Hypo and adrenal cortex

[Dawn733]

I have Hashimoto's hypothyroidism but with diet my antibodies are undetectable. My rt3 was high, ft3 low, so we lowered NDT to half (120mg to 60) and I started feeling much better. I feel awful, but the hyper symptoms are less. I tried to add t3 only but makes me so anxious and ears ring.I tested adrenals with 4 pt cortisol test and no wonder I feel bad. They are all low. Besides diet, sleep, stress reduction, keep trying to add t3 to solve low ft3, I bought Thorne Adrenal cortex but haven't tried it yet. I'm a little nervous. Is it safe? Anyone have good results with adrenal cortex supplements?

Recent labs

October 30 2024

TSH 0.116

Ft4 1.39 (0.82-1.77)

Ft3. 2.7 (2-4.4)

Reverse t3 26.3 (9-24)

Ferritin 99 (15-150)

Saturation 20%

B12. 1275 (232-1245)

Folate >20

Vit d 69. 5 (30-100)

Tpo <9

Thyroglobulin. <1

Testosterone 48 (4-50)

Free testosterone 2.7 (0-4.2)

Fsh 2.3. (<9.9)

DHEAS 266 (67-279)

SHBG 57.6 (24.6-122)

Estradiol 252

Prolactin19.7 (4-33)

Progesterone 5.1

[GlowCoach Administrator]

You look under replaced.

How are you taking your blood test?

Time of day?

When was last dose of NDT before the test & how much?

Ideally to show stable blood levels it should be a small dose around 1/3rd 8-12hrs before the test.

RT3 can have many causes not just thyroid.

[Dawn733 in reply to GlowCoach]

I was having extreme hyper symptoms for 19 months and have done so many things with little improvement (solving nutrient deficiencies, getting on HRT, improving diet). After a month of lowered NDT, the hyper symptoms began to fade. So lowering NDT was the right choice but now I need to add liothyronine,. I'm at only 2.5mcg added daily and trying to increase.

These labs were done before I decreased NDT. They were done at 9am, and about 10 hours after 60mg NDT, since i was splitting my dose.

[GlowCoach Administrator in reply to Dawn733]

What is the reason you are taking NDT? Have you been shown to be a poor converter?

What other treatments have you tried? NDT doesnt suit everyone.

FT4 is only at 60% of range which might be OK but many need it at 70% of range after a 24hr dose gap with testing.

Not enough thyroid hormone can mean low cortisol.

[Dawn733 in reply to GlowCoach]

I have had hypothyroidism for 20 years. I was on just synthetic t4, then added synthetic t3, eventually tried np thyroid, nature thyroid, then Armour which I've been on for almost 9 years. Doctors have always been dismissive and said my low ft3 was fine. My ft4 goes up and down, but not drastically. Ft3 has been around that level for as long as I can remember, and I never felt good. A new doctor ran the reverse t3 for the first time and he also said I clearly wasn't converting well.

His explanation was I've probably been hypo and undermedicated for so long that it caused adrenal fatigue and cortisol problems. He is a telehealth doctor and wasn't comfortable treating something serious without seeing me in person. So I went to an endocrinologist who ruled out obvious things like Pheochromocytoma and Hyperaldosteronism, but she was stumped. So I did my own saliva test.

[GlowCoach Administrator in reply to Dawn733]

Levo+ T3 is a lot easier to adjust is all, something you could think about.

[Dawn733 in reply to GlowCoach]

I've considered this too because also maybe my body just does not like ndt anymore. The endo wants me on t4 only which I will never do. I see the telehealth doctor in Feb, and I can discuss it then. I'd really like to work on cortisol in the meantime.I feel so stuck. I can't raise ft3 without t3, can't take t3 because low cortisol, can't raise cortisol unless I fix ft3. I don't know what more I can do

[Noelnoel in reply to Dawn733]

I cannot tolerate a raise in dose when my adrenals need more support so I always have to raise Adrenavive simultaneously/accordingly

Adrenavive comes in two forms; cortex only and cortex plus medulla and works well but I can’t comment on Thorne

[Jazzw in reply to Dawn733]

I’m not convinced that you needed to reduce your NDT—your labs don’t indicate that you were over medicated.

However, it’s incredibly common for people to feel better when they reduce their dose—to start with. And then they usually find they feel awful a few weeks down the line. I’ve done it. Lots of us have…

Reducing by half seemed a bit over the top in any case. We usually counsel here not to make big changes in dosage—ideally no more than a quarter of a grain at once (15mg). Reducing by 60mg (1 grain) all at once seems a bit drastic…

I think you need some thyroid function tests to see what’s happened. I suspect you’re going to be very undermedicated now.

RT3 can be a red herring.

[Dawn733 in reply to Jazzw]

We reduced from 120 to 90 for a month, then to 60 a month later. I definitely don't think I was overmedicated. I just think he's right in that the t4 was converting to rt3, keeping my ft3 down and making me feel awful. Before this, my old doctor tried to increase ndt because of the low ft3, and it was HORRIFIC. I was not okay. The new doctor had me nervous about lowering NDT but like I said, I'm so much better. I know there are many reasons why rt3 can be high, and I know I'm getting more hypo. That's why he wanted to add the t3.

[greygoose in reply to Dawn733]

RT3 doesn't make you feel anything. It doesn't cause symptoms. It is totally inert and only stays in the body for a couple of hours before being converted to T2. And it doesn't keep your FT3 down, your FT3 is low because you are a poor converter and under-medicated.

rT3 is the result of poor conversion, not the cause. And, as you said, there are many causes of high rT3. And as you're on NDT it's highly unlikely that your high rT3 has anything to do with thyroid because your FT4 is just not high enough. So, if I were you, I really wouldn't be worried about high rT3, seems to me that is the least of your worries.

[TiggerMe Ambassador]

Thorne Adrenal Cortex is a low dose of 60mg per capsule so a good place to start when you can take up to 550mg ish (I think) Do you take a good amount of Vit C and salt which are adrenal food?

I've used adrenal cortex and whole adrenal which helped, then swapped to low dose hydrocortisone for 10 months (cheaper and too much bovine gives me a little digestive upset) and back to Pure Adrenal which has worked well for me, I currently take 1 capsule which equates to 80mg cortex and 160mg whole adrenal

Sex hormones on the low side except testosterone...

I don't really understand the chart which suggests optimal is above normal range during the day??

[Dawn733 in reply to TiggerMe]

I do take a liposomal vit c daily, 1000mg,plenty of electrolytes. I'm also currently on.200mg progesterone daily.I didn't get a chart like you typically do so I asked chatgpt to chart my results along with lab ranges, then asked it to chart optimal as well, so the optimal numbers are not from the lab.

[TiggerMe Ambassador in reply to Dawn733]

Vit C can be increased to gut tolerance and then slightly reduced

[JumpJiving]

Dawn733 With low cortisol, get your GP to do an early morning cortisol blood test, and if it is low get them to refer you to an endo to be prescribed hydrocortisone. Do not start on adrenal cortex. With HC, you know what the active ingredient is and that the quantity is the same from batch to batch. With adrenal cortex they don’t even tell you what is in it, let alone how much or guarantee the same from batch to batch. Cortisol is not a hormone to mess around with, especially for more than a few weeks

[Dawn733 in reply to JumpJiving]

Ive been to an endo, and she's been pretty worthless. Nothing obvious jumped out. She wants to retest everything for some reason and do a dexamethasone test, but follow up appointment isn't until may 2025 so I'm not l expecting anything helpful from her. My serum cortisol, along with every thing else she tested was fine.

Cortisol serum

[Katherine1234]

I had all but flatlined on my cortisol saliva test. I used Thorne adrenal complex and Jigsaw adrenal capsules. Upped my salt and fluid. My cortisol came up a bit, I could feel a difference. It was not until I was on T3 along with my T4 that my cortisol finely started to come up.

[Dawn733 in reply to Katherine1234]

I can just feel that T3 is what I need but man my adrenals won't tolerate it yet. I'm trying!

[Katherine1234 in reply to Dawn733]

[FoggyThinker]

I tried them briefly but found it hard to get the right dose, then read about circadian T3 which helped a bit, and now using Izabella Wentz' Adrenal Transformation Protocol (another book) which is working well for me (though I'm on T4 only at the moment).

I think the Thorne Adrenal cortex is effective but I preferred the other options and just wanted to make sure you're aware they're out there

[Dawn733 in reply to FoggyThinker]

I am currently reading this book! For months I have implemented much of what she says. I have been gluten /grain /dairy/soy/added sugar free for a while. I have made adrenal cocktails for months. I keep stopping to look up supplements she recommends, like 2 types of carnitine, which I see is not good for hypothyroidism, so stuff I'm not sure on.

[FoggyThinker in reply to Dawn733]

Interesting about the carnitine, I'll look that up. Actually she recommends milk thistle in the hashi's book but I think that's also not recommended...

It's a lot of reading and a Lot of work and supplements! - I'm sorry it isn't working for you and hope the ACE is successful

[Insomania]

I’m midway through a book by Paul Robinson “The CT3M Handbook: More on the Circadian T3 Method and Cortisol (Recovering from Hypothyroidism Series Book 2).” I’m on Armour too. Finding it v interesting.

I’ve previously read Izabella Wentz' Adrenal Transformation Protocol and it’s a LOT of work which as an unpaid carer I don’t have bandwidth to do. I’ve managed to eat more protein, I enjoy the adrenal cocktail (orange juice, coconut water & sea salt) and I take more magnesium citrate at night. I bought an adrenal supplement (adrenotone) but I haven’t started it because my last Armour dose increase plus an iron infusion has taken 2-3 months to settle.

I’m due a cortisol saliva check in the NY but my last two in 2024 and 2023 were similar to yours.

[FoggyThinker in reply to Insomania]

I never replied to you on the post I wrote about the book, sorry! I attempted CT3M when on NDT and I think it helped quite a bit; maybe would have sorted the problem altogether, but I don't think I was quite on the right dose (or maybe needed to add some T4, or NDT just didn't suit me).

[Insomania in reply to FoggyThinker]

Oh that’s interesting. I’ve got on well with NDT. My NDT dose has been tweaked again after the iron infusion, I’m doing 3 days 1.5 grain and 4 days 1.25 grain.

@Dawn733, I did a very very slow titration with NDT. It took 15 months, increasing by 1/4 grain every 2-3 months. (Then I had a blip with low iron which really impacted my T3, then high iron.) Slow and steady was definitely the right decision.