Continuation of Janie’s Blog on her adrenal issues
THIS IS PART ONE, which starts with Dec. 28, 2006, when I thought I had sluggish adrenals and low cortisol. You will note the VERY similar symptoms to low cortisol, plus I explore treatment options. You will see that I ended up with high cortisol, and honestly shouldn’t have continued with HC, but just used PS or Holy Basil, which I stated at the very end.
PART TWO below is when I finally found out I had HIGH cortisol–a real shocker considering my symptoms.:
I normally don’t write about me here, but more on thyroid advocacy issues. But this time…it’s going to be ME, because YOU need to be aware of what happened to me…because it can happen to you.
I appear to have adrenal fatigue.
Now understand this: I didn’t have it when I got on Armour over 4 years ago. I raised my Armour without a hitch, except for low Ferritin twice that I had to correct. And for approx. 3 1/2 years, I’ve been optimal with Armour with a perfect mid-afternoon temp of 98.6
So why adrenal fatigue now?? It helps to explain it this way: Two years ago, in Dec. of 2004, I entered serious peri-menopause. My progesterone fell rock bottom while I still had a youthfully high estrogen. And I’ve had to deal with the misery of severe estrogen dominance for two years. I’ve used compounded progesterone cream for those two years, but it was often never enough to stop the symptoms of estrogen dominance.
Also, Dr. Lam states the following and it explains me to a T: “In early stages of adrenal fatigue, cortisol output is high as the body attempts to neutralize the stress by producing more of it. However, when too much cortisol is produced, it will have multiple undesirable effects. For example, cortisol blocks progesterone receptors, making them less responsive to progesterone. Progesterone normally produced by the adrenals comes to a halt in favor of cortisol. Insufficient progesterone production leads to an imbalance of estrogen to progesterone…” (aka estrogen dominance). And voila–I did have high cortisol in the morning and noon. I had done the saliva adrenal test just a month after my progesterone had dropped.
Finally, this past October, I noticed the estrogen dominance FINALLY stopped, as did my periods. A huge victory. But in early December, after a particularly busy day on a Saturday, I majorly crashed………and haven’t recovered since.
And ALL my symptoms point to adrenal fatigue. First, my temps fell. And they were all over the place. My highest would only be 98.3, and one night, I was 97.1. That was VERY wrong for me.
Next, I started waking up EVERY night between 3-5 am. A typical adrenal symptom. Also, if I felt emotional about something, my body would get VERY hot. At first I thought it was a hot flash…but it was different.
And I was achy for 1 1/2 weeks. That stopped when I raised my Armour and got my temps back up. But even without the achiness, I have felt fatigued all over, and just bad.
Also, I fail the blood pressure test in the mornings. The other day, my supine blood pressure was 135/84. Standing, it was 115/84. A good sign of adrenal fatigue. I also have a faster and a pounding heartrate.
I have sent off my saliva samples…but have no doubt what the results are going to be. So….I am going to start the very adrenal support that I have written about in so much detail here on STTM. Because there is simply too much stress in my life to think that practicing all the other adrenal support methods are going to help my adrenals recover, or even help me feel better.
And by the way, for the past year and more, I have always given myself 5000 mgs of Vit. C and high dose B-vitamins, plus E. I have exercised regularly by walking. But it wasn’t enough to stop what a huge female hormonal change has done to me. I now am using Licorice Root daily (which stops some of the breakdown of cortisol in your liver) and 1/2 tsp sea salt, stirred in orange juice and my morning yogurt. And I’ll have to start on cortisol.
What can you do to not find yourself in my shoes? For one, if you enter peri-meno, even without the presence of adrenal fatigue, I would start on some mild OTC adrenal support now, which I was never on. Also, do whatever you can to counter excessive emotional stress in your life during this time by finding times to laugh and doing what you enjoy. I have been stuck with a job that wore me down, and family issues that stressed me terribly, and I’m sure that played a part.
1-7-07 ISOCORT TO HC–the journey
As mentioned above, I did start adrenal support the day after I did my saliva vials and got them sent, which was about ten days ago. It was Isocort, which I thankfully had on hand. I have always kept a supply in case I ever got the flu, which decimates your adrenals.
I multi-dosed it, taking the highest in the morning, a little less by noon, less by 3 pm and the least by 5-6 pm. 4, then 3, then 2, then 1, to equal what may be 10 – 15 mgs cortisol. We know that Isocort does NOT contain 2 1/2 mgs of cortisol per tablet, as they state. I also wasn’t worried about any thyroid dump on this amount.
And I did feel a little better because of it. My blood pressure tests have improved. The Isocort also stopped the few bouts of nausea I would get when I entered my place of business.
But, I’ve still had to deal with the feels bads which would start by late afternoon and would stay with me through the evenings. Many adrenally fatigued individuals start to feel better after 6 pm–I’ve been the opposite. My heart also pounded during that time. Remarkably, the blood pressure test would always be good at night, which taught me that mornings are a better time to get good information from the blood pressure test. (It’s described on the Adrenal Info page–self-test #1)
Additionally, I’ve maintained this internal shaky/buzzy feeling all the time, even feeling it when I wake up. I also continued to wake up during the night. And just as when this started, I’ve had another crash after a slightly busy day which left me sleeping on the couch and not feeling too swift the next day, on TOP of how bad I already feel.
Finally, I picked up my prescription for Cortef, aka Hydrocortisone or HC, and multi-dosed 17 1/2 mg. (I should have only done 15 mg–I’m impatient) And REMARKABLY, I felt MUCH better last night! My experience just confirms the experience of thousands before me who’ve had to treat their adrenal fatigue–that HC works far more superior than Isocort, or perhaps than any over-the-counter product.
Today will be my second day on HC, and for the first time since this started a month ago, I feel like I have stepped through an open window…finally. The past month, I felt like I entered a brooding and dark foreign land. Granted, the past two years of estrogen dominance was a hell in itself, but the difference in my life due to Armour was huge, so I coped. But the past month was different, since my temps dropped, and I have been fatigued every single day, and just plain felt bad.
What will the future hold? I’m unclear. I can tell I will feel much better now, just as I have felt since I started Armour 4 1/2 years ago. But for this to work, I know I’m going to have to change certain stressors in my life. I will also continue the daily Vit. C, high dose B-vitamins and other supplements I use. Plus I am using Licorice Root, which I will discontinue after two months.
And I am heartened by what I once read in Dr. Wilson’s book Adrenal Fatigue–that the road to recovery is a journey. There are “set-backs, frustrations, and periods of discouragement”, but progress is all along the way. I believe it. I also recommend Jeffries book, Safe Uses of Cortisol, to anyone who has to go through adrenal fatigue, as well as Peatfield’s book “Your Thyroid and how to keep it healthy”.
And by the way, I still don’t have the results of my saliva due to weather delays and holidays, but I am hoping to see them in a week.
1-9-07 STOPPED THE LICORICE ROOT
I have stopped the Licorice Root and let me explain why. One of the side effects of licorice, though rare, is high blood pressure. I kept doing my blood pressure, and it never got high. But what I kept noticing was that I had strong heart beats in the evening. It never dawned on me that they were due to anything other than my adrenal fatigue. But Missy, the Ferritin moderator, also started on Licorice Root to support her adrenals since she weaned off HC. And guess what? She started getting strong heart beats. hmmmm. Next, Perry from the Men’s forum stated that when he once used Licorice root..HIS HEART FELT LIKE IT WAS BEATING OUT OF HIS CHEST!
So I stopped two days ago. And viola…no more strong beats. But I still note that my heart is beating faster at night, so perhaps the Licorice Root was simply exacerbating that.
I am still dosing with 17 1/2 mgs, which helps serve to mellow down my ACTH’s battering on my adrenals. I feel pretty good during the day. But at night, I am still waking up, which I hate. And yesterday morning, I woke up a tad dizzy. Sure enough, my blood glucose was only 84. I may have to add the other 2 1/2 mgs to my nighttime regime. Eating protein at bedtime hasn’t helped.
I am also looking into any and every non-HC support I can use. Wilson, in his book Adrenal Fatigue, mentions in detail some support–some I use, some I want to add. I am also working on emotional stress issues, which I know for a fact played a part in all of this. And the cell extracts are interesting to me…even if highly expensive. (yes, you will occasionally hear a bird chirping when on this page. ) Ironically, this website is for Chronic Fatigue Syndrome, which in most cases, is simply undertreated hypothyroid with possible adrenal fatigue complicating it.
1-10-07 IMPORTANT SUPPLEMENTS
The below is a summary of the supplements recommended by Wilson, which I think is important. But I find it interesting that I was doing 3/4′s of the below (i.e wasn’t going Ashwagandha, Siberian Ginseng or Ginkgo) and STILL got adrenal fatigue, which tells me that the estrogen dominance, and emotional stress, were HUGE factors. My estrogen dominance is gone, so at least I won’t have that scratching the chalkboard. But I have to face the emotional stress.
Vitamin C (very involved in adrenal metabolism–highest amount of C in your body is found in your adrenals!) Wilson likes seeing Ascorbic Acid mixed with bioflaviniods. I’m still investigating that. Shoot for at least 3000 mg Vit C.
Vitamin E (important indirectly to help adrenal function)–choose MIXED tocopherals, approx 800 iu. I also eat nuts daily.
B-vitamins I use a high-potency B supplement. Eating whole grains also gives you natural B-vitamins
Magnesium I always take this for my heart since I have MVP, but it’s very important in the optimal function of your adrenals. Find “Magnesium Citrate”, approx 400 mg. but I am shooting for 800 mg.
If your adrenal fatigue makes you nervous and jittery, add calcium to your supplements as well as trace minerals, which include Selenium plus others. Iodine is in this area, and I take two Kelp tablets daily now since the Iodoral was giving me a headache.
Licorice Root is supposedly the best herb for supporting adrenal function and can decrease your hypoglycemia. It works by blocking the conversion of cortisol to cortisone, which leaves more cortisol in your system. But…I think it made my heart pound harder at night, so I stopped it. I’m disappointed. I got my first case of hypoglycemia the other morning aftere I stopped it! I’m considering re-adding it back in, but every other day, and see. Keep track of your blood pressure occasionally on it.
Wilson also recommends:
Ashwagandha Root and Leaf–normalizes cortisol levels, whether high or low. Not to be taken above 35 gms a day. I’m impressed with this.
Siberian Ginseng Root–normalizes adrenal function. I’m also impressed with what it does
Ginger Root–helps modulate adrenal function. This pleased me since I take Ginger Root daily! I can’t take more than one capsule a day tho, since it stimulates my MVP
Ginkgo Biloba–a powerful antioxidant, which is important for adrenal function since fatigued adrenals produce free radicals
DHEA usually falls with adrenal fatigue, but as a woman, you should only take about 5 mgs daily. Taking progesterone also helps produce DHEA
We all recommend Sea Salt, especially unrefined. I have a shaker especially made to grind the salt. Sodium loss is common with adrenal fatigue, so you want to give it back.
1-15-07 CANARY CLUB gets an F, SUPPLEMENTS, and the return of Estrogen Dominance
Sadly, I still don’t have my Canary Club/Diagnos Tech saliva results. It was received on Dec. 29th–18 long days ago. In fact, a friend’s saliva was received on Jan. 4th, and she received her results last week. And….alas…the Diagnos Tech part of the Canary Club website is down tonite. A very disappointing experience. We hope to see this vastly improve if we are going to continue recommending Canary Club.
But, I am now on liquid form of most of the above, which hastens the absorption. Two of the herbal liquid extracts–Licorice and Ginkgo–are in an alcohol base, which I thought I would tolerate fine. I was wrong. Found out the hard way that ten drops from each causes me to get sleepy. So tonite I will be boiling out the alcohol on these two. (And yes, I’m giving licorice root another try in this form)
As far as using liquid herb extracts (or even B-vitamins, etc), it’s stated that you use 98% of what’s in the liquid as compared to 39-53% of what you take in a capsule or pill. So think about it–where do you think the remainder goes?? Ahem. (also the same reason we recommend doing Armour sublingually)
My estrogen dominance unfortunately has been back for several days. So, I’m finding my morning a little harder. I don’t feel great until after I’ve taken my noon 5 mg dose of HC. I’m also quite emotional. I’m currently doing 10, 5, 2 1/2, 2 1/2. I sneak in 2 1/2 mgs at bedtime, or three Isocort. My temps seem to be just as stable as they were before.
1-16-07 It concerns you; it concerns me…STRESS
As I look back, I now understand that I may have been a high cortisol person my entire life! From a difficult childhood on, I’ve had major long term stress over and over. I have no doubt that the high morning and noon cortisol that I discovered in January of 2004 has been there in one way or another for years.
And, I may still have been a high cortisol person today…if severe estrogen dominance hadn’t been added to the mix. In my mind, along with my current stressors with my job and extended family, the estrogen dominance simply put me over the edge.
So here I am; and there are you are. And as I think about it, UNLESS YOU AND I EITHER CHANGE THE STRESSORS, and/or CHANGE THE WAY WE THINK ABOUT AND VIEW YOUR STRESSORS, we’re going to be in trouble.
First, if you are currently on HC, and if you are currently dealing with the same stress, or contining the same way you view or deal with the stressors…1) you will end up requiring more HC to manage your current situation, 2) you can have a hard time weaning, and 3) if you do succeed in weaning, you’re going to face much stress-dosing to keep yourself from falling back to where you are today.
In my mind, dealing with our Adrenal Fatigue has to be much more than using HC, giving ourselves plenty of adrenal-friendly supplements, and using sea salt. You and I are going to have to work on our stress…one way or the other. I can’t tell you what to do…but I am going to deal with it all, somehow.
PART TWO: WHEN I DISCOVERED I HAD HIGH CORTISOL:
1-23-07 To say I am shocked is only putting it mildly!
Today, I got my saliva results. They were delayed due to a glitch at Diagnos Tech.
And by my symptoms following the crash in early December, I would NEVER have guessed this. I am HIGH in all four times. The below was done Dec. 29. I had been on Licorice Root for 4 days, but can’t imagine that Licorice Root would have caused this.
7-8 am 45 (13-24)
Noon 23 (5-10)
4-5 pm 13 (3-8)
Midnight 8 (1-4)
Cortisol Burden 89
DHEA: 3 (3-8)
The above would be considered Stage 3! I felt like Stage 4 or 5.
I felt horrid. I was waking up at night constantly (but not having a hard time falling asleep—the rhythm was still there). Nausea during the day when I went to work. Absolutely no recovery from that crash the second Saturday in December. Lower and vacillating temps.
This is bizarre. It shows that excessively high cortisol levels can produce the same symptoms as the other stages–4-7. I am shocked. It has been proposed to me by fellow moderator Valerie that I may have only needed Phosphatidylserine, aka PS, which is a nutrient that helps lower cortisol. But how to emotionally and literally make a transition from the HC…which has seriously helped by lowering my ACTH…to PS…is an unknown.
I found the following about PS, and note that it may be useful for BOTH high and low cortisol:
One of the best known and most effective ways to lower excess cortisol levels is with the nutrient Phosphatidylserine (PS). Phosphatidylserine is believed to facilitate the repair of the cortisol receptors in the hypothalamus. It is believed that the cortisol receptors get damaged by high cortisol levels reducing the ability of the hypothalamus to sense and correct high cortisone levels. Because Phosphatidylserine helps repair the feedback control apparatus, it is useful in correcting both high and low cortisol levels. Phosphatidylserine is also useful for preventing short-term memory loss, age-related dementia and Alzheimer’s disease. Typical dosages are one to three 100 mg. capsules per day. http://answers.google.com/answers/threadview?id=757599
But there’s more to this story:
Free Testosterone: 54 (8-20)
Progesterone: >1000 (Postmeno-No HRT: 5-95 or HRT Target Range: 100-300)
Estradiol: 12 (Post meno-No HRT: 1-4 or HRT Target Range: 5-13)
The above suggests a lot. For one, I am on topical progesterone and testosterone. There’s a strong possibility that the high level of progesterone has been converting to estrogen…explaining my continual estrogen dominance. Same can be true for the testosterone. It has been proposed to me that I stop the topicals for several weeks, then resume only on troches or oral, since the topicals may be over saturating my fatty tissue and not releasing it to counter the high estrogen. (and I may cease to have the high estrogen if I lower the high progesterone).
Additionally, the high progesterone could be causing the stress response of my cortisol.
One more thing: I broke my own rule, doing the noon test right around the peak of my Armour administration, which caused my free T3 to look too high. Slapping my own hand there.
A good overview of too high or two low hormones.
1-28-2007 A new direction in my treatment…and much insight!
First, because my progesterone levels were acutely high, I stopped my topical progesterone gel. It certainly appears that though topical progesterone gel was helping me at the beginning (in early Jan. of 2005 when I needed it to counter my youthfully high estrogen levels), I can only guess that it may have been over-accumulating in the fatty tissues under my skin. And after awhile, no matter much I used, it seemed to stop countering my estrogen levels. In fact, in spite of being on topical progesterone, and increasing it, my estrogen dominance got WORSE many times, which I’ve had chronically for 1 1/2 years. Additionally, my high level of progesterone has probably been converting to estrogen–namely, I have been creating my own estrogen dominance!
I will resume on progesterone eventually, but will only do it orally.
Next, five nights ago, I stopped the HC at bedtime, and switched to a 1000 mg PS combined formula. The first night was an improvement–didn’t wake up as much. The second was a huge improvement…slept solid for 7 hours. The third night, I tried only 500 mgs–woke up more. I added 500 mg in the morning and stuck with 500 mg at night–still woke up more. Last night, I returned to the full 1000 mgs and didn’t have the success of the second night—I kept waking up and waking up after 6 am. But that is far better than waking up all night long. I’ll continue to try the full 1000 mgs at night.
I also decreased my HC to 5 mg in the morning and 5 mg at noon–that was Thursday and Friday. I felt fine. Yesterday, due to a busy day that started early, I took NO HC and did fine. Was sleepy that night, but female hormonal factors may be playing in that.
But….with high cortisol levels, I know I need to support my adrenals, which in turn will stop the ACTH pounding, to see if I can prevent the slide into Stage 4 and beyond. So I made sure to stick with the HC today…and will continue with that for several weeks. I did my usual 10 mgs this morning, and will do 5 at noon. (one observation, tho, I had heart pounding within a hour of my 10 mgs dose. I can only wonder if that was the delay in the feedback system to lower to my own high cortisol production.) I may go back down to 5 mg and 5 mg. I want to support–not over-support.
As I write this, I still haven’t found the answer as to why my cortisol levels are so acutely high. I have stress in my life, but that seemed extreme. Could this be the result of my difficult entry into peri-meno, followed by two years of estrogen dominance that I may have created in myself?? There is also evidence that higher estrogen prevents the clearance of HC from your body, but I did not appear to be estrogen dominant for two months when this hit me in December…though it did return one week after I did the labs. I also wonder if my severely high progesterone levels have been a stress to my body, thus the higher cortisol.
I have also learned that having high levels of cortisol (i.e Stage 3 of Adrenal Fatigue) can cause the exact same symptoms as the deeper stages. I had the nausea in the face of stress: I had the inner hot feeling when feeling emotional; I had unstable temps; my blood pressure dropped when standing. And I felt horrid.
Bottom line: I have to do whatever it takes to prevent the slide into Stages 4 and beyond, and using HC support, the PS and continuing with the supplements seems to be one focus. But stress reduction has to remain a factor, as it does for anyone reading this, no matter what stage of adrenal fatigue you are in. To follow the Stages of Adrenal Fatigue, go here.
2-15-2007 Still hanging in there
It is now 3 weeks since I stopped the progesterone gel and still doing MUCH better in that arena. I have noticed a slight amount of dominance the last few evenings…but it’s slight as compared to the constant dominance I was unknowingly giving myself the last year and more.
And subjectively, I can tell my high cortisol levels are still there, at least in the mornings. I continue to need 10 mgs HC at breakfast due to an internal shaky feeling. Occasionally, I add 5 mg at noon if I’m under extra stress, but it’s rare. I feel fine all afternoon and evenings as compared to the feel-bads I had at those times of the day when this first started. Still use PS at bedtime successfully. I will be curious how this is going to turn out…and whether continuing to lose the extreme dominance will help my cortisol levels to fall to a normal level.
3-27-2007 A post I made this month appears to have not made it above.
I am doing nearly 100% better. I still use 5 mg HC in the mornings in the presence of a slight internal shaky feeling within the hour after waking. And on more stressful days, I add 2 1/2 mg by noon. But the latter is rare. Occasionally, I need nothing in the mornings. Of course, 100% would represent no need for cortisol at all. But the improvement is immense so I’m happy. I have NONE of the misery I had last December and January due to high cortisol. My experience reveals that HC use spectacularly helps high cortisol.
It’s called the “feedback regulatory loop”… which is from the hypothalamus to the pituitary to the adrenals….and back to the hypothalamus again.
1) The hypothalamus senses the need due to stress 2) sends a message to your pituitary gland called the CRH (Corticotropin-releasing hormone) 3) causing the pituitary gland to send a message to your adrenal cortex called the ACTH (Adrenocorticotropic hormone) 4) which causes the release of cortisol.
So, with high cortisol, the manual addition of cortisol causes the adrenals to be LESS stimulated by the ACTH…and your overall cortisol levels will lower.
I am proof.
I am now off of any support and doing well. I still wake up FAR too early in the morning (which turns out may be a side-effect of my crazy temp regulation due to being newly in menopause) and have to force myself to stay in bed the full eight hours. I do always fall back asleep, tho. As the holidays approach later this year, I’m going to pay more attention to my stress levels, and make sure I am supporting my adrenals fully with B-vitamins, Vit. C, sea salt, and some of the supplements I used above when I thought I had adrenal fatigue. Here’s lifting my glass to all of you for a successful treatment of your adrenals!
9-14-2007 Looking back, if I had known that my high cortisol was what it was all along, I would have only done the PS. There are also supplements which are known to lower high cortisol, with zinc being one, and you can read about that here.