Do I have adrenal insufficiency?

[Neil Olson]

Thursday I am getting an ACTH stim test. Right now I replace growth hormone, thyroid, and testosterone. Might as well add cortisol and aldosterone right? I hate my pituitary gland.

 

[Vettester Chris]

How about a 4x diurnal cortisol & DHEA test? We can review the circadian profile and get a good picture with how your adrenals are functioning.

 

[Neil Olson]

I need to find out more about what she is testing. I know cortisol and aldosterone. Test lasts 1.5 hours with periodic blood draws.

 

[Neil Olson]

Looks like secondary adrenal insufficiency. My adrenals work, but my pituitary is not telling them to

 

[Vettester Chris]

Did your physician discuss a plan of action? What more can you tell us about your tests and results?

 

[Neil Olson]

Haven't talked to the doc yet. I do not have the numbers in front of me, however my morning baseline cortisol level was only 1 point in the normal range. When the stimulant was given my cortisol levels went up above normal levels. This tells me my adrenals are working. At the same time my baseline cortisol was taken my acth was taken as well. It was low as well. Based on that my adrenals are working, but my pituitary is not.

I already know I have pituitary issues. I took growth hormone and tyroid meds as a child many years ago. Started back in the mid 70's. I have a small bone deformity that is squeezing my pituitary.

With that said I am trying to juggle hypopituitary, hypothyroid, low testosterone, sleep apnea, and we will see about the cortisol. I have a horrible endocrinologist and am seeing a new one on June 6th. New endo came recommended.

 

[Vettester Chris]

OK, great, I'll keep an eye out for additional updates. Hang in there!

 

[tmckenzie]

In the same boat here man. The 4 x saliva I recommend to everybody with low t. I had a atch stim and failed wonderfully, I have empty sella so no pit gland signal. On hydrocortisone, but it has thrown me into full blown diabetics, so when you start replacement, buy a glucometer. Some days are great, some hit you between the yes, I am a couple months in and hopefully I can get back to normal. Seems like when a man, especially a younger one presents with low t, an MRI would be first on the list. Sadly that is not the case. I had one so called expert endo check me, feel my nuts, said these are huge, they should be working, let's pull you off test and put you on clomid. After a month of increasing the dose to over 100 Mgs a day I demanded test back, I was like a dead man. I recently saw him, told him I had empty sella, and asked why no MRI doc? He could not explain. I honestly think he never heard of empty sella. I will see if I can find my test number from the stim test and post, after the injection I got sick, and my cortisol never went above 10.

 

[Vettester Chris]

TM, interesting story ^^. There are obviously a plethora of variables when it comes to the adrenals. It's bad enough if adrenal fatigue sets in, and not having the sufficient cortisol to react to stress, and to the gluconeogenesis process with glucose. However, I stress this in just about every thyroid related thread, you NEED an ample level of cortisol in order for T3 to effectively get into the receptors of the cells in the body, which also stems to the glucose that is related with cortisol.

 

[tmckenzie]

Bow does one find out if they are taking enough cortisol for the t3 to get into cells. They have me skiing 40 mgs a day just to keep double vision and headaches away. The main trouble is, there are few drs who know what empty sella is, let alone treating the problems it causes.

 

[Vettester Chris]

Bow does one find out if they are taking enough cortisol for the t3 to get into cells. They have me skiing 40 mgs a day just to keep double vision and headaches away. The main trouble is, there are few drs who know what empty sella is, let alone treating the problems it causes.

Not sure if there is an exact established amount, but you want your circadian rhythm profile to reflect a few things ... You want the AM to be at the TOP of the reference range, mid range to upper quartile on the two (2) daytime and early evening tests, and the last one on the PM should be towards the bottom of the range.

If adrenal fatigue has been a factor with thyroid productivity, the first tell tale sign will be an elevated Free T3 level compared to Free T4 (compare percentages of each lab to their respective reference range), and ALSO a higher than 'normal' conversion ratio of T4 to Reverse T3. If your Free T3 isn't getting distributed adequately into the body, it will "Pool", or basically backup like a traffic jam on the freeway. If this happens, the body redirects T4 conversion to more Reverse T3. So, when these values normalize, it's safe to say that cortisol is on the right track. Other factors like Iron, Ferritin, D3, B12, Magnesium, etc., also need to be considered when looking to get one's thyroid functioning properly.

Hope that helps ... I know it gets a little confusing at times putting it all into perspective.

 

[Neil Olson]

Not sure if there is an exact established amount, but you want your circadian rhythm profile to reflect a few things ... You want the AM to be at the TOP of the reference range, mid range to upper quartile on the two (2) daytime and early evening tests, and the last one on the PM should be towards the bottom of the range.

If adrenal fatigue has been a factor with thyroid productivity, the first tell tale sign will be an elevated Free T3 level compared to Free T4 (compare percentages of each lab to their respective reference range), and ALSO a higher than 'normal' conversion ratio of T4 to Reverse T3. If your Free T3 isn't getting distributed adequately into the body, it will "Pool", or basically backup like a traffic jam on the freeway. If this happens, the body redirects T4 conversion to more Reverse T3. So, when these values normalize, it's safe to say that cortisol is on the right track. Other factors like Iron, Ferritin, D3, B12, Magnesium, etc., also need to be considered when looking to get one's thyroid functioning properly.

Hope that helps ... I know it gets a little confusing at times putting it all into perspective.

All of this stuff can get real confusing. When you are dealing with multiple problems it gets really confusing. Trying to optimize all hormones. A person really needs a good endocrinologist to help. That is where I have been having problems. My current endo I have to practically beg for certain tests. To date I still have not had my T3 tested as well as Iron or ferritin. No 24 hour saliva/urine test. My B12 levels are great, but I needed a mega dose of vitamin D and am now on a maintenance dose. New endo I am going to go see has a much better reputation for being willing to run all necessary tests. Unless you are diabetic stay away from the University of Colorado Endocrinology.

 

[tmckenzie]

Not sure if there is an exact established amount, but you want your circadian rhythm profile to reflect a few things ... You want the AM to be at the TOP of the reference range, mid range to upper quartile on the two (2) daytime and early evening tests, and the last one on the PM should be towards the bottom of the range.

If adrenal fatigue has been a factor with thyroid productivity, the first tell tale sign will be an elevated Free T3 level compared to Free T4 (compare percentages of each lab to their respective reference range), and ALSO a higher than 'normal' conversion ratio of T4 to Reverse T3. If your Free T3 isn't getting distributed adequately into the body, it will "Pool", or basically backup like a traffic jam on the freeway. If this happens, the body redirects T4 conversion to more Reverse T3. So, when these values normalize, it's safe to say that cortisol is on the right track. Other factors like Iron, Ferritin, D3, B12, Magnesium, etc., also need to be considered when looking to get one's thyroid functioning properly.

Hope that helps ... I know it gets a little confusing at times putting it all into perspective.

I have an appt with my primary today, I want thyroid all things chexked. they have me dosing the hc so I take most doase in the am when I get up, and one pill at lunch then around three the lastpill. unles I am stres dosing. just to be clear, this is not adrenal fatigue . it is adrenal insufficiency caused by lack of pituitary signal. proven by a acth stim test. God only knows what else is messed up, as no doctors want to work on a man with no insurance and no hope of getting any. and pays the best he can. thanks for the replies, do not mean to hijack thread.

 

[a_crossfitter]

I started taking Adrenal supplements last Tuesday. That day I took a nap from 530PM to 930PM and when I woke up I felt good; I actually did. Testosterone, HCG, Armour, Sermorelin nor clomid made me feel how I felt after waking up from that nap. I hope this continues

 

[Nelson Vergel]

I started taking Adrenal supplements last Tuesday. That day I took a nap from 530PM to 930PM and when I woke up I felt good; I actually did. Testosterone, HCG, Armour, Sermorelin nor clomid made me feel how I felt after waking up from that nap. I hope this continues

What adrenal supplements?

 

[a_crossfitter]

What adrenal supplements?

Sorry for the delay.

I started taking:
Dr. Wilson's super adrenal stress formula, herbal adrenal support formula and adrenal c formula. I am also supplementing with nutrigold ashwagandha gold.

I had the saliva cortisol test and the levels, although were not the best, were average upon waking up, high at night and almost low during the day.

Like I said, I'm responding to the adrenal supplementation stuff.

 

[Nathan]

If adrenal fatigue has been a factor with thyroid productivity, the first tell tale sign will be an elevated Free T3 level compared to Free T4 (compare percentages of each lab to their respective reference range), and ALSO a higher than 'normal' conversion ratio of T4 to Reverse T3. If your Free T3 isn't getting distributed adequately into the body, it will "Pool", or basically backup like a traffic jam on the freeway. If this happens, the body redirects T4 conversion to more Reverse T3. So, when these values normalize, it's safe to say that cortisol is on the right track. Other factors like Iron, Ferritin, D3, B12, Magnesium, etc., also need to be considered when looking to get one's thyroid functioning properly.

Awesome. I'd guess that I've been near secondary hypopituitary for a while (my testosterone, LH, TSH is bottom normal) and I guess subclinical hypopit would be called "Adrenal Fatigue".

I got my recent labs back this week and it showed that I have low range FT4 and high range T3. I'm not sure what to make of that without RT3 results (doc forgot it), but my body is working it's butt off to convert T4. I'd guess that I'm converting a lot to RT3 (low energy even on TRT). From what I've heard, supplementing with T3 in this situation would be best, but I also have below range cortisol (doc is going to do more tests to see if i'm full AI) and I hear taking T3 while having low cortisol can be an issue. Any thoughts?

 

[a_crossfitter]

Awesome. I'd guess that I've been near secondary hypopituitary for a while (my testosterone, LH, TSH is bottom normal) and I guess subclinical hypopit would be called "Adrenal Fatigue".

I got my recent labs back this week and it showed that I have low range FT4 and high range T3. I'm not sure what to make of that without RT3 results (doc forgot it), but my body is working it's butt off to convert T4. I'd guess that I'm converting a lot to RT3 (low energy even on TRT). From what I've heard, supplementing with T3 in this situation would be best, but I also have below range cortisol (doc is going to do more tests to see if i'm full AI) and I hear taking T3 while having low cortisol can be an issue. Any thoughts?

I went from Armour 60mg to 45mg to 30mg and can honestly say that I do not feel any difference. In fact, I feel somewhat more dragged down when I take 15mg of Armour. I am experimenting at the moment. Just taking the Adrenal supplements and resting a lot. I plan on not even working out in the month of September.