much active inflammation (unsure what it is yet) and feet that have Collapsed on me as I’m gone flat footed and so it goes on. I am worried by it all and having to think private root for some of this. I have not got diabetes nor pre diabetes but my daughter is type 1. Thanks anyway,

what is your dose?

friz42 profile image
friz42

l am on 9 mg a day of prednisolone. Mixture of 5 mg dissolving and normal 1 mg x 4. I reduced from 15 ml ( liquid prednisolone) but still had terrible symptoms. I reduced because the steroids were causing me problems as in fractures and possibly diabetes in the foreground maybe. I am always flaring with my condition as not found biologic to help yet.

caledoniancat profile image
caledoniancat

In addition to the symptoms you mention in the first post you also later mention, "I have the distinctive brown markings on my hands which never go so think it’s to do with cortisol levels etc .". Hyperpigmentation is one of the typical symptoms of Addison's disease (autoimmune adrenal disease) . Were you actually diagnosed with this and if so, have you also been prescribed with fludrocortisone alongside the prednisolone?

friz42 profile image
friz42 in reply to caledoniancat

Hi -

No it is adrenal insufficiency. By long term steroids. My calcium and potassium are both ok. I have brown marks on right hand mostly .! I have thin skin because of steroids that bleeds with slightest knock, However the brown marks are distinctive and never go away. Had them for months/ possibly 2 years at least.

I am under endocrinology but they will not do anything else until down to 5 mg of prednisolone.

I am classic shape of weight around the middle and soaking sweats. Extreme fatigue and thirsty. I crave sweet things and juice drinks and am dehydrated.

Thank you

heathermr profile image
heathermr

Have you tried Hydrocortisone instead of Prednisolone? I was taking 40mg of Prednisolone because my breathing was so poor but when my pituitary specialist saw my SST results and confirmed I had adrenal insufficiently and he wanted me on Hydrocortisone. I swopped over to Hydrocortisone and managed to get the dose down to 10, 10, 5 but all my breathing problems went within a couple of days. I am much better on the Hydrocortisone. Heather

friz42 profile image
friz42 in reply to heathermr

hi-

I have tried hydrocortisone in the past and found taking it 3 times a day felt no better for it. I may try it again at some point but the endocrine team are not planning on seeing me atm.

I am trying a new routine with the dissolving steroid tablet and normal oral ones to see if any difference symptom wise.

Early days yet but giving it a go.

Thanks for your reply.

humanbean profile image
humanbean

You might get some help for Adrenal Insufficiency from The Pituitary Foundation. They have a few Helplines and an email address you can use :

pituitary.org.uk/support-fo...

friz42 profile image
friz42 in reply to humanbean

Thank you for that. Will contact them.

Gustie88 profile image
Gustie88

Hi Friz-

As you know, your adrenals are shut down from exogenous steroids. You are getting cortisol, but have lost the other hormones the adrenals produce; importantly Pregnenolone and DHEA. Perhaps try adding small doses of these 2 hormones and see how you feel? Wishing you well.

friz42 profile image
friz42 in reply to Gustie88

I will ask. Unfortunately when I phone I always get the practice pharmacist and there are no further appointments booked for me . (She is helpful).

My last appointment last August did not get written up. (Maybe an error or forgot etc). I think they have no plans to see me until on 5 mg of prednisolone.

Thanks anyway.

distanttree profile image
distanttree

here are some ideas.

Keep a food diary, and report the next day on how you are. It is really easy, buy a diary in a pound shop, and keep notes in it. Then look out for patterns..like underline in blue when feeling fine. Yellow when sick…can be fun.

There may be a relation between what you have eaten and how you feel.

Avoid xnthar gum…..from tests I have made, it erodes the mucus membrane in the body.

Try a paleo diet. After being a veggie for thirty seven years , eating meat sorted most of my issues. Sorry , wish it was not so. We live the life with the cards dealt us. Ho hum.

Create as simple a life as possible, and enjoy as much as possible.

Hugs and deep breaths to you.

friz42 profile image
friz42 in reply to distanttree

Thank you for your reply. Lots to think about here. Although I am having more issues with pain and inflammation than anything. It has a big impact on doing anything.

I am trying a new regime of timing of tablets at the moment also as the past ie 7 am etc did not work for me. I realise that now . Will continue to monitor though as lots of other issues as well. Diet does make a difference I agree.

distanttree profile image
distanttree

for inflammation and pain, tumeric and ginger. …just a thought. Hug and deep breaths.

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