Hi all,
Continuing on from my adrenals results… healthunlocked.com/thyroidu... I have spent some time researching and experimenting with adrenal support.
This is what I understand. If I am off about any of this please do feel free to correct or challenge 🙂
The adrenals are split into 2 major chunks; the medulla which secretes adrenaline and the cortex. The cortex is made up by 3 zones that combined secrete cortisol (corticosteroids), aldosterone (mineralocorticoids), and androgens (male sex hormones).
Cortisol in particular is highly relevant for thyroid hormone metabolism. Together cortisol & thyroid hormone have a powerful partnership that contributes towards metabolism, and metabolism (making energy & using that energy well) is the golden ticket to vitality💫
When things go wrong - In the face of failing thyroid hormone (hashimoto’s, central hypo etc.), cortisol levels may rise to try and battle on alone. Because the state of thyroid diagnosis & treatment is so heartbreakingly abysmal, adrenals are often heavily over-recruited to help this now very one-sided partnership.
Over time we may then see the adrenals begin to flag. This is twofold (I think) -
1. The adrenals are “fatigued” from overproducing cortisol to compensate metabolism without enough of its partner thyroid hormone to help. (This is defined as a primary adrenal problem, ie. The problem is with the adrenals themselves).
2. The pituitary (that sends the ACTH signal down to the adrenals to wake them up) is a very T3-dependant gland, so this can become low and the signalling can drop so adrenals are not stimulated enough. (This is defined as a secondary adrenal problem, ie. The problem is with the brain that has a consequential impact on the adrenals)
For me, my results demonstrate a poor (but not dreadful) response to ACTH indicating I have a primary adrenal issue, ie. The adrenals themselves are overworked. I hypothesise that there are 3 reasons why I personally have poor adrenal output -
1. I developed hashimoto’s at 13, but was not diagnosed until 21. At that stage I was under treated on T4 only and remained symptomatic - prolonged hypothyroidism.
2. I engaged in a highly restrictive form of ketosis/carnivore diet without realising that I actually just needed T3 in my treatment. (At that time I didn’t even know my health problems were because of my thyroid, I was told my labs were normal…🫠 but closer inspection shows rock bottom T3 and high T4 on levo). One of the major roles of cortisol is breaking down fats & proteins into sugar (gluconeogenesis), so the demand on adrenals was made greater still by ketosis because when we run on fat for fuel our body must find a way to make sugar for us as there are some cells that simply cannot run on fat/protein.
3. I personally have a genetic need for vitamin C - adrenals are the most vitamin C-dense organs of the body, so I would have likely always had a weakness in adrenals.
So, I have begun trying hydrocortisone (HC). In preparation, I dropped my NDT by 0.5 grains to avoid speeding my metabolism up too much with the long-awaited arrival of cortisol.
Initially I tried 10mg as one dose in the morning, but my midday I was in a crying heap with blood sugar issues. So I switched to the STTM approach (Do Not Come For Me!🙈) which is 10mg waking, 7.5mg noon, 5mg PM, 2.5mg before bed. However, after reading around I began to feel nervous about taking steroids after 1pm as this may impact my adrenals’ capacity to reawaken once I try to wean off them. (Adrenals apparently do not tend to wake back up once they have been overreplaced for a sustained time. Someone told me that something in the region of 40mg HC for 3+ Weeks would likely shut adrenals down completely) So I have had to think hard about how I approach this adrenal situation. Additionally, my response to the steroids has been very mixed - I have had very high anxiety, a flushed face, thundering heart, blood sugar issues, intense tearfulness, headaches and head pressure, light sensitivity, dissociation, fatigue, high tinnitus with random bouts of joy, energy, no tinnitus and very warm feet. My BBT has swung from 35.6 to 36.8 within hours of taking the steroids - which is all to be expected when pouring lighter fluid on my weak metabolism that’s been wonky for 17+ years.
After much consideration, I have decided I want to strip it all back and begin again. It is advised by STTM & Peatfield that beginning thyroid hormone after adrenal support is preferable. The chaotic mental state I find myself in (is it the steroids? Is it increased uptake? Is it the dropping of NDT? Should I drop my NDT more? Should I add some T3? Should I decrease the steroids? Will I get stuck on steroids now forever? Should I follow STTM? Should I stop steroids before 1pm?) is driving my anxiety through the roof. I can’t think of anything else. I have, ofc, considered introducing steroids slowly and titrating them up but I have also read that this can cause worsening of symptoms as under-replacing steroids can exacerbate the situation instead of improving it… I cannot risk this.
So, considering all of the above I have decided to begin again and take the approach of the triangle. This will include coming off the 1.5 grains of NDT I am already on - HEAR ME OUT - I am gaining no benefit from this 1.5 NDT. I had some initial improved response, but I have lost my period again (I tried increasing my dose, it just gave me chest pains and more fluid retention - I think because my adrenals couldn’t keep up?) and all other hypo metrics are no good. So the next month I will be slowly weaning myself off my 1.5 NDT to start from scratch.
I should also add that I have been ill for many decades now, I have trialled many medications and thyroid hormone formulations. My situation is specific to me, and I do not recommend in any way that others copy what I am choosing to do.
Stripping back means I will be able to add things in in the correct order - something I have never known I should do, in spite of the Tens of thousands I have spent on the best doctors Google can find. It also removes this chaotic uncertainty about what is creating which reaction.
I will begin by tackling insulin sensitivity and then work my way up the pyramid.
If anyone has any recommendations for insulin sensitivity supplements or ideas please do suggest them 💡
My insulin sensitivity regime will be as follows -
👉🏻Ovasitol
👉🏻Cinnamon
👉🏻Berberine
👉🏻Chromium Piccolinate
🥗Mediterranean style diet
🥾Walking & light weight training
☀️Circadian Rhythm - blue blockers after sunset, watching sunrise (🙈maybe a few days a week at first) and avoiding artificial lights
📲CGM to track glucose response to foods
💊 I am considering Metformin (it has been offered to me before for PCOS but I turned it down) so I would welcome any feedback on that. I am aware it depletes specific nutrients.
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I just want to add, I sincerely hope I do not come across as a know-it-all-know-nothing. My aim is simply to use the forum to keep myself accountable for my decisions, leave a trail for a future “me” who is totally lost and gain the invaluable feedback from others in this forum. I don’t claim to know everything, and in reality ofc I know very little but I am doing my best.
Unconditional love to those blighted by this terrible disease,
Relentless xx