I didn’t prepare well for Dr. Saya this time, really need some help.

[Everydaystruggle]

So I had another consult with Dr. Saya and unfortunately I dropped the ball I feel. I was trying to be positive despite still not feeling good. I was tell Had my self things are getting better (and they have to a certain extent) but I'm still not feeling good. My lack of sleep is really getting to me. I hardly feel like I sleep st all any more, if I am sleeping it's extremly light. To the point where if a hair fell on the floor it would wake me up. On top of that I wake up at least a dozen times a night, I'm extremly sweaty st night, my heart constant feels like it's beating out of my chest, and heart palpitations I always feel my heart beat, extremly fatigues is an understatement, I'm exhsusyed but my body is wired and feels like I constantly have adrenaline going through my body, I feel like I'm starting to get incoherent from not sleeping, and lackadaisical, and foggy brain again. He told me to get a sleep study which I want to do but since I'm unable to work I don't work and my wife makes just barley enough for me not to qualify for state insurance I can't afford the sleep study as this time. I was also diagnosed with adrenal fatigue and have been taking pregnenolone, dhea, rhodiola rosea and ps100. On paper it has improved some but I feel really nothing and feel like it's gradually getting worse rather I want to admit that of not. I don't know I'm writing this to vent or asking for more help. On top of that I think possibly things one of the medications is making me have a very nauseated stomach. I thought it was something I had ate or flu but it's definitely not. I just need to sleep. I've tired melatonin and magnesium and the supplements I'm on and medications are supposed to help with sleep also but they are not. Part of Me still wonders if getting my thyroid checked wouldn't be a bad idea. I haven't mentioned it because I trust Dr. Saya 100% but I still have to wonder. Any help is appreciated.

 

[Vince]

My answer probably won't be out of any help to you. I've been taking 3 mg of now brand of melatonin. As I'm getting ready for bed I slowly dissolve one in my mouth either by my saliva and or chewing. It has made a big difference on my sleep quality.

 

[CoastWatcher]

I'm sorry you're not responding to TRT as you hoped you would, but what would you like from us? Did you tell Dr. Saya, "I'm still not feeling good"? You write it here, but what did you say to him? A good doctor looks at the objective evidence, your lab results, and then balances that data with the subjective, how you feel/what worries you/what you're curious about/what you'd like to try/your frustrations...whatever you want to present.

The points you make in your initial post are valid...because they reflect how you feel. If Dr. Saya doesn't know this, I am not sure how he (or we) can help you.

 

[Vince]

I should have added one more thing. My oldest son who normally only sleeps 5 hours a night, also started supplementing with 3mg of melatonin before bed and now he sleeps 8 hours a night.

 

[Weasel]

Are you on TRT? Labs?

 

[Dr Justin Saya MD]

So I had another consult with Dr. Saya and unfortunately I dropped the ball I feel. I was trying to be positive despite still not feeling good. I was tell Had my self things are getting better (and they have to a certain extent) but I’m still not feeling good. My lack of sleep is really getting to me. I hardly feel like I sleep st all any more, if I am sleeping it’s extremly light. To the point where if a hair fell on the floor it would wake me up. On top of that I wake up at least a dozen times a night, I’m extremly sweaty st night, my heart constant feels like it’s beating out of my chest, and heart palpitations I always feel my heart beat, extremly fatigues is an understatement, I’m exhsusyed but my body is wired and feels like I constantly have adrenaline going through my body, I feel like I’m starting to get incoherent from not sleeping, and lackadaisical, and foggy brain again. He told me to get a sleep study which I want to do but since I’m unable to work I don’t work and my wife makes just barley enough for me not to qualify for state insurance I can’t afford the sleep study as this time. I was also diagnosed with adrenal fatigue and have been taking pregnenolone, dhea, rhodiola rosea and ps100. On paper it has improved some but I feel really nothing and feel like it’s gradually getting worse rather I want to admit that of not. I don’t know I’m writing this to vent or asking for more help. On top of that I think possibly things one of the medications is making me have a very nauseated stomach. I thought it was something I had ate or flu but it’s definitely not. I just need to sleep. I’ve tired melatonin and magnesium and the supplements I’m on and medications are supposed to help with sleep also but they are not. Part of Me still wonders if getting my thyroid checked wouldn’t be a bad idea. I haven’t mentioned it because I trust Dr. Saya 100% but I still have to wonder. Any help is appreciated.

Hi everydaystruggle - please always be 100% candid during consults, or it will be impossible to make the correct treatment decisions for you. I recall your case from previous posts about your “fight or flight” symptoms, etc.

Finally your circadian flip with cortisol levels has reversed (previously low in morning, high at night...now higher in morning and lower at night - as it should be). Thus, the adrenal supportive regimen is paying dividends. As we discussed we now need to turn focus to what is/has caused your adrenal issues in the first place and based on our discussions sleep apnea is a real possibility. If a sleep study is not economically feasible, perhaps do a trial of one of the many oral appliances that are available OTC. They are not always effective, but if a sleep study isn’t possible it may be worth a try.

 

[Systemlord]

It's always a good idea to write down questions and concerns on a piece of paper before a consult, this way you can glance at your notes and cross them out as you go and get the most out of your consult. It sounds as if your body is in an adjustment period, I went through something similar that mostly lasted for about a month before I started seeing improvement.

 

[HarryCat]

There are people who, rather than go through the expense of a sleep study, will buy a used auto adjusting CPAP machine and use it to see if their symptoms improve. There a at least 2 online sleep apnea forums that could guide you through the purchasing and set up process.

 

[Dr Justin Saya MD]

There are people who, rather than go through the expense of a sleep study, will buy a used auto adjusting CPAP machine and use it to see if their symptoms improve. There a at least 2 online sleep apnea forums that could guide you through the purchasing and set up process.

Very interesting, I wasn’t even aware of this. Not surprising, though, as there seems to be a second-hand market for just about everything!

 

[Saul]

It's always a good idea to write down questions and concerns on a piece of paper before a consult, this way you can glance at your notes and cross them out as you go and get the most out of your consult.

Good advice.

 

[Everydaystruggle]

Hi everydaystruggle - please always be 100% candid during consults, or it will be impossible to make the correct treatment decisions for you. I recall your case from previous posts about your “fight or flight” symptoms, etc.

Finally your circadian flip with cortisol levels has reversed (previously low in morning, high at night...now higher in morning and lower at night - as it should be). Thus, the adrenal supportive regimen is paying dividends. As we discussed we now need to turn focus to what is/has caused your adrenal issues in the first place and based on our discussions sleep apnea is a real possibility. If a sleep study is not economically feasible, perhaps do a trial of one of the many oral appliances that are available OTC. They are not always effective, but if a sleep study isn’t possible it may be worth a try.

my apologies. I think maybe I just over analyzed everything. Sometime I feel as I have a hard time expressing things out loud. Something my wife struggles with me about to lol. I guess I didn’t realize that the sleep apnea could be the cause of my adrenal fatigue. I thought it was just to figure out about why my hematocrit was still raising despite lower my testosterone dose. Also I will be picking up a sleep apnea mouth guard and my grandpa just brought over a brand new CPAP machine that he didn’t use. I will try and save anything extra change I might to still get the sleep study. My biggest concern is just not being able not to sleep and stay asleep. I’m able fo fall asleep fairly ok but I can’t stay asleep. Other then melatonin, do you have any suggestions on something otc that could help level stay asleep? Also do you feel my thyroid could be causing any issues? Thank you Dr. Saya very much along with everyone else. It’s grewlty appreciated from both me, my wife and can my family.

 

[Dr Justin Saya MD]

my apologies. I think maybe I just over analyzed everything. Sometime I feel as I have a hard time expressing things out loud. Something my wife struggles with me about to lol. I guess I didn’t realize that the sleep apnea could be the cause of my adrenal fatigue. I thought it was just to figure out about why my hematocrit was still raising despite lower my testosterone dose. Also I will be picking up a sleep apnea mouth guard and my grandpa just brought over a brand new CPAP machine that he didn’t use. I will try and save anything extra change I might to still get the sleep study. My biggest concern is just not being able not to sleep and stay asleep. I’m able fo fall asleep fairly ok but I can’t stay asleep. Other then melatonin, do you have any suggestions on something otc that could help level stay asleep? Also do you feel my thyroid could be causing any issues? Thank you Dr. Saya very much along with everyone else. It’s grewlty appreciated from both me, my wife and can my family.

Yes sleep apnea will absolutely trash the adrenals (and the hematocrit issue is another clue to its possibility).

This has worked well for many folks:

http://www.gnc.com/expanded-assortm...MIx53NmOWU2QIVgkGGCh0MzA7nEAQYAiABEgL_tvD_BwE

Would try 1/4 to 1/2 to start with.

I know budget is a concern for you, so pursuing comprehensive thyroid evaluation has been on back burner as there are more pressing issues (adrenal/possible sleep apnea). A comprehensive thyroid evaluation is always an option if budget permits.

 

[Everydaystruggle]

Thank you very much Dr. Saya. As always, I greatly appreciate it.

 

[Charliebizz]

I know for me trt alone lowered my already suspect cortisol levels. But seems dr saya has fixed yours to a degree. For me low dose ssri helped tremendously with low cortisol symptoms.

 

[Gman86]

You can also use a sleep tracker app. Sleeptracker 24/7 is a free app that can test for sleep apnea with apparently a very high degree of accuracy. It also allows you to playback the audio so u can literally hear throughout the night whether you stop breathing or not. Very easy to use and like I said it’s free

 

[Esq]

There are people who, rather than go through the expense of a sleep study, will buy a used auto adjusting CPAP machine and use it to see if their symptoms improve. There a at least 2 online sleep apnea forums that could guide you through the purchasing and set up process.

This. While consulting with a reputable sleep specialist and having a proper sleep study done is ideal, if you truly can’t afford the expense this is a good option. A good auto machine (ResMed AirSense 10 Auto Set would be a good choice) combined with the SleepyHead software should allow you to see whether you’re having apnea issues and allow you to titrate the settings accordingly.

The mods over at http://www.apneaboard.com/forums/ are extremely helpful. If you post screenshots of the SleepyHead data, they can make recommendations on settings. They helped me dial in my own settings, though I did have a sleep study done and am under the care of a sleep specialist. That forum has detailed instructions for using SleepHead and excellent recommendations on machines and masks.

Seriously, if you suspect you have apnea, figure out a way to get it treated. Hormonal issues suck, but untreated apnea can be deadly (and contribute to hormonal/adrenal issues). I’d make that priority #1.

 

[Dr Justin Saya MD]

Seriously, if you suspect you have apnea, figure out a way to get it treated. Hormonal issues suck, but untreated apnea can be deadly (and contribute to hormonal/adrenal issues). I’d make that priority #1.

Yes sir. Sleep apnea is like being repetitively choked throughout the night...sometimes hundreds of times per hour. The resultant hypoxia is horribly draining on the body as a whole, especially the cardiovascular system, endocrine system (hormones), and the brain (neurotransmitters, cognition, etc). The words “I feel great” are seldomly uttered by the victim of sleep apnea.