Adrenal Fatigue

socknitster, I too hope you will get to the bottom of this situation and recover.

I think you are on the right track thinking some form of autoimmune disease. You have way too many abnormal symptoms to suggest many other things. One thing I do woner though, have you been exposed to any unusual chemicals? Sometimes, chemical exposure can bring on debilitating syndromes in people. It is interesting that one person will become very sick from exposure to a given chemical, and others will not be affected at all.

This discussion sheds some new light on something that happened about 2 years ago. At that time, I was helping tend to a dying lion who had a range of vague but crippling symptoms. We had two good vets working on this cat, and they eventually threw up their hands. There was nothing they could do. It was obvious that this lion's immune system was massively attacking his body (much worse than what you are dealing with, and it is very difficult to treat a big cat by treating only the visible symptoms), and they could not make a definite diagnosis. Even after he died, a very thorough necropsy (which was a big learning experience for me!) turned up nothing. We could see tissues that had been attacked, but a specific cause for the attack was never found. About the only real conclusion we were able to reach was this cat very likely had a genetic defect that predisposed him to this problem (he had a number of other genetic problems as well). I wonder if there isn't something genetic in your case that is predisposing you to this syndrome. You are not alone; there are a number of other people here fighting syndromes like this. I feel for these people because there is so much hopelessness when everything seems to be wrong.

Hang in there, and consider the unlikely!

S-Knitster writes...The vitamins and herbs the alt doc recommended have actually helped some, but I am still fairly sick most of the time.


Would it be prying to ask which vitamins and herbs you take regularly? Meds?

Hoping that you can resolve this soon and completely.

- - Capt M


.

CaptM,

Not prying, Ill be glad to share (I just copied and pasted from my current "take to the docs document":

Medications/Supplements
Long term:100 mg Sertraline/Zoloft

1 multi vitamin (centrum)
1000 mg calcium citrate (divided)
250 mg magnesium citrate
Complete Essential Fatty Acids (400mg each flax, borage, fish oil)
1000 mg salmon oil

New (about 1 month)
200 mg oral micronized progesterone
2000 mg C (Ascorbic, Rose Hips, Acerola Cherry with 600 mg bioflavenoids)
Mega B-Stress 100 mg each B vitamin, timed release

Astragalus root extract 260 mg (Chinese Herb) well-being, immune system, regulate blood sugar
Licorice glycyrrhiza glabra root 450 mg, 3x per day, combat fatigue, assist adrenals
Ashwagandha 2.96 mg withanolides (Indian Herb) energy, combat fatigue, assist adrenals

timbalionguy,

No Chemical exposures that I'm aware of. I did work at a greenhouse 7 years ago, but in the store, not in the greenhouse and I never applied any chemicals. IT was my understanding they were rarely used there. It could be genetic since my mother has similar but milder symptoms. Her father was always sick (died of complications to breast cancer treatment in the early 90's) and his mother (my great-grandmother) died of the flu in her early 30's.

Muse-inc,

My new alternative doc has put me on 200 mg progesterone. The otc progesterone creams I tried for 4 months offered a very small relief. The oral form has been helping much more, by degrees. I'll have to go to an endo to get the salivary cortisol. My internist did blood this morning even though I insisted on salivary. And you are right, I should have it done mult times + urine. As you can see above I take a lot of omega 3 and eat salmon twice a week. New alt doc tested reverse T3 and said it was borderline high but didn't offer any treatment for that. I consume a lot of coconut because I'm allergic to milk and soy--didn't know it could help me! I'm on a low carb/low glycemic index diet--very strict. No bread. Just fruits veg, oatmeal, lean animal protein. Vitamin D levels were normal in April 2007. Thanks for all your suggestions. Maybe time to go back to the alt doc and ask more questions and go back to the endo too.

socknitster wrote: timbalionguy,

No Chemical exposures that I'm aware of. I did work at a greenhouse 7 years ago, but in the store, not in the greenhouse and I never applied any chemicals. IT was my understanding they were rarely used there. It could be genetic since my mother has similar but milder symptoms. Her father was always sick (died of complications to breast cancer treatment in the early 90's) and his mother (my great-grandmother) died of the flu in her early 30's.

Although insecticides could (and I think have) triggered syndromes like this, usually it is harsh industrial solvents used in induatry-- trichlorethylene, cellosolve acetate, etc. In any case, a good allergy panel may not be a bad thing at this point.

socknitster wrote: Muse-inc,

My new alternative doc has put me on 200 mg progesterone. The otc progesterone creams I tried for 4 months offered a very small relief. The oral form has been helping much more, by degrees. I'll have to go to an endo to get the salivary cortisol. My internist did blood this morning even though I insisted on salivary. And you are right, I should have it done mult times + urine. As you can see above I take a lot of omega 3 and eat salmon twice a week. New alt doc tested reverse T3 and said it was borderline high but didn't offer any treatment for that. I consume a lot of coconut because I'm allergic to milk and soy--didn't know it could help me! I'm on a low carb/low glycemic index diet--very strict. No bread. Just fruits veg, oatmeal, lean animal protein. Vitamin D levels were normal in April 2007. Thanks for all your suggestions. Maybe time to go back to the alt doc and ask more questions and go back to the endo too.

Like yourself (and Muse-inc, for that matter), I like to practice a strict low-carb diet. I tend to have food tastes like a cat-- love animal protein, detest most veggies (and the ones I like are the high glycemic index ones). I can eat meat morning, noon and night. My biggest weakness though, is a very strong sweet tooth, which, when I am off the diet, is extremely difficult to control. (This also tends to be at times when eating wrong is a problem anyway-- out with friends, travel, challenging work schedule etc.) I have finally 'turned carnivore' again after a particularly disruptive (but the best ever!) Christmas season. I have eleven weeks before I have to 'break' the diet, and hope I can stay compliant in the midst of temptation. I struggle with CPAP in the sense that the therapy works only stubbornly for me, even when I have lost a little weight (need to lose about 100 pounds, and CPAP is offering me the first realistic chance in years to do this). I think I need to work on a combination of things-- sleep positions and comfort, dealing with short life on mask seals, and very likely, a xPAP machine with a different algorithm.

On your low carb diet, you indicate that you are using 'lean animal protein'. You seem to be doing OK on the unsaturated fats (which are an essential nutrient, unlike any carbohydrate). But I wonder if you would benefit from having more saturated fat in your diet. Try eating fattier steak cuts, chicken with the skin on, in general meat the way the good Lord intended it to be eaten-- as untrimmed and whole (and rare where appropriate) as possible. This advice is especially important if you are low-carb enough to be ketogenic. If not ketogenic, try cutting back on the oatmeal a little to compensate for the additional fat. Something tells me that that increasing your saturated fat intake may help your overall well being.

timbalionguy wrote:...On your low carb diet, you indicate that you are using 'lean animal protein'. You seem to be doing OK on the unsaturated fats (which are an essential nutrient, unlike any carbohydrate). But I wonder if you would benefit from having more saturated fat in your diet. Try eating fattier steak cuts, chicken with the skin on, in general meat the way the good Lord intended it to be eaten -- as untrimmed and whole (and rare where appropriate) as possible. This advice is especially important if you are low-carb enough to be ketogenic. If not ketogenic, try cutting back on the oatmeal a little to compensate for the additional fat. Something tells me that that increasing your saturated fat intake may help your overall well being.

OMG, I missed this, thanks for catching that Tim! Yes, yes, yes, increase sat fat, organic if possible!!! The polysats are evil things biochemically because we eat waaaay too much of them! Monosats are good. Avocado is it's own sort of fat and esp heart healthy. Sat vs unsat affects cell wall permeability; too much polys and the cell wall is esp leaky...not good for the cell and eventually not good for you and too much sat can be unhealthy as the cell wall becomes too rigid, that's why those of us who eat low carb tend to eat a lot of sat fat with some monos. That's the balance of omega 3s to omega 6s I mentioned. The body normally surrounds each brain cell with omega 3 but if it's not available, it will use the omega 6 (veggie fat)...this will degrade the normal cell-to-cell communication between brain cells...not good! This is why nutritionally-savvy psychiatrists recommend omega 3 fats to their patients, it improves mood (ending or at least helping depression and is essential for mom's after the baby's born to replenish her omega 3s which went to building healthy brain cells in the fetus) amongst other improved brain functions (The stories of mom's postnatal depression are heart-breaking because a simple solution, some fish oils or Neuromins or Salmon, would prevent if not eliminate it.) Most of our hormones are built on a cholesterol substrate (foundation) so low cholesterol means there is less of it to use to create hormones...not good. As I increased my sat fat my LDL went down (docs quit demanding statins) and then up as the particle size increased; overall, it is still lower than it was and my LDL pattern type is the healthy one in spite of the large number.

PS The constipation that some report when on a low to very low carb diet is eliminated with adequate amts of sat fat -- we were designed to eat it!

Post-natal depression can be avoided just by eating salmon, etc.? Oh please! That is insulting to so many women out there who have followed very good diets, including lots of salmon (or equivalents) and still suffer tremendously. I can't stand simplistic one-size-fits-all 'answers' and that one takes the cake. There is more to it than that.

Regarding the saturated fats, that isn't a problem, lol! I do mostly eat lean meats but do get good plant sources of sat fats in my diet from palm and coconut. Coconut I get in the form of coconut kefir and milk (now available in a carton like rice milk, yippeee!) as well as the occasional treat of coconut "ice cream." So delicious brand ROCKS! The palm I get from a soy free Earth Balance margerine which I use on my veggies and the rare slice of sprouted wheat bread. I don't think there is any ketosis going on, here.

Update: Had my addisons test this morning: ACTH challenge. I had to go in fasting. They put in a saline port in my arm and took a baseline cortisol at that time. Then they injected ACTH, which stimulates the adrenals to produce cortisol, then they took blood at 1/2 and 1 hour. Then I was free to go. I think I might have results tomorrow. I have a feeling it will be negative. I got up at 7 am and couldn't leave til 10:30 and got home to a hungry toddler at 11, so it took some time for me to get some food in me. Boy was I glad to eat those scrambled eggs and oatmeal!

I really feel that the vitamins and herbs are finally kicking in. I'm feeling a degree better the last few days.

I had enough energy to do some serious research over the weekend and started a new book called something like Type 2 Hypothyroidism. This book is EXTREMELY enlightening but completely ignores one aspect of deranged thyroid metabolism that I think (from my own research and general understanding) is CRITICAL. And that is the Reverse T3 phenomenon.

My new alt doc tested me for Reverse T3 like I stated in a post above. However I had completely forgotten (symptom=brain fog) that he HAD offered me therapy for that but I refused (at the time it sounded strange and I don't jump into too many things without a lot of thought and research!) He also offered me B12 shots among other things, so I was just a little bit overwhelmed! So between reading this new book and researching the Reverse T3 phenomenon on the web, I became aware that I made a mistake in refusing that therapy that he offered and I called him back today and scheduled another appointment for this Thursday. I think they are going to put me on Wilson's Temperature Protocol, but at any rate it will definitely be a slow release T3 to flush the Reverse T3 out of my system and reset my metabolism.

Luckily for me, I have a degree in biology and what I read about this made total sense to me. First of all, doctors have been struggling with diagnosis and treatment of hypothyroidism for the last 100 years. In the late 1800's is when "cretinism" (nice word, eh) was first recognized and treated with desiccated thyroid. Since then, docs have tried testing basal metabolic rate and various blood tests and none of them have really been satisfactory. Even as short a time ago as the 1960's there was a confusing array of blood tests available and many doctors at that time just relied on the patients story and whether they responded to a trial of dessicated animal thyroid (armour). More recently the tsh test has become entrenched as the gold standard even though early adopters of this test frequently recognized its shortcomings. Now, however it has been taught as dogma, unfortunately for anyone with thyroid issues.

Here is where it becomes fascinating. We all have tons of T4 circulating around in our blood, which our body converts to T3 (the active thyroid hormone that does all the work) whenever and wherever it is needed by our mitochondria (the energy powerhouses of each cell of our body). When we are under acute and prolonged stress and the body is full of cortisol (an adrenal hormone), the cortisol BLOCKS the conversion of T4 to T3. So instead, the body sends the T4 down a different pathway--to a molecule the same size and shape, merely an isomer, or mirror image of T3--called Reverse T3. Now this would be an ADVANTAGE if you were trying to survive a FAMINE. And in fact it is hypothesized that many people suffering from the syndrome are descendants of people who survived famine--Irish, Native Americans, Russian etc etc. The reason it is an advantage is that it literally slows down your metabolism. Your temp is lower. Everything slows down. You require less food (which is why we have trouble losing weight and/or gain so easily). But, it isn't conducive to a modern active lifestyle and causes its own set of problems because many of our enzymatic functions were specifically designed to operate at 98.6 degrees.

The interesting thing about Reverse T3 is that it still FITS into all the cell receptor sites for regular T3--but it doesn't DO anything. Also, it BLOCKS, just like corisol, the return to the normal T4 to T3 pathway. So, each time you have a stressor, you notch up the amount of Reverse T3 in your blood to your own detriment and make it harder and harder to reverse.

So, how does it apply to me? In the last 7 years I have had 2 pregnancies, nursed 2 children for a sum total of 2.5 years, both children were sick/colicky for most of the first year of life, had 3 surgeries--all of which were excrutiating and had long recovery times, and there is, of course the OSA! The recent bout of the flu just put the icing on the cake. Each time these stressors brought me a little lower. Another new symptom. Another degree of fatigue.

The treatment involves small amounts of T3 in timed release fashion to flush out the RT3 and suppress the conversion of T4 to any form of T3 temporarily. You do this for a short time, then wean off and see if you feel better and are able to maintain 98.6 degree temps. If not, you do another cycle of the timed release T3. Usually takes 1 or two cycles. I have taken my temp with a very accurate basal temp thermometer (for women trying time their ovulation) and it has consistantly been 97.2 over the last 24 hours. There are more than one protocol for using timed release T3, Wilsons Temperature Syndrome Protocol is only one. I'll talk with my doc about this more on Thurs.

So, yeah I think I have this now and am hopeful the treatment will bring me back to normal. I'm an eternal optimist, so this new hope has actually brought me so much new energy and has been an incredible mood lifter--more than any antidepressant could do!

One interesting thing about thyroid issues is the tongue swelling associated. If that goes down (my tongue is literally scalloped when I stick it out), I might be able to get off xpap, which would be such a dream!

So, if you run out and Google Wilson's Temp Syndrome, you are going to find out it is controversial, of course. Wilson, himself, actually had his license revoked when a woman died of heart complications while under his care (even though she admitted she wasn't taking the meds as directed). Because it goes against the entrenched "gold standard" of care, Wilson and his techniques are under suspician. I'm not worried about it, however, because I am smart enough to know a warning sign when I see it and I'm very cautious. And the science makes total sense to me as an educated adult. Sure there haven't been big drug company studies about it. What big drug company would do such a study? You can't patent a naturally occuring human hormone, so they have no interest in putting the money out there. How else is this research going to be done, except by open-minded grass roots researchers like my doctor?

Sorry I went on so long! I'm just really excited to share what I've learned.

Jen

Thanks for sharing that information, Jen!

As you know, you and I share many of the same symptoms, so I'll be very interested to know what is found through the testing and treatment. I hope you'll give us an update in the future. More importantly, I hope you'll be feeling better very soon!

Actually Julie, Muse makes a valid point. I take massive doses of Omega 3's and other Essential Fatty Acids, but I didn't start doing this until I was about 8 weeks pregnant with my second child. I became a raving lunatic at that time and just happened to pick up a bottle of 3-6-9 at the pharmacy that said it was screened to eliminate toxins, mercury, pcbs etc and decided to take it (previously I had been afraid to take omegas during pregnancy because of fear of mercury toxicity etc for the baby). I felt better within 3 days and realized it had to be from the supplement because I hadn't changed anything else--then I did the research and found that it was a well-documented phenomenon. The brain is actually something like 60% omega 3 fat. If you aren't getting it in your diet, the baby steals it from mom. Did you know that they typical brain shrinks something like 10% during pregnancy? That is directly related to growing a new baby brain! What I was experiencing was actually something that is scientifically documented--women need omega 3's all the time but even more desperately during pregnancy and lactation. I'm actually taking half the omegas now that I took while breastfeeding. While this certainly doesn't apply to everyone--it is something to try that is NOT going to hurt anyone! A great place to start especially if a woman is reluctant to take antidepressants while breastfeeding!

DreamOn wrote:Thanks for sharing that information, Jen!

As you know, you and I share many of the same symptoms, so I'll be very interested to know what is found through the testing and treatment. I hope you'll give us an update in the future. More importantly, I hope you'll be feeling better very soon!

I hope it makes sense, Dream. I have to work hard to make sense to other people, you know! LOL! It all makes sense in my head!

socknitster wrote:...Coconut I get in the form of coconut kefir and milk (now available in a carton like rice milk, yippeee!) as well as the occasional treat of coconut "ice cream."

I loved those too! Until I investigated agave...it can be up to 90% fructose...not good! Fructose is now suspected as causing fatty liver and it can wreck havoc trying to stablilize blood sugar or reduce circulating insulin levels. I am so sorry that the mfg used agave...they have great, really yummy coconut products. I now buy Thai Kitchens premium coconut milk and use it for a high-protein shake or chilled and eaten directly or over a few berries.

Keep me (us) posted on using Wilson's protocol. I got their e-newstrs for awhile...interesting as so many seem to be 'cured' from their poor T4-->T3 conversion problem. I took Cytomel for poor conversion for several months until I was laid off following 9-11...helped (brain fog disappeared totally) but I only took it on the mornings my temp was <98 (temp was continuously trending upwards). However, I had undetected OSA at the same time which compromised all other attempts to improve my health. Good luck on finding the info re reverse T3...my levels were skyhigh during that time, suspect it's high again but primary (& Endo I fired) pooh-poohs testing for it . It is theorized that reverse T3 is the mechnism the body uses to control metabolic rate, so when cortisol (fight or flight) is high from unresolved ongoing stress (no mammoths to run from or saber-tooths to fight), the cortisol pulls 1 of the 4 iodine (not sure which form) molecules off the T4 (in the molecular postion that will create reverse T4) which then downregulates thyroid activity which compromises the ability of the mitochrondria to produce energy because we do not need metabolic processes interferring with our need for short-term fighting or running (there'e enough fuel stored in the muscles & the liver for that short-term need). (The question I haven't found a good answer to is just how long does reverse T3 [that biologicially null-blank] remain in the receptor..minutes, hours, days?) Complex area that seems to be such a critical element in metabolism mgmt which is currently IMHO superficially understood. In my case, my thyroid function improved (supps? finding another satisfying job eventually?) until the 18 months or so...doc wouldn't believe me until my TSH rose to 5.91 before he'd start me on thyroid hormone...all those months of misery. Sounds like you've got a positive plan going forward.

Thanks for the bit about the reverse-T3 mechanism. As a student of biochemistry myself, I will have to check that out further. My doctor is generally very interested in stuff like this, so maybe I can talk him into doing some tests next time.

I had forgotten about the role of the omega-3 EFA's in brain function. I should pick up an EFA supplement the next time I am near Sam's club. They have one I used a few years back that seemed pretty good. I need to go there anyway to get a multivitamin I have been using.

socknitster wrote:I'm resurrecting this thread because I've been on bipap for 2.5 years and a
only getting worse and worse. I have been diagnosed by an alternative m.d. with adrenal fatigue, but my research shows I actually have symptoms of Addisons including high white count and hyper pigmentation in my armpits and knees. I called my regular internist to have testing done. The vitamins and herbs the alt doc recommended have actually helped some, but I am still fairly sick most of the time. Anyone have any thoughts on this?

Hi! It's so good to see you : )

By alternative m.d. do you mean a Naturopathic type doctor? Does that doctor feel comfortable with and order appropriate blood tests? Are your cortisol levels testing abnormally low and potassium levels abnormally high? Have your ACTH levels been checked?

Are you sure its fructose and not high fructose corn syrup that causes the fatty liver etc? Because fructose is present in variable quantities in fruits as the natural sweetener. It would seem to me that in moderation it would be fine. I use it so sparingly that I'm not worried--its not like I eat a pint every night. More like 1/3 of a pint on a rare occasion. I think the real issue is people drinking gallons of high fructose corn syrup laden soft drinks etc, don't you? I keep hearing agave nectar is lower glycemic than table sugar. Maybe more sleuthing is needed in this matter. . .

As far as how long the RT3 remains in the receptor, that is unclear to me, but everything I've read made it sound as though conversion is ongoing all the time--considering that there are mitochondria in each cell. . . well, its only a matter of time that all the RT3 would be replaced with active T3. Cytomel is not slow release, so it is not recommended for this particular therapy. But it sounds like it worked for you anyway. I have heard that most people get relief in 2 weeks to a month on this protocol. That would be such a blessing.

On another note about the health care profession in general. My nurse (a female in her 50's) today at the ACTH test was so understanding about the misery I'm going through and yet she said, you know--its just the time of your life. Many women go through this. She said she did. And once she got to 50 and through menopause she got a lot better. It took everything I had to not make a face at that comment. This started in my 20's and has gotten worse and worse to the point I can barely function and you are telling me to just hang on another 13 years? Ridiculous. She did make a valid point, that most people never find out what was wrong with them and they eventually get better. Yes, but I'm not most people.

I'm planning my spot on "Mystery Diagnosis," LOL!

Jen

By alternative m.d. do you mean a Naturopathic type doctor? Does that doctor feel comfortable with and order appropriate blood tests? Are your cortisol levels testing abnormally low and potassium levels abnormally high? Have your ACTH levels been checked?

Hey, Gasp! Long time no see!

No, he isn't Naturopathic. I'm not even sure what that means, but I think they go to a different kind of school, not medical school? I could be wrong about that! He is just a regular medical doctor. Went through med school and all. Just got fed up with having so many patients that he couldn't really treat successfully using standard medicine. Part of it is that he is in his 50's, kind of a maveric, and was taught by old-time doctors that you treat the symptoms, not the blood tests. He said he was taught to listen to the patient's story. Now, there is a change for you!

So, he is open-minded about new treatments and he conducts his own research on case-study basis, as opposed to clinical research with their double-blind studies. It is a different kind of research, not necessarily bad as long as the doctor is neutral and honest about the outcome. Most grass-roots changes in modern medicine start with case studies this way. Docs come of with their own off-label treatments for disease etc. Anyway, he keeps abreast of new treatments coming out and offers them to patients if they want to be a case study. He actually asked me to be on his review board because I take the time to learn so much and they need people of all walks of life from m.d.'s to lawyers, to naturpaths and chiropractors etc on the board. Due to my bio degree and my interest, he asked me to review some of his protocols as they come up from time to time.

That said, my local health food store says there are lots of alternative doctors in our area which really surprised me! You can't get much more conservative than this part of Indiana.

This new doc has ordered lots of bloodwork including the RT3.

My regular internist, whom I'm still seeing, (doesn't have an alternative bone in his body, bless his sweet soul), had me tested for ACTH today. My cortisol and potassium checked normal, but since he can't explain the symptoms, he wanted to rule it out.

The alt doc thinks that in additon to the RT3 problem that I also have adrenal fatigue, another fringe diagnosis that is a milder form of adrenal disfunction than addisons. It should also show up on ACTH test as a more moderate result than Addison's would have. For the adrenal fatigue, I am taking vitamins and herbs to support adrenal function and I am feeling a bit better, thank goodness.

timbalionguy,

If you have a trader jo's near you, they have an excellent EFA supplement and a salmon oil supplement. I take one of each every day, one a.m. and one p.m. These are priced right, too if you can't find it at Sam's. You can print out the Wilson's Temperature Protocol booklet for doctors and take it along with you or you can get a tape from the Wilson people to give to him to listen to. Both are available on the Wilson website: google it!

Jen