Optimal Cortisol Levels
Some people feel tired all the time. No energy to get stuff done. They may wake up frequently at night, or have trouble falling asleep. Adrenal fatigue has been called the 21st Century Syndrome by some docs, and I've had my own bout with it. This picture shows what Sabre Sciences, in Carlsbad, California, deems as optimal cortisol levels. Further below, you can see mine, as measured by six saliva samples throughout the course of one day in January.
Adrenal glands produce hormones like cortisol, cortisone, estrogen and progesterone, and also chemicals such as adrenalin and dopamine. Cortisol helps you deal with the stressors in your life. Too little or too much of this hormone can cause problems like hypoglycemia, for example. People who are hypothyroid and don't get treated for it often become low in cortisol production. And when they try to treat the hypo with dessicated thyroid, they don't feel better, because they need cortisol for the thyroid hormones to enter the cells from the blood.
A fantastic resource to help understand how it all works together is StopTheThyroidMadness.com. This site was started by Janie Bowthorpe, a woman who still felt pretty terrible after many years of T4-only treatment for her hypothyroidism. Through trial and error, which included correcting iron and cortisol deficiencies, she was able to feel great with natural dessicated thyroid.
I tried Armour (natural dessicated thyroid, porcine) about 5 years ago. Only 1/2 grain. Even on that small amount I started to feel worse. And now I know why (thank you Janie) - my ferritin (iron) and cortisol levels were both low. Here are some of my journal entries during this time period. I was on the right track then, getting tested for thyroid and adrenals, but my doctor at that time was clueless as to how to help me.
5.24
WHY I THINK I MIGHT HAVE HYPOTHYROIDISM AND/OR LOW ADRENAL FUNCTION:
History of heart palpitations (arrhythmias)
Low blood pressure
History of radiation treatment to the head and neck area
My hands and feet are cold all the time
I'm cold usually
I'm tired usually, no energy
A bit on the down side
Dry lips and nails
Worsening near-sightedness
Poor poor memory
Difficulty concentrating
I haven't used iodized salt in many years
My mother's been on Synthroid for 40 years
Poor libido
Thick tongue/toothmarks
Light very short period - 2 days
Veininess?
Day 1 basal read: 97.2
5.29
Dr. G wasn't too helpful. He looked at my thyroid panel from last year, looked at my saliva free T3 and antibody test. Said didn't know how accurate that lab was. He has had success sometimes with Wilson's protocol for hypothyroid - supping with T3 hormone. He has done it 50 times in the last 10 years. Won't know anything til we get blood test results in a few days. He took a CBC and a new thyroid panel including for antibodies. He did say "I see you tested positive for antibodies....that could be part of a downward spiral" or something like that. When I brought up the subject, he said that he knows about iodine deficiency as an epidemic but didn't say much more on that.
I'll hear what he has to say about what I should do.
I'll go to acupuncturist Susie Vance this week and find out: what I'm allergic to, how I can get fluoride out of my water (this is proving tricky), and how she thinks I should proceed. After hearing from these two, I'll either follow one of their instructions or I'll look into maybe treating myself with iodine or maybe I'll see Dr. F.
5.30
Last night at 7 pm I painted iodine on my shoulder. It was gone in a few hours, maybe taken off by the shower. Then I painted it on my breast, and it was gone by morning. Then I painted it on my foot at 7am this morning, it's 10 pm now and it's faintly still there.
6.13
What I have in my purse is Dr. G's prescription for Armour, 15 mg, equivalent to a quarter grain of natural hormone.
He had reservations giving this to me. He wanted me to know the risks: afib or heart arrythmia leading possibly to chronic afib for which you need something that starts with a C that is rat poison to counter blood thinning to prevent a stroke. He doesn't 'buy some of it' when I asked about how many people have normal bloodwork but feel tons better on small amounts of hormone. This despite the fact that he has 'hundreds' of patients on hormone - some on Armour and some on synthetic.
He said other doctors in town don't buy it either which is why one person to me who does this type of thing - his former partner, who does functional medicine.
I outlined my years-long symptoms - low blood pressure, low energy, no libido, low body temp, thick tongue, poor memory and concentration etc. "Classic symptoms of hypothyroid" I said. "Classic symptoms for a lot of things" he said. I said sure. He mentioned low adrenal function. I said I'm sure I have some of that. But if we try a bit of hormone, going slowly, and it helps, it would give me a lot of insight into what my problem is. He said we'll know by 4-6 weeks if it's doing anything. I should have the thyroid panel done then. He thinks there's not much room with my TSH to go any lower and we need to watch for that. Most of those he puts on hormone have higher TSH's than mine (mine was 1 point something). He recommended the Genova Adrenal Insufficiency test and possible trying Cortef (steroid) if proven insufficient.
He also mentioned risk of osteoporosis.
I'm going to read all I can. I've just now been reminded by Dr. Mercola's site to split the Armour tablet in two (then chew) and divide the dose to twice a day to achieve blood levels that don't fall because of the short half life of T3. Or something like that.
6.14
Day 1 - took half of a 1/4 grain tablet after dinner
Day 2 - took half of a 1/4 grain tablet after breakfast
Last night was awake a bit in middle of night. Loose bowels this morning. Period coming any moment now so cried this a.m.
6.16
This a.m. I took one Prolamine (3 mg iodine by Standard Process, which my acupuncturist recommended). Then at 2:30 p.m. I took FOUR prolamine (12 mg). I am trying to feel something here. Iam disappointed that i haven't found more feeling good after all my work into natural health. At 3 p.m. I felt a muscle twitch (these had stopped recently) and then my eyes got very very itchy.
It's Day 4 on 1/4 grain Armour and I don't feel any different.
I did try 2 capsules of 5-HTP yesterday and got a warm peaceful feeling, which means my serotonin levels need increasing.
7.3
I'm at work. It's July. My hands are ice. I took 3/4 grain Armour last night and again this morning. I added 2 5-HTP and 2 L-Tyrosine and nothing. From reading the Mood Cure I know I have a case of the blahs big time, and have for years. If four or so days of 1.5 grains of Armour do nothing for me - and actually I read that people who need adrenal support first before supplementing with thyroid hormone can get hperthyroid if they skip the adrenal support - then i'll taper off it and assume that my adrenals need help.
I sent off for a list of physicians for brodabarnes.org. Tonight I'll do the home adrenal tests. I don't feel overly stressed now but I sure did for years and years - tight stomach and everything. I had a life-changing spine operation at age 14. I have an adrenal fatigue cd by Donna Gates. I'll hear it again. Too bad I can't take the four day rest in bed she recommends.
Maybe i should buy the glyzcherlks licorice supp that's supposed to help with adrenals.
7.5
My plan is to: 1. find a physician who knows adrenals/thyroid2. take basal temp and temp throughout day, average and chart them3. saliva testing for adrenal function with physician4. get thyroid tests together5. do home adrenal tests(already failed one - you go into dark bathroom, shine light into side of eyes, if pupil starts fluttering after 20 or so seconds trying to remain closed then aldosterone is low aka low adrenal function) 6. will physician test my hormone levels too?7. continue efa's - ground flax seed and fish oil8. continue hydrocortisone cream 4x/day9. options: Isocort (dessicated adrenal gland)
Hydrocortisone (synthetic cortisol - start with 2.5 mg 8am, 12 and 4 but after a month can suppress body's own adrenal function - don't take more than 20 mg a day)Ashwaganda (1000 then 2000 then 3000 mg in 3rd week)Whole Licorice Extract (150 mg = 5 mg cortisol)PregnenaloneDHEA 25-50 mgProgesterone Cream
It can take 2 years for adrenals to recover. I think I'm on the right track this time.
7.9 All day today all I can do is think about how awful and exhausted I feel. I see Dr. G tomorrow at 4:15. I will tell him I need to do the cortisol test and also test my testosterone and I don't know what else. My eyes hurt from reading about adrenal health all day on the computer screen. That didn't used to happen. It's slow at work so I can do this.
I want to go on Hydrocortisone which is supposedly safe, temporarily, at doses under 20 mg a day. But I am nervous about going synthetic with Cortef. I know there are risks. But I just want to feel better. Maybe I'll try Isocort instead, dessicated adrenal gland, but I hear it's not as strong.