Having established thyroid function probably not the only problem it was confirmed with a saliva test panel (Genova).
Here are the results.
NOTE: This was done while I was on 0mcg thyroxine for 10 days + no other supplements.
8.00 am 4.7 (ref. 12-22)
12.00pm 4.3 (ref. 5.0-9.0)
4.00pm 0.5 (ref. 3.0-7.0)
10.00pm 1.8 (ref.1.0-3.0)
8.00am 0.18 (0.30-1.0)
4.00pm 0.10 (0.30-1.0)
•Adrenals struggling – low cortisol and DHEA production (DUH!!)
•Must be affecting hormone production – oestrogen, progesterone etc. Zero libido
•On NAX I get CONSISTENT FULL NIGHT’S SLEEP
(1st time since I had kids, now 9 and 11)
•Bedtime HAS shifted from 7.00pm (!!!) to 10.00pm without crippling tiredness
•No need for top-up sleeps around 3pm
•CURIOUS TO KNOW OTHER HORMONE LEVELS...
•Also this is a one-time, one-day test - would be good to see a pattern.
Several Things to Note-
First - on testing cortisol...
Finger-prick tests are available for this. Generally finger-prick tests available online are one-time tests. Cortisol levels MUST be measured over the course of a day so don't waste your money. Also, even pricking your finger can increase cortisol production and screw the results. The saliva test is commonly used in the US by doctors and other practitioners and has been found to be a good indicator of adrenal function. But be aware - there is debate on this.
UK doctors generally use the Synacthen test to test adrenal function (usually if they're looking for Addison's Disease (low adrenal function) or Cushing's Syndrome/Disease. ~90% of cases of Addison's are autoimmune. 70% of Cushing's Disease are caused by pituitary adenoma or growth. My GP has offered me the Synacthen test via an endocrinologist.
The Synacthen Test involves stimulating the adrenals with tetracosactide injected into the bloodstream. Cortisol levels are then measured to determine how well the adrenals produce cortisol. There's a Short Synacthen Test (measurement after 30 mins) or Long Synacthen Test where levels are monitored over 24 hours. There's debate on this test too.
I know I don't to have AUTOIMMUNE Addison's as my anti-adrenal Abs are negative.
Addison's is one of the autoimmune diseases that can travel with autoimmune thyroiditis and with the thyrogastric cluster (more on this when I tackle the immune System tomorrow).
So...from my POV brief hooray - (so far) because Addison's (and Cushing's) can be life-threatening if not treated properly. I also don't tick the weirder boxes on the symptom checkers for these.
For those who aren't familiar with this DHEA it's important for a whole bunch of things.
This link explains it best in my view:
Summary - a decent amount of this is crucial to balanced metabolism across the board.
Now back to my test results.
Needless to say they didn't cheer me up. I decided to test my cortisol at night to be sure what was going on. By 12.00am it should be low as you're supposed to be asleep.
In my case it wasn't - after all it was already heading upwards at 10.00pm. It kept going.
12.00am 2.8 (ref.1.0-3.0)
02.15am 4.0 (ref.1.0-3.0)
NOTE: I was waking up between 2-4am so why not test then?
No surprises. Whatever way I cut the results they were bad. Somehow I'd managed to deny that stress could have caused me any health problems. After all...I was invincible (...not!)
I decided to dig deeper - beyond the test results - to get a handle on what stress really meant for me. I used the Holmes and Rahe Stress Test.
In 1967, psychiatrists Thomas Holmes and Richard Rahe examined medical records from over 5,000 medical patients to determine whether stressful life events might be linked to illness. Patients chose which of 43 life events they'd suffered. A positive correlation was found between their life events and illnesses. The results were published as the Social Readjustment Rating Scale (SRRS) (Holmes and Rahe Stress Scale). Subsequent validation in 1978 supported the link between stress and illness.
I decided to test myself year by year since 2002 when my thyroid started malfunctioning.
How It Works
The test scores on everything from death of a spouse, loved one, change of job, house move all the way down to Christmas. Each stressor has a score reflecting how severe it is.
You simple tick and total. Like the Basal Barnes Test it's good to use this test alongside others to help build a fuller picture.
Scores >300 indicate high risk of illness
150-299 indicate moderate risk of illness
<150 indicate slight risk of illness
For me out of 10 years (2002-2012)
4 years scored 150-299 with an average of 285
6 scored >300
Of those 6 years, 2 years - 2004 & 2011 - scored 584 and 625 respectively.
Then the penny finally dropped. This was a long term problem. I guess I was aware of feeling stress all that time - my stupid long-houred corporate job, 6 country moves, 8 house moves, 2 births, 2 deaths. And those were only the really high stressors.
I sent all my stress to my gut and shoulders. I worked and played hard and sleep badly.
I used Nytol BUT
on the flip-side I exercised regularly (always been ruthless about this).
I did yoga, walked and swam - things I find relaxing as well as periods of gym work.
I ate sensibly and not too much. (But I probably drank a fair bit socially (how naughty!))
So...I had done a couple of things right. But not enough to protect my body.
I'll tackle the Immune System more fully in my next blog because in "Thyroid Disease - The Facts" p37 there's a cursory nod at the link between stress and immune function.
Short version - short term stress (fight or flight where adrenalin is produced) and long term stress (where cortisol levels are increased) leads to suppression of the immune system.
Vanderpump and Tunbridge state that when the stress goes away the immune system rebounds and in susceptible people this can lead to autoimmune disease.
Cursory just isn't good enough.
So that's me.
In 2001/2002 I moved country, changed job, had my first child, moved house twice, had a largely absent spouse, a genetic scare with my daughter.
And bingo Hashimoto's thyroiditis.
I now believe that had I been able to see the full picture (immune system meets adrenals meets thyroid meets gut = hormones all over the place) when my thyroid started acting up - I would've acted then and perhaps my Hashimoto's would've come and gone.
It's possible for this kind of autoimmune thyroiditis to resolve up to 2-5 years after it starts.
For me I fear that horse has bolted.
I have no idea how much functional thyroid I have left.
(May have to check that...)
I guess at this point I'm stoic. This is a big lesson I never wanted to learn.
The truth is that at any time I could have taken better responsibility for my health.
I could've stopped driving myself so hard, cut myself some slack, pushed back on the people around me, asked for more help, stopped trying to be an all-things-to-all-people-goddess-all-the-time. Clearly an A-type personality doesn't help.
My children finally forced me to stop. I couldn't continue to work and have kids. Something had to give. There wasn't enough energy to go round. I'm VERY lucky - I had enough savings to take time. Most people aren't so lucky.
Today the picture is brighter.
I'm treating my adrenals. I don't expect a quick fix - this WILL take months/years but I want them working properly again if possible. I'll deal with other supplements in a later blog - how much and why - for each one.
I'm building low stress me-time into my life - yoga, breathing, walking outdoors, laughing with my kids, going to the movies with my husband. Sounds cheesy but hey - this is my life. I only get one. I'd like it to last as long as possible.
On the flip-side - I'm starting a business. To be honest that's all good and my business partner is a legend so we make work part of our lives not all of it. Again lucky we can.
I'll tackle the Immune System tomorrow.
Thanks for reading...
Happy to field questions
Final Quick Note:
I'm testing out a urine-based adrenal test today. This checks the amount of salt excreted which is elevated for people with adrenal insufficiency.
NOTE: I don't add salt to my food - this is important as it affects the test.
I'm testing it to see what it shows, how it works etc...
Not sure how I feel about it yet. Need to read some more on this o ne...and let you know how it goes...