Louis Neipris, M.D., a staff writer who has written many fine articles for myOptumHealth.com, recently wrote one article titled Adrenal Fatigue: Is it for real? It appeared on Upper Michigan News, TV 6 website on July 16th and is making the rounds on other sites. His answer to his own question? “Not really”. He adds “it’s not an accepted medical diagnosis.”
Oops.
Dr. Neipris, thyroid patients all over the world beg to differ, as do a growing body of colleagues in your profession. Adrenal fatigue, aka low cortisol, has been discovered on the back of a huge body of thyroid patients, wearing them down with irritability, anxiety, shakiness, feeling dizzy or lightheadedness, sleep issues, sweating, salt craving, nausea in the face of stress, and a host of other symptoms unique to each individual with adrenal fatigue. My personal observation, as a thyroid patient activist, is that up to 50% of millions of thyroid patients all over the world, may have adrenal fatigue, or at the very least, a sluggish feedback loop.
Even worse, the widespread occurrence of adrenal fatigue, especially in thyroid patients, has caused problems when they try raising a far superior thyroid medication called desiccated thyroid. Because cortisol is needed to facilitate the move of thyroid hormones from the blood to the cells, the direct T3 in desiccated thyroid pools in the blood, causing low-cortisol-induced hyper symptoms like a pounding heartrate and irritability. The first-pass treatment then has to start with hydrocortisone like prescription Cortef from their doctors.
Why have such a large body of thyroid patients found themselves with adrenal fatigue and its low cortisol? It’s clear. The TSH lab test sucks, giving one a “normal” reading for years in spite of obvious clinical presentation of hypothyroid symptoms, and pushing one’s adrenals into overdrive with high cortisol and adrenaline to keep the patient going, and ultimately leading to adrenal fatigue. On page 65 of the Stop the Thyroid Madness book, you’ll read about a 44 year old woman who went 15 years with a “normal” TSH result, in spite of obvious clinical presentation of hypothyroidism, and which led to her own low cortisol. This is not uncommon.
Second, the risk of adrenal fatigue is high due to the inadequate treatment of T4 medications like Synthroid, Levoxyl, levothyroxine, Eltroxin and other T4-only meds. They all leave patients with their own brand and intensity of lingering symptoms of a poor treatment, forcing the adrenals to kick in too long for many.
Even William Mck. Jeffries MD., who wrote the medical classic Safe Uses of Cortisol around 1984, understood the preponderance of adrenal fatigue even without the diagnosis of Addison’s, and the need for physiologic doses of cortisol treatment, or the amount needed by each individual. And he would certainly be amazed by the explosion of adrenal fatigue that has occurred since then in thyroid patients thanks to the lousy TSH and synthetic T4-only ‘affaire de coeur’ with doctors.
Adrenal fatigue may not be an “accepted diagnosis” by many. But medical professionals and doctors who think it’s not real or an acceptable diagnosis will have to face a huge body of patients globally who DO have real live adrenal fatigue. And adrenally-fatigued patients can get realllllly hostile and angry because of low cortisol, and be very impatient when you deny their reality. (You’re going to see a lot of comments to this post which I highly suggest reading.)
P.S. Even desiccated thyroid like Naturethroid and the pre-reformulated Armour are not considered to be the standard of practice for treating hypothyroidism, yet thyroid patients all over the world are having lives CHANGED thanks to it.
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***Read below why thyroid patients are not happy with Armour and switching to brand names like Naturethroid.
Shae said:
Jul 20, 09 at 11:57 amI have adrenal fatigue. I am a holistic practitioner, so I also get alternative therapies, such as acupuncture, massage, chiropractic, Reiki and acupressure. EVERY person I see, I am constantly lectured on the low “chi” in my overworked adrenals. I take a supplement for adrenal support and am on Armour (3 months new to Armour after years of Synthroid).
The dizziness is insane! I have been known to pass out on occasion if I move too quickly. there are also days that I could just lay on the sofa and sleep. I am often grumpy and I cannot stand being grumpy!
I am very lucky to have a male doctor who is also hypothyroid (I feel like I won the medical lottery) and I pass along a lot of information to him regarding thyroid education. He is very well versed in adrenal fatigue and no matter what my tests say — he believes me, because he, too, lives with it!
Rachel Pineau said:
Jul 20, 09 at 12:05 pmOh do i ever know about the nausea in the face of stress. I’m a living example of adrenal fatigue due to inadequate treatment of hypothyroid using synthroid and measured by TSH test. I’ve suffered now for almost 10 years and can’t seem to find a doctor who will listen, except my naturopathic doctor. Unfortunately she could not prescribe either dessicated thyroid or cortisol, but i did get some relief with glandulars and restructured diet, but alas, it’s just not enough to get my life back. Now I’m on the correct meds thanks to some great info i got on the facebook site from some very helpful people. We’ll see how that goes as i only started a few weeks back.
Liza C. said:
Jul 20, 09 at 12:14 pmSTTM helped me connect the relationship between HypoT and Adrenal Fatigue. I got treatment for HypoT 3 years ago but things still weren’t great and I still had many symptoms. A year ago, I increased my thyroid meds to 3.5 grains in hopes of solving the remaining symptoms but this caused a severe adrenal crash where I cried for 3 weeks and couldn’t move from the couch. When I read on STTM that the crash was likely due to weak adrenals I realized I had almost all the symptoms of adrenal fatigue. That’s when I asked my doctor for Hydrocortisone.
The day I started HC my mother and husband said the air around me shifted, I was more alert, moved faster, talked faster, my face lifted, I smiled more. I have been on HC for a year but noticed improvement in my life immediately. I can now exercise like normal people (1 hour, every day if I want and have energy the next day, instead of crashing). I handle life stress with ease, my body temp is definitely more even, I sleep better at night, stay awake and alert all day. The list goes on and it is nothing short of a miracle.
Given my own journey and both what I have observed in myself, and what my family has confirmed in their observation of me, I am absolutely certain adrenal fatigue is real and can be treated. Thanks to STTM for everything.
Laura said:
Jul 20, 09 at 12:16 pmI have only had to fire two doctors. The one I see now understands adrenal fatigue a little better than most, but I still had to educate myself. No one can afford NOT to educate themselves.
Georgia said:
Jul 20, 09 at 1:05 pmI am pretty sure that I have adrenal burnout. I worked for a couple of years in a stressful social work job. During that time I took a stimulant for ADD, lost a brother, and my military husband was sent away for a year.
My life has been practically stress free for a year now but I feel like I have a debilitating disease. On a scale of 0 – 10 in terms of energy, with 0 being the lowest I feel like I fluctuate between 1 – 3. I get an average of 12 – 16 hours of sleep a day and when I’m not sleeping I lie or sit almost all day. I have most of the hypothyroid symptoms. I am not anemic, diabetic, and my TSH is normal (of course). I tried antidepressants for awhile that made me feel worse. When I did find a doctor willing to treat me for hypothyroidism, he put me on a synthetic T4/T3 combination and progesterone cream regimen. I felt worse and gained an additional 40lbs in 6 months. I was also so depressed on this regimen that I even felt suicidal at times.
I am not taking any medication, just trying to eat a wholesome, clean diet, get plenty of sunshine and get acupuncture. So far, I haven’t noticed any improvement but I haven’t gotten any worse, either. I am trying to find out as much as I can about adrenal fatigue but I find a lot of the advice to be contradictory (do/don’t take adrenal glandular). I am at such a loss over what to do at this point. I feel despair. I can’t work, can’t exercise, can’t participate in enjoyable activities. Some experts say that it could take years for me to recover. I know I caused a lot of damage to my body during those few high-stress years but how long will I have to pay for it and is there anything that can help me along besides lots of rest and proper nutrition?
Elenor said:
Jul 20, 09 at 2:08 pmI first started on Iodoral — which gave me energy, lifted a fog I didn’t even realize I was under, and of which I still take 3 – 4 pills a day! A half-year later, after finding STTM, I started on Isocort. I didn’t notice much response to the Isocort. I am thankful that a local doc was on the STTM list: I took him my proposal (HC and Armour, as per suggested dosing sched. at STTM) and he was willing to go along and prescribe it. (Thank you Janie and STTM!!)
A bunch of symptoms I thought were “because I was old (52), fat (nearly 300 pounds), and sedentary” were in fact adrenal and thyroid! I did not realize that the feeling I woke up with — like someone had taken a bat to my kidneys! — was adrenal, until it went away. I did not realize that my hyper sensitivity to bright light and loud noises was adrenal. I did not realize my stiff neck every morning (“must be a bad pillow”) was adrenal. It DID take nearly two years on HC to completely relieve those symptoms, and I did gain a real-quick 30 pounds (that I had previously lost {sigh}); but the relief was SO worth it!
I am now working out the dosing for the (new horrid-bad) Armour (and waiting for the carpal tunnel, that came roaring back when they changed it, to go away again).
Rainbow said:
Jul 20, 09 at 3:04 pmIf adrenal fatigue isn’t real, then why did I FINALLY start sleeping through the night once I got on 30mg of HC? I had been experiencing insomnia for over a year and nothing else had worked. I am now sleeping beautifully, which I’m SURE is helping my body heal. I sure hope doctors wise up one of these days.
Natalie said:
Jul 20, 09 at 3:26 pmThis is insane, but I am not surprised. So many hard-headed doctors don’t know how to look past what they has been spoon fed for years. Why do they acknowledge that there is a hypo-functioning thyroid problem before the thyroid completely gives out, but they don’t acknowledge that adrenals give out as well? It is ridiculous. I think it is just because they don’t like to step out of the comfort zone of what they already “know”. I am so glad there are people like you Janie, and other doctors who will open their minds and really take a look at what is going on with our bodies. If I gave myself over to the drug-happy traditional medical doctors, I would be a complete zombie.
With the new knowledge I am gaining I finally have hope for having a life again.
Nick R. said:
Jul 20, 09 at 4:51 pmAdrenal fatigue is a reality. Period. After struggling for years with I-didn’t-know-what, and then being told I had weak adrenals by natural practitioners, I have been finally coming to learn about my hypothyroid condition and the oh-so-common link between that and my flagging adrenals. I’ve been blessed enough to get a doctor who’s open minded and will listen to what I say (although I don’t think he really believes me) and go along with me for a while. He’s even given me a prescription of armour and HC — I hope it works, I’ve got a lot to prove to him!
aprillv68 said:
Jul 20, 09 at 6:39 pmI clearly remember when my symptoms of Adrenal Fatigue really went into high gear, and that was when i first started on Armour (approaching 6 years come November) and i could not understand what was happening to me. I had just about every symptom under the sun, including sluggish pupils (when i went to the adrenal page on STTM website). I took some much needed advice and started on Hydrocortisone (with , of course, lowering my Armour temporarily before starting again) ands within a very short period those low cortisol symptoms went away. But,after a few months, i had to experiment and i didn’t want to leave well enough alone, so i made the dumb mistake of weaning off just when i was feeling better, and enough to slowly start raising my Armour and, you guessed it, those adrenal/low cortisol symptoms returned. Long story (to long to post here) but i finally went back on it last fall after a 24 hr adrenal saliva cortisol test showed that it was more than i thought, and it showed adrenal insufficiency! I am now doing better on a regimen of 3 grains of Armour and 25 mg of Hydrocortisone daily.
Missy said:
Jul 20, 09 at 8:19 pmI have no idea why a doctor would think there are no problems that fall between having normal, healthy adrenals, and having complete adrenal failure! When most any other part of our bodies get sick and it happens gradually, it is treatable early for the relief of symptoms. Why oh why don’t most doctors get a clue and give us the relief we need before we are so sick that it is tough to get well even with cortisol replacement?
My adrenals can produce a low normal amount of cortisol..but when stimulated, they barely rise. So most doctors would say that I am fine, in other words, I am not at death’s door. But I do not respond well to stress. I lose too much salt, have low blood pressure, ache all over and have chronic fatigue. Quality of life is lacking. This is all helped with a simple replacement of cortisol. The solution is simple and not expensive. I am thankful I have a doctor who understands this.
Sam said:
Jul 21, 09 at 1:14 amThis week I took my 24 hour salivary cortisol test to my doctor which in my mind showed my adrenal system was not working properly — my 8am reading was below threshold and all others were just on the lower limit of ‘normal’.
According to him however my results showed that my adrenal output is normal as if you average it out over the day it just bumps along the bottom of the graph. So I got sent away with — no cortisol treatment, the same level of T4 and T3 and an increase in my anti-depressants because I must have a “rare form of depression which causes tiredness and not depression!”. I want to scream. all I want is to get on with my life not sit in this fog of exhaustion and pain.
ibeji said:
Jul 21, 09 at 1:17 amDear Janie,
you wrote: “Because cortisol is needed to facilitate the move of thyroid hormones from the blood to the cells” — as far as I know, there is a receptor molecule in the cell (or even in the nucleus, I can’t remember which right now) which binds to T3 and Cortisol at the same time, only then can it attach to a specific spot onto the DNA in the nucleus and block the expression of that specific gene, which in turn increases the rate of cell metabolism.
So T3 and Cortisol are in fact co-factors, which by the way also explains why one can “replace” the other, at least up to a certain point, because the concentration of the product, T3+Cortisol+receptor, depends on the concentration of all three reactants, and as long as there are sufficient minimal amounts of two of these, raising the concentration of the third reactant also increases the concentration of the product (law of mass action).
Cheers,
ibeji
Anita Theodoropoulos said:
Jul 21, 09 at 4:41 amOMG am I glad you sent me the article on Adrenal Fatigue! I just did another series of blood tests(TSH normal again) and am seeing another doctor tomorrow. The symptoms are VERY REAL. I have been exhausted for one year now and no doctor is listening. I have gone to 3 orthopedics for my neck pain and stifness. I crave salt, I sweat like a pig when I walk outside, and if I can walk I get tired doing that. I go to sleep tired and wake up tired that is when I can sleep. I have constant soar throats and fall asleep during the day with out wanting to. Plus I have 2 small growths on my thyroid but there is nothing wrong with me so the doctors tell me. hopefully the new one I will go to tommorow will listen. If not I need all the articles I can get to self educate myself. The question is when will doctors educate themselves on listening to patients and not just looking at TSH tests and T4 but looking at physical symptoms as well!!!!!!!!!!!!!!
Laura said:
Jul 22, 09 at 7:09 amI have adrenal fatigue. When I first took the 24 hour saliva test, two times during the day my levels were so low they were unreadable! I am so blessed to have found a doctor that not only will prescribe Armour, but actually ordered the cortisol test for me and prescribed HC! I felt so much better within days of starting the HC! My mind was lifted from a fog. It was like seeing clearly through glasses for the first time! I had more energy, and actually had enough ambition to get things done, instead of just sitting around all day. It was lovely! Then I got pregnant with my second child and went off the HC. I did “ok” during the pregnancy, but after I had her I crashed horribly, and dr wouldn’t prescribe the HC because I was breastfeeding. I had a really bad 6 months before my body recovered on it’s own enough to function. Just as I was about to get back on HC, I got pregnant with #3. I convinced my dr. (after lots of research) to let me get back on HC. It helped some, but not as much as before. I am afraid to take too much and hurt the baby, I haven’t tried rasing the dose (I was on 20mg), or rasing my Armour. I weaned off of it, but am sure I will need to get right back on again after the baby comes. I am confident that I will be able to figure it out, and get myself back again!
ibeji said:
Jul 22, 09 at 9:27 amP.S.: See for instance “Coregulator Interactions with the Thyroid Hormone Receptor” by Jamie M.R. Moore and R. Kiplin Guy in Molecular & Cellular Proteomics 4:475 – 482, 2005, available online at http://www.mcponline.org/cgi/reprint/4/4/475?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=4&firstpage=475&resourcetype=HWCIT
Jennyfer said:
Jul 26, 09 at 7:44 amAdrenal fatigue is real. Many years ago, i could no longer affectively cope with the stress of this world. I shut down. I went to all the doctors. no one could help me. I was irritable, couldn’t sleep, felt better in the evening, was having strange weight fluctuations (it was like diet and exercise didn’t help, it was like the calorie theory just didn’t apply to me, was having menustral difficulties, problems with acne, hair dry and brittle, facial edema. and it goes on) I finally found somebody who tested all my hormones. I was low in dhea and cortisol. my insulin levels were elevated, my thyroid was whacked out “despite being normal” i was vitamin d deficeint. I was low in progesterone. I was a mess.
amanda said:
Aug 21, 09 at 12:46 pmCan someone tell me where to locate a doctor who will be willing to work with me and see if adrenal fatigue is a proper diagnosis? I’ve wondered for the last few months if it isn’t the case or if I might be clinically depressed. But reading over clinical depression symptoms and also adrenal fatigue symptoms, the latter seems much more fitting. From reading all of your posts, it looks like a doctor who is willing to recognize the reality of this diagnosis is rare.
(Go here: http://www.stopthethyroidmadness.com/how-to-find-a-good-doc
Also join groups and ask: http://www.stopthethyroidmadness.com/talk-to-others.
And it’s strongly recommended to do the 24 hour adrenal saliva test http://www.stopthethyroidmadness.com/adrenal-info , which does not require a doctor, and take those results to the doctor after you have read this: http://www.stopthethyroidmadness.com/lab-values)
Jacqueline said:
Oct 25, 09 at 8:53 amIt’s odd that this is the stance that’s taken, since Addison’s and Cushing’s diseases ARE accepted as ligitimate diagnoses. The newsletter I get from Women to Women just covered Adrenal Faitgue. The article came with a handy chart lining up symptoms of AF with Cushing’s and Addison’s — they are more similar than they are not. Here’s a link to the article. Scroll about half way down for the chart.
Adrenal extremes — could you be on your way to Cushing’s or Addison’s disease?
Bonnie Monzeglio said:
Oct 28, 09 at 12:44 pmOMG! How long have you people been here? feel like I’ve found the end of the rainbow! I have an endo who refuses to listen to me, I have slightly low levels of TSh and FreeT4 and I am on Armour, but I don’t take the same every day, or sometimes I don’t take any at all. In fact, I just went a week without any, and I felt pretty good. I have had many of the symptoms mentioned here, and have told my endo, he just makes me drink water and swallow, tests my reflexes and writes me a new script! I’m doing my own research. I just found out that you are supposed to take Armour 2 x aday, not once, like I have been doing. No wonder I feel like crap! And , you should take Cortisol (Hydrocortisone ?) with it. Well, well, well. I should have gone to medical school. I have a lot of reading to do.
(From Janie: glad you found STTM. And patients are only taking HC if they prove they have adrenal fatigue. http://www.stopthethyroidmadness.com/adrenal-info You may not. Here’s how to find a much better doc: http://www.stopthethyroidmadness.com/how-to-find-a-good-doc )
Bonnie Monzeglio said:
Oct 28, 09 at 1:03 pmHI Janie, I do have many of the symptoms mentioned, fogginess, dizziness, neck pain, sleep forever, but still tired. I just checked my levels of 1 week ago against the “normal levels” My TSh was 3.71, my FreeT4 was .0.5 and my Total T3 was 1.01. Endo says that my free T4 was low, others were normal. They are not normal. I am going to go back and havean adrenal test done to see what that shows, and maybe try the other armour thyroid compositions. Maybe the new formulation is not working for me. I had radioactive iodine in 2005 after 5 years of suffering with hyperthyroidism. Thought I would be better onthe other side, but not quite. Also, gaining weight. Thanks for all your help.
Brooke said:
Dec 13, 09 at 6:24 amI too suffer from Adrenal fatigue, and the westerns doctors are absolutely useless! I display al the classic symptoms of adrenal fatigue, the constant illness and lung infections, the need to sleep 12 – 16 hours per day, the weight gain (ETC.). The only relief I have found is from Chinese Herbal Medicine. I encourage everyone with adrenal fatigue to explore TCM for possible “cures”. Licorice Root, Chinese Ginseng, and Ashwaghandha are the 3 best herbs to help repair your adrenals. *Unfortunately I can’t remember the case study which provided the evidence for this* You can find adrenal support tonic in health food and vitamin stores, and African Rooibos tea, Chinese white tea, and yerba mate are all excellent substitutes for coffee, and soda. Plus, they help your body repair your adrenals with a huge dose of antioxidants, w/o all the caffeine.
I have started taking the above mentioned supplements, and substituting tea for coffee and soda for over a year with excellent results. What worked for me may not help everyone, however I felt I had to contribute the little knowledge I’ve acquired to the rest of the Adrenal Fatigue sufferers out there.
Gerry Geneva said:
Dec 29, 09 at 9:51 pmThese doctors irritate me so much. I constantly hear from people who experience this exact situation. Their doctor simply doesn’t believe them when they bring up adrenal fatigue. My response: fire your doctor and get one that has a clue.
I think we’ll be seeing a common trend in coming years of people taking their health into their own hands and utilizing the massive amount of information available from sites like this to “treat” themselves.
Nice post.
Missie Turnen said:
Jan 15, 10 at 7:50 amI need advice. I am taking levothyroxine 75 mg and now have been prescribed 20 mg of hydrocortisone in the morning and 10 mg in early evening. I don’t like the way the hydrocortisone makes me feel. I have swelling and some of my joints hurt and sometimes tingling throughout my body. I am thinking of stoping the hydrocortisone and starting homeopathic adreneal support. Any comments/advice?
(From Janie: I’d strongly recommend joining the NTH Adrenals group: http://www.stopthethyroidmadness.com/talk-to-others )