Lab Tests for Hypothyroidism

Lab Tests for Hypothyroidism

Miss Lizzy

It’s important patients order the right lab tests for hypothyroidism, adrenal fatigue, and related conditions, otherwise, patients may go untreated. While TSH test has been used as the main test for hypothyroidism over recent years, it is not a reliable measure of thyroid function. Below is a list of lab tests recommended by patients and doctors.  1 2 3 4.

PRIMARY LAB TESTS for HYPOTHYROIDISM

The following is a primary list of lab tests for hypothyroidism run by my doctor. These lab tests provided a baseline for diagnosing hypothyroidism and related conditions. In addition, these primary lab tests are the ones we run regularly to monitor my thyroid health. To help monitor and assess treatment, I find it helpful to track lab test results, body temperature and medicine doses.

FREE T3 Lab Test

Free T3 is the workhorse of all thyroid hormones, measuring the free, unbound levels of triiodothyronine in the bloodstream. It’s important to remember that Free T3 is considered more accurate than Total T3. In hyperthyroidism Free T3 is typically elevated. In hypothyroidism, Free T3 is typically low. 5

According to Stop the Thyroid Madness 6, at the optimal dose of natural desiccated thyroid, with no lingering hypothyroid symptoms and with healthy adrenals, patients tend to have a Free T3 at the top of the range.

On natural desiccated thyroid (lower than 3 grains), with the Free T3 high or above range, and continuing hypothyroid symptoms or even hyper-like symptoms, patient could have adrenal fatigue.

For patients who are not on thyroid medication, a lab test showing high Free T3 could mean they have Hashimoto’s disease or Graves disease. Whereas for patients who are not on thyroid medicine and have hypothyroid symptoms, a lab test showing Free T3 mid to lower range could mean hypothyroidism.

Free T3 Results by Miss Lizzy Hypothyroid Advocate

FREE T4 Lab Test

Free T4 measures the available and unbound T4 hormone. For patients on natural desiccated thyroid medicine with healthy adrenals, a normal lab test will show Free T4 at mid to high range, and Free T3 at the top end of the range. Hypothyroidism generally occurs with Free T4 in the low range, and Free T3 at mid-range or slightly high.

Reverse T3 (RT3) Test

The RT3 test must be done at the same time as the Free T3 in order to calculate the ratio with the results and measurements. According to Thyroid-Rt3.com, divide Free T3 by reverse T3. The amount should be 20 or greater. If it’s less then that you have a RT3 problem. If it’s vastly smaller or larger you may have to move the decimal point to get the units right.

FT3 should be twenty of more times higher than RT3.  (Stop the Thyroid Madness book  page 162-163 for more.)

24-Hour Cortisol Saliva Test for Adrenal Fatigue

This lab test is done at home to evaluate cortisol levels during a 24 hour period. This test helps patients determine if they have adrenal fatigue. In addition the lab test will show the times during the day when adrenal function is too high or too low. Patients with healthy adrenal function will have the follow results:

  • 8 am will be at the very top of the range
  • 11 am-noon in the upper quarter of the range
  • 4-5 pm will be mid-range
  • 11 pm to midnight at the very bottom of the range

It’s important to remember, the rise and fall pattern of cortisol reflects the a person’s energy throughout the day. In simple terms, we have more energy in the morning, yet as the day goes on our energy tappers down slowly until bedtime. When the cortisol pattern is off, it greatly affects our energy and sleep patterns in the following ways:

  • Low morning cortisol may make it hard to wake up, especially before 9 AM.
  • Low afternoon cortisol may cause patients to require a nap.
  • High bedtime cortisol may make it hard to fall asleep.

Two weeks prior to the 24 hour saliva test, make sure to stop all adrenal supplements.

Order the 24 Hour Saliva Test from TrueHealth Labs

Antithyroglobulin Test

According to About.com, testing for thyroglobulin antibodies (also called antithyroglobulin antibodies) is common. If you have already been diagnosed with Graves’ disease, having high levels of thyroglobulin antibodies means that you are more likely to eventually become hypothyroid. Thyroglobulin antibodies are positive in about 60 percent of Hashimoto’s patients and 30 percent of Graves’ patients.

B-12 Test

According to Stop the Thyroid Madness, B12 can can be low in hypothyroid patients due to low stomach acid. The normal range for B12 is 200-900 pg/ml. Though Stop the Thyroid Madnesss indicates a healthy range is on the high end.

Ferritin 

The ferritin test measures the level of ferritin, the major iron storage protein in the body 7. The results may vary slightly among laboratories, but in general, normal ferritin levels are 12-300 nanograms per milliliter of blood (ng/mL) for males and 12-150 ng/mL for females.

According to Stop the Thyroid Madness, if your Ferritin result is less than 50, your levels are too low and can be causing problems…as well as leading you into anemia as you fall lower, which will give you symptoms similar to hypo, such as depression, achiness, fatigue. Optimally, females shoot for 70-90 at the minimum and men 100-130.

Elevated Ferritin, can indicate inflammation, rheumatoid arthritis, liver disease, hyperthyroidism, adult Still’s disease, type 2 diabetes, leukemia, Hodgkin’s lymphoma, iron poisoning or frequent blood transfusions.

For at least 12 hours before testing and as much as 5 days  before testing, stop taking iron supplements for best accuracy.

Iodine Loading Test

While iodine is an important nutrient for thyroid and whole body health, iodine deficiency is a primary cause of Hypothyroidism. Learn more about iodine. In The Iodine Crisis by Lynne Farrow, the 24 Hour Iodine Loading test is recommended for assessing iodine sufficiency.

People undergoing the test are deemed to be deficient in iodine if they excrete less than 90% of the iodine loading dose. 8

Sodium Test 

The sodium test is often part of the Basic Metabolic Panel. The right amount of sodium is important for health. Blood sodium can also be part of an electrolyte panel.

Normal results for this test are 135-145 mEq/L 9, however Stop the Thyroid Madness noted that healthy folks report 142 and even slightly higher.

Thyroid Peroxidase Antibody (TPO) Test

The TPA antibodies work against thyroid peroxidase and the enzyme that plays a part on the conversion of T4 to T3. TPO antibodies can indicate Hashimoto’s disease. In 95% of patients with Hashimoto’s thyroiditis TPO antibodies are detectable. While in 50-80% of patients with Graves disease TPO antibodies are detectable. 10

TSH Lab Test

TSH is a measure of the pituitary function, therefore it is not an accurate measure of thyroid function. Learn more about why TSH can be unreliable. Here is how TSH can be used in thyroid treatment to:

  • Help determine hypothyroidism only if it’s in the high range.
  • Understand the relative range for you.
  • Diagnose a pituitary problem, not a thyroid problem. Especially if low TSH is accompanied by low Free T3.

Vitamin D test

As explained by Dr. Mercola 11, there are two vitamin D test. The 1,25(OH)D and the 25(OH)D. The correct test is 25(OH)D, also called 25-hydroxyvitamin D. The lab test ranges for 25-hydroxyvitamin D are:

  • Deficient > 50 ng/ml
  • Optimal 50-70 ng/ml
  • Treating Cancer and Heart Disease 70-100 ng/ml
  • Excess > 100ng/ml

Low vitamin D can contribute to thyroid problems 12.

Serum Iron

According to Healthline 13, the serum iron test measures how much iron is in your serum. This test can help your doctor figure out if there is a problem with your iron levels (high or low) resulting in symptoms such as fatigue, weakness, difficulty concentrating, and moodiness.  Though its a less common test.

Stop the Thyroid Madness suggests a value of about 110 for women, and the 130′s for men, based on what they’ve seen on hundreds of lab results. 14

TIBC (Total iron binding capacity) test: measures whether a protein called transferrin, produced by the liver, has the ability to carry iron in the blood. Used to determine anemia or low body iron. If your result is high, and in the absence of chronic disease, you may be anemic. With healthy amounts of iron, this test will be low in the range—about 1/4th above the bottom number.

SECONDARY LAB TESTS

Aldosterone

Aldosterone is a hormone that is produced by the adrenal glands to help maintain the balance of fluids and electrolytes in our bodies through the kidneys. In addition, aldosterone affects blood pressure, as well as regulating salt (sodium) and potassium in the blood. If aldosterone production is not functioning properly, there can be serious consequences to the heart, kidneys and electrolyte balance. 15

According to GlobalRph.com 16, the normal range for Aldosterone is 4-31 ng/gl.  Low range results indicate adrenal insufficiency.

Stop the Thyroid Madness suggests for women to test aldosterone in the first week of the menstrual cycle, or up until the beginning of the second week. This phase of the menstrual cycle is when progesterone is at its lowest. By the end of the second week in the menstrual cycle progesterone begins to rise. Progesterone can falsely drive up aldosterone.

DHEA test

DHEA is a natural steroid and precursor hormone produced by the adrenals. The truth is that — for the women who need it — adrenal support with DHEA supplementation can make a big difference. I’ve seen it help patients get going again when they feel like they’ve hit rock bottom. But it’s never as simple as just popping a pill. For me personally, supplementing with DHEA was not the right fit but for others it can be effective. On WomentoWomen they like to see estrogen, progesterone, and DHEA in the upper quadrant of normal.

Folate Test 

Folate or Folic acid, is a b-vitamin which can be low in hypothyroid patients. The normal reference range of folic acid in the blood is 2.7 to 17.0 nanograms per milliliter (ng/mL). Low levels of folic acid may indicate anemia, malabsorption, or malnutrition. 17

RBC Magnesium Test

While a lack of magnesium in normal diets can cause low thyroid function, it can be solved with proper diet and supplements. Magnesium deficiencies are common, especially in well-developed countries where processed foods are a part of the diet. Seven out of every ten Americans is likely to have a magnesium deficiency, causing many problems including underactive thyroid (hypothyroidism). 18

Signs of magnesium deficiency include weakness, extreme thirst, muscle cramps, muscle twitching, poor memory, confusion, Type II Diabetes, high blood pressure, fatigue, anxiety and more. 19

For RBC Magnesium results, Stop the Thyroid Mandess suggests a good range is mid to high. 20

Renin Lab Test

Aldosterone and renin tests are used to evaluate if adrenal glands are producing appropriate amounts of aldosterone. The test is also used to distinguish between the potential causes of excess or deficiency. Aldosterone may be measured in the blood or in a 24-hour urine sample, which measures the amount of aldosterone removed in the urine in a day. Renin is always measured in blood.

Low renin can mean primary aldosteronism (Conn syndrome) or Cushing Syndrome. While high renin can mean Secondary aldosteronism, or Adrenal insufficiency.  21

Zinc

The plasma zinc test can establish zing deficiency. While the plasma zinc test is good at detecting major zinc deficiency, it is not as good at catching minor zinc deficiency. When this happens, a patient can have “normal” zinc results but still be zinc deficient. The optimal range for plasma zinc is 3.8 – 22.9µmol/L ( 90-150µg/dl).

ACTH STIM

The ACTH Stimulation test assesses the function of adrenal glands stress response to ACTH (adrenocorticotropic hormone). This test is used to diagnose primary or second adrenal sufficiency, Addison’s disease, and related conditions. 22

For details about range, see the simple diagnostic chart.

T7, Total T3, Total T4, Uptake, or any other thyroid labs

These tests are unnecessary 23

When talking with a good doctor, it’s important to know which lab tests for hypothyroidism and track the results over time!

Notes:

  1. StoptheThyroidMadness.com ↩
  2. The Iodine Crisis by Lynne Farrow ↩
  3. Adrenal Fatigue by Dr. James L. Wilson ↩
  4. Mary Shomom at About.com ↩
  5. http://thyroid.about.com/od/gettestedanddiagnosed/a/bloodtests.htm ↩
  6. StoptheThyroidMadness.com ↩
  7. http://www.medicinenet.com/ferritin_blood_test/article.htm ↩
  8. http://www.townsendletter.com/Jan2013/iodine0113.html ↩
  9. http://www.healthline.com/health/sodium-blood#Results ↩
  10. http://thyroid.about.com/od/gettestedanddiagnosed/a/bloodtests.htm ↩
  11. http://articles.mercola.com/sites/articles/archive/2002/02/23/vitamin-d-deficiency-part-one.aspx ↩
  12. http://www.wellnessresources.com/health/articles/low_vitamin_d_contributes_to_thyroid_problems/ ↩
  13. http://www.healthline.com/health/serum-iron#Overview ↩
  14. http://www.stopthethyroidmadness.com/lab-values/ ↩
  15. http://pcos.about.com/od/normalmenstrualcycle/f/aldosterone.htm ↩
  16.  http://www.healthline.com/health/aldosterone#Overview ↩
  17. http://www.healthline.com/health/folic-acid-test#UnderstandingtheResults ↩
  18. http://www.progressivehealth.com/thyroid-magnesium.htm ↩
  19. http://naturalsociety.com/16-magnesium-deficiency-symptoms-signs-low-levels/ ↩
  20. http://www.stopthethyroidmadness.com/lab-values/ ↩
  21. http://labtestsonline.org/understanding/analytes/aldosterone/tab/test/ ↩
  22. http://en.wikipedia.org/wiki/ACTH_stimulation_test ↩
  23. http://www.stopthethyroidmadness.com/lab-values/ ↩
Miss LizzyLab Tests for Hypothyroidism
Adrenal Fatigue Overview

Adrenal Fatigue Overview

Miss Lizzy

Adrenal Fatigue Overview

Adrenal fatigue is a condition that weakens the adrenal glands due to stresses on the body.  It’s important to understand, people can have adrenal fatigue separate from Hypothyroidism. However it is quite common for patients to have both Adrenal Fatigue and Hypothyroidism.

According to Natural Thyroid Treatment, of the millions of people who are diagnosed with thyroid conditions, many of these people also develop adrenal fatigue. If a healthcare professional aims their treatment directly at the thyroid gland and ignores the adrenals, there is absolutely no chance of restoring the patient’s health back to normal.

Basics Causes of Adrenal Fatigue

Adrenal fatigue occurs when the adrenal glands cannot adequately meet the demands of stress.* The adrenal glands mobilize the body’s responses to every kind of stress (physical, emotional, and psychological) through hormones that regulate energy production and storage, immune function, heart rate, muscle tone, and other processes that enable you to cope with the stress.

Whether you have an emotional crisis such as the death of a loved one, a physical crisis such as major surgery, or any type of severe repeated or constant stress in your life, your adrenals have to respond to the stress and maintain homeostasis. If their response is inadequate, you are likely to experience some degree of adrenal fatigue.*

During adrenal fatigue your adrenal glands function, but not well enough to maintain optimal homeostasis because their output of regulatory hormones has been diminished – usually by over-stimulation.* Over-stimulation of your adrenals can be caused either by a very intense single stress, or by chronic or repeated stresses that have a cumulative effect.*

  • Stressful relationships, stressful work, financial stress, or traumatic events
  • Major surgery
  • Long-term malnutrition or poor eating
  • Drug addition
  • Long exposure to toxic chemicals or pollutants
  • Recurring disease, infection or illness

Basic Symptoms of Adrenal Fatigue

Natural Thyroid Treatment explains there are many different symptoms people can experience with adrenal fatigue, but here are the more common symptoms:

  • Extremely tired, especially in the morning
  • Find it difficult to obtain quality sleep
  • Crave sweet and salty foods
  • Feel stressed out most of the time
  • Decreased sex drive
  • Low blood pressure (light headedness)
  • Loss of body hair
  • Needing stimulants or high doses of caffeine

How Stress Affects Adrenals

The adrenals are what handle the Fight or Flight” response in the body. Meaning, we experience stress, adrenaline kicks in and gives our body an energy boost.  As cave women, it was great for fighting the occasional tiger (or running from said tiger) which we only had to do on occasion. But in the modern world we can experience stress every day from work, family stress, financial stress, poor diets, sickness, chronic illness or disease which means continually draining the adrenal system. When we are sick with a condition like Hypothyroidism, our bodies are continually draining the adrenals. Many people who have hypothyroidism also find they have adrenal fatigue.

We risk burning out the adrenals, resulting in a “crash”.  You know that feeling, for example, after a big family holiday ends you just want to lie on the couch for days?  Or you’ve finished a big work deadline and either you get sick, or simply can’t do anything for a few days? That’s the adrenal crash from stress.  When you say “you burned yourself out” that’s totally true! You did. You fought that tiger, and you won, sister! But now you’re paying.

Adrenal Fatigue Can Be Missed

Although adrenal fatigue affects millions of people in the U.S. and around the world, conventional medicine does not yet recognize it as a distinct syndrome. According to AdrenalFatigue.org, Adrenal Fatigue has been known by many other names, such as non-Addison’s hypoadrenia, sub-clinical hypoadrenia, neurasthenia, adrenal neurasthenia, and adrenal apathy. 

Adrenal fatigue can wreak havoc with a person’s life. In more serious cases, the activity of the adrenal glands is so diminished that people may have difficulty getting out of bed for more than a few hours per day.

As the adrenals become more tired, every organ and system in the body is increasingly affected. Changes occur in carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and even sex drive. The body does its best to make up for under-functioning adrenal glands, but it does so at a price.

Learn more at According to AdrenalFatigue.org, or read Dr. Wilson’s book, Adrenal Fatigue: The 21st Century Stress Syndrome.

Can people experiencing adrenal fatigue heal and feel good?

According to AdrenalFatigue.org, YES. In my own experience, and reports from other patients, YES. It is possible to heal weak adrenals and feel healthy again.

How to Get Started

Miss LizzyAdrenal Fatigue Overview
Adrenal Fatigue Testing

Adrenal Fatigue Testing

Miss Lizzy

Adrenal Fatigue Testing

There are several options for Adrenal Fatigue Testing, including the free at-home Pupil Test, Blood Pressure test; and the 24 Hour Saliva Test. These testing options may give you some information in order to have more insight when you talk with a good doctor.

Symptoms Checklist

If you answered yes to at least half the Adrenal Fatigue symptoms, in particular the symptoms related to low energy and poor sleep that’s a good first indicator of Adrenal Problems.

The Pupil Test

Adapted from Adrenal Fatigue by Dr. James L. Wilson, you can do this test at home yourself for free and will give you quick insight about whether there might be an adrenal fatigue. You need a chair, a small flashlight, a mirror, a watch or timer, and a dark room.

  • Darken the room and sit in a chair in front of a mirror
  • Angle a flashlight from the side (not directly into it), and shine the light toward your pupil
  • With the other eye observe, holding for two or three minutes
  • Normally a pupil will stay contracted in the bright light
  • With adrenal fatigue or hypoadrenia, the pupil will not hold its contraction. Within two minutes the pupil will start to dilate and this will last 30-40 seconds before it recovers and contracts again.
  • Make note when the dilation started, how long the dilation lasted, and the date.
  • Let the eye rest
  • Re-take the test monthly
  • If needed, ask a friend to help you with the test

Blood Pressure Test

Also according to Dr. James L. Wilson 1, blood press is an important indicator of adrenal function. Wilson says if your blood pressure drops when you stand up from a lying position this almost always indicates low adrenals. For me personally, when I stood up too fast I would nearly black out!

This test can be done at home. All you need is a blood pressure gauge which does not require a stethoscope. After you know how to use the blood pressure gauge here are the steps:

  • Lie down quietly for 10 minutes
  • Then while laying down take your blood pressure
  • Next stand up and immediately measure your blood pressure
  • Normal blood pressure will rise about 10-20 mmHg
  • If it drops when you stand up this likely means you have some form or hypoadrenia, adrenal fatigue, or you may be dehydrated
  • The more severe the drop the more severe the hypoadrenia
  • Dizziness or light-headedness might accrue when standing, so it is wise to do this test with someone beside you, or next to something you can grab like a chair

For more about the Blood Pressure test see Dr. Wilson’s book., Adrenal Fatigue.

24 Hour Saliva Test

The Saliva Hormone test is the single best lab test available for testing adrenal fatigue 2,. This test is done at home, but  typically it is not covered by insurance. The cost runs about $120-150, but it is more accurate than blood or urine tests which are covered by insurance.   The test measures cortisol levels at four different times of the day to show how your cortisol varies during the day:

  • Between 6-8 AM (within one hour after waking and cortisol is at its highest)
  • Between 11AM-12 PM
  • Between 4-6 PM
  • And between 10PM-midnight

Dr. Wilson also notes that, when doing the saliva test he usually measures DHEA-S (but not necessarily DHEA) because the adrenals are a primary source of DHEA-S.

The 24 hour Saliva test can be ordered by a doctor or by patients directly through these labs:

 

Notes:

  1. Adrenal Fatigue, .79 ↩
  2. Adrenal Fatigue, Dr. James L. Wilson, p. 83 ↩
Miss LizzyAdrenal Fatigue Testing
The Importance of Sleep for Adrenal Health

The Importance of Sleep for Adrenal Health

Miss Lizzy

If you have adrenal fatigue like me, or know someone who does, getting up before 9 a.m. can often be painful. As far back as high school I joked about not being “a morning person”. Staying up late at night was easy for me, but mornings were so bad that in college I scheduled all classes after 2 p.m. Seriously, I did.  I would be a zombie until around noon. People thought I was lazy, I thought I was lazy. But my brain just didn’t function in the morning, so I did what my body was telling. And you know, my body was pretty darn smart, thank you.

Even as a adult it was painful to wake up before 9 AM. I admired early-risers and longed to be one, having a strange idea that morning people are good people. Only the lure of coffee would pull me from the comatose state of sleep.  The idea of waking up at 6 a.m. actually made me panic. If I woke up before 9 a.m., I could easily drink two cups of coffee and go right back to sleep for hours.  Curiously though, if I slept until about 9 a.m. I could pop right out of bed awake and alert.  This always seemed odd, but apparently, there are lots of people out there like me!

Anyone who has chronic illness will understand you lead a secret life, arranging your business hours around rest opportunities and finding excuses for missing social events – Lynne Farrow, author The Iodine Crisis

Then I started learning about Adrenal Fatigue and how cortisol runs our body clock. So my sleep pattern wasn’t a matter of choice after all. What a revelation! According to James L. Wilson, Ph.D, Adrenal Fatigue: The 21st Century Stress Syndrome, though most people’s schedules do not allow it, it helps to sleep until 8:30 or 9 in the morning.

Wilson also writes, for people with normal functioning adrenals, cortisol rises rapidly between 6-8 am, which helps them to pop out of bed.  (And explains why some people can’t sleep past a certain time.)  Further, there is something magical about the restorative power of sleep between 7-9 a.m. for people with Adrenal Fatigue. Partly, he says, because cortisol levels rise slower in people with adrenal fatigue, and when cortisol levels are lower it takes longer to feel fully awake. Wilson also explains that with adrenal fatigue, when you sleep may be more important than how much you sleep.

Finally something that made sense after all these years!  After getting treatment for Adrenal Fatigue, my Cortisol levels have become more normal, so waking up is much easier. In fact, I can get up at 7:45 a.m and actually function these days. But given the chance, I sleep late without guilt, knowing it will help me tackle the day with energy. Brilliant.

 

Miss LizzyThe Importance of Sleep for Adrenal Health

My Treatment for Adrenal Fatigue

Miss Lizzy

My Treatment for Adrenal Fatigue

Here is the history of my treatment for adrenal fatigue. Each person is different so please consult a doctor you trust. This information is available for educational purposes. Please read about diagnosis and treatment options.

Diagnosing Adrenal Fatigue

First I did a 24-Hour Saliva Test to get a diagnosis for Adrenal Fatigue. Once Adrenal Fatigue was confirmed, initially for my treatment I was treated with a low dose of Hydrocortisone in pill form (20-30mg/day). The brand name is Cortef.  My doctor gave me a prescription.

Treating Adrenal Fatigue with Hydrocortisone

Hydrocortisone is a steroid, I know, that sounds scary. But the body is already creating it naturally (or at least it was until it got burned out).  According to my doctor and other experts like Dr. Wilson,  there is really only concern about Hydrocortisone in high doses (say 80 + mg a day) and for long-term use. Hydrocortisone doses under 30mg a day is considered safe.

How Will I know if Hydrocortisone Works?

My doctor said I would know pretty quickly if the Hydrocortisone works. In fact, I would know within in a few hours. Prescription Hydrocorisone works right away, and only stays in the body for about 4-5 hours. He said if I took the Hydrocortisone and didn’t notice a difference right away then probably I didn’t need it.

In my case, within hours of starting the first dose of Hydrocortisone I felt amazing and had lots of energy. Over time my adrenal symptoms improved, specifically my ability to exercise and have energy throughout the day. My thinking became faster, and clearer. My word retrieval and humor were quicker. I felt motivated and energized. My life felt good!

Daily Medicine Dosing

For me personally, the dose of Hydrocortisone lasted about 3.5 hours in my body (everyone is different). This meant regular dosing throughout the day. I took more in the morning to mimic the natural rise in Cortisol and tapered accordingly through the day. First thing in the morning I would take 10mg, at lunch 7.5 mg, mid-afternoon 5mg, and 2.5 mg  just after dinner.

Stress Dosing

In times of stress like sickness, holidays, travel, or work stress I would “stress dose” which means I would take an extra 10 mg when I felt adrenal stress signs of shaking hands, racing heart, low energy or foggy thinking.

Stress dosing helped me during those “fight the tiger” moments. Its important not to stay at the higher stress dose. And also to wean back slowly to the original dose, according to the Yahoo Adrenal Group. For example, if I stressed dosed from my normal 25 msg up to 35mgs, over the next two weeks I would slowly reduce back down to my normal 25mg dose.

Duration and Possible Risks of Hydrocortisone

In my personal experience, I believe I stayed on Hydrocortisone too long. The Yahoo group suggested about 3-4 months before weaning off but I stayed on for over two years. I was just too afraid of stopping the medicine and reverting back to my old low adrenal fatigued self.

Because of the extended use of Hydrocortisone, I believe my hair volume became quite thin. In many ways Hyodrocortisone was great for me. But the risk of thin hair is a concern. Low hair volume, and dry brittle hair are associated with Hypothyroidism so it is possible that the hair loss was not specifically Hydrocortisone. This was my experience treating Adrenal Fatigue. Each person is different.

Learn more about Adrenal Fatigue Treatment Options.

Miss LizzyMy Treatment for Adrenal Fatigue

What is Adrenal Fatigue?

Miss Lizzy

What is Adrenal Fatigue?

Low energy, feeling tired and run-down, frequently waking up at night, craving salty or sweet snacks, frequent illness, feeling overwhelmed, difficulty waking up in the morning are all possible signs up Adrenal Fatigue.

With Adrenal Fatigue the body burns itself out trying to produce Cortisol. If you’ve had a poorly functioning thyroid, the body considers this a kind of stress which could then drain the adrenal system leading to a host of symptoms.

According to AdrenalFatigue.org, as the name suggests, the paramount symptom is fatigue that is not relieved by sleep. You may look and act relatively normal with adrenal fatigue and may not have any obvious signs of physical illness, yet you live with a general sense of un-wellness, tiredness or “gray” feelings.

People experiencing adrenal fatigue often have to use coffee, colas and other stimulants to get going in the morning and to prop themselves up during the day.

Another important detail is that Cortisol helps move the thyroid hormone from the blood to the cells. So while you might be taking Natural Desiccated Thyroid Medicine for Hypothyroidism, it may not be making into the cells because of the low Cortisol. In short, treating Hypothyroidism also means looking at Adrenal Fatigue.

Well we all know stress is bad. But why?

The adrenals are what handle the Fight or Flight” response in the body. Meaning, we experience stress, adrenaline kicks in and gives our body an energy boost.  As cave women, it was great for fighting the occasional tiger (or running from said tiger) which we only had to do on occasion. But in the modern world we can experience stress every day from work, family stress, financial stress, poor diets, sickness, chronic illness or disease which means continually draining the adrenal system. When we are sick with a condition like Hypothyroidism, our bodies are continually draining the adrenals. Many people who have hypothyroidism also find they have adrenal fatigue.

What happens when we continually exhaust the Adrenals?

We risk burning out the adrenals, resulting in a “crash”.  You know that feeling, for example, after a big family holiday ends you just want to lie on the couch for days?  Or you’ve finished a big work deadline and either you get sick, or simply can’t do anything for a few days? That’s the adrenal crash from stress.  When you say “you burned yourself out” that’s totally true! You did. You fought that tiger, and you won, sister! But now you’re paying.

Why Don’t People Talk About Adrenal Fatigue More?

Although adrenal fatigue affects millions of people in the U.S. and around the world, conventional medicine does not yet recognize it as a distinct syndrome. According to AdrenalFatigue.org, Adrenal Fatigue has been known by many other names, such as non-Addison’s hypoadrenia, sub-clinical hypoadrenia, neurasthenia, adrenal neurasthenia, and adrenal apathy. 

Personally, I think every doctor, and every person would benefit from knowing about this condition. Adrenal fatigue can wreak havoc with your life. In more serious cases, the activity of the adrenal glands is so diminished that you may have difficulty getting out of bed for more than a few hours per day.

As the adrenals become more tired, every organ and system in the body is increasingly and profoundly affected. Changes occur in carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and even sex drive.

Many other alterations take place at the biochemical and cellular levels in response to and to compensate for the decrease in adrenal hormones that occurs with adrenal fatigue. The body does its best to make up for under-functioning adrenal glands, but it does so at a price.

Learn more at According to AdrenalFatigue.org, or read Dr. Wilson’s book, Adrenal Fatigue: The 21st Century Stress Syndrome.

What causes adrenal fatigue?

Adrenal fatigue is produced when your adrenal glands cannot adequately meet the demands of stress.* The adrenal glands mobilize your body’s responses to every kind of stress (whether it’s physical, emotional, or psychological) through hormones that regulate energy production and storage, immune function, heart rate, muscle tone, and other processes that enable you to cope with the stress. Whether you have an emotional crisis such as the death of a loved one, a physical crisis such as major surgery, or any type of severe repeated or constant stress in your life, your adrenals have to respond to the stress and maintain homeostasis. If their response is inadequate, you are likely to experience some degree of adrenal fatigue.*

During adrenal fatigue your adrenal glands function, but not well enough to maintain optimal homeostasis because their output of regulatory hormones has been diminished – usually by over-stimulation.* Over-stimulation of your adrenals can be caused either by a very intense single stress, or by chronic or repeated stresses that have a cumulative effect.*

How can I tell if my adrenals are fatigued?

You may be experiencing adrenal fatigue if you regularly notice one or more of the following:

  1. You feel tired for no reason.
  2. You have trouble getting up in the morning, even when you go to bed at a reasonable hour.
  3. You are feeling rundown or overwhelmed.
  4. You have difficulty bouncing back from stress or illness.
  5. You crave salty and sweet snacks.
  6. You feel more awake, alert and energetic after 6PM than you do all day.

Read the full symptom list.

Are there health conditions related to adrenal fatigue?

The processes that take place in any chronic disease, from arthritis to cancer, place demands on your adrenal glands. Therefore, it is likely that if you are suffering from a chronic disease and morning fatigue is one of your symptoms, your adrenals may be fatigued to some degree.

Can people experiencing adrenal fatigue heal and feel good?

According to AdrenalFatigue.org, YES. And in my own experience, and reports from other patients, YES. It is possible to heal struggling adrenals and feel better again.

What It Means For Me, Miss Lizzy

With proper care most people experiencing adrenal fatigue can expect to feel good again. For me personally, I brought myself to good heath and was able to treat my adrenal fatigue and feel better. It is an on-going journey. I am careful to protect my body from stressors so I can remain in good health. If I stress my body too much, it lets me know and I listen.

Miss LizzyWhat is Adrenal Fatigue?

Adrenal Fatigue Treatment Options

Miss Lizzy

There are several Adrenal Fatigue treatment options, including supplements and prescriptions, depending on the severity of the condition and doctor recommendations. This information is made available for educational purposes, to discuss with a good doctor.

Licorice

For slightly Low Cortisol. Licorice is an anti-stress herb known to increase energy, endurance and vitality. Licorice has also been used to help decrease symptoms of Hypoglycemia. The best form of Licorice is in tea. And can also be found in the form of capsules, liquid herbal extract and dried root which can be chewed. 1

Ashwagandha Root

Therapeutic uses of Ashwagandha date back to at least 1000 B.C. Ashwagandha has beneficial effects on the adrenal tissue and function. Ashwagandha is considered an adaptogen which means it helps the body function more towards its normal level. Ashwagandha is capable of normalizing cortisol levels whether they are low or high. But it should not be taken at doses higher than 35 gms/day because this would inhibit adrenal function.  2

Adrenal Cortical Extracts

According to Dr. James L. Wilson  3 probably the most reliable way of rebuilding adrenals from adrenal fatigue is the use of adrenal cortical extracts. In 1918 Adrenal Cell Extracts became commercially available, and since then they have been a powerful form of treatment for non-Addison’s type of hypoadrenia.

There are several brands available both in table and liquid form. According to Wilson the the liquid is generally more powerful than the tablet, but also costs more. He uses the tablets for milder cases, and the liquid in moderate to severe cases. Dr. Wilson explains:

  • Dosage for the adrenal cortical extract tablets is 6-12 per day, depending on severity
  • Dosage for the liquid is usually one vial under the tongue 2 or 3 times a week as directed by your physician

Many doctors are unaware of the existence of this type of therapy and do not know how to use it. This can mean some doctors are reluctant to explore it even though there is a long history of its use.

Adrenal glandular products 

According to Stop the Thyroid Madness, Adrenal glandular products should be avoided.

Hydrocortisone (HC)

Corticosteroid therapy with Hydrocortisone is the best natural form of cortisol, available by prescription 4. When administered in physiological doses of approximately 20 mg per day it can give the adrenals a rest. This is considered a short -term protocol for treating adrenals with a goal of gradually decreasing the dose after six months.

For me personally, and from the stories of others, Hydrocortisone helped me to strengthen my adrenals and provide the cortisol needed to help with absorption of Natural Desiccated Thyroid medicine. In hindsight, I believe I stayed on Hydrocortisone too long and should have weaned off after six months. But it did indeed help me.

Notes:

  1. Adrenal Stress, Dr. James L. Wilson, p. 203 ↩
  2. Adrenal Stress, Dr. James L. Wilson, p. 204 ↩
  3. Adrenal Stress, Dr. James L. Wilson, p. 209 ↩
  4. Adrenal Stress, Dr. James L. Wilson, p. 217 ↩
Miss LizzyAdrenal Fatigue Treatment Options

Foods for Adrenal Fatigue Recovery

Miss Lizzy

Finding the right balance of foods for adrenal fatigue was a helpful part of my recovery. Because of adrenal fatigue, I had severe hypoglycemia which meant I needed to eat every two hours. And I was drawn to foods which gave me a boost, including sugar and caffeine. Understanding how foods affect my body helps me to keep my adrenals feeling strong.

According to AdrenalFatigue.org, when your adrenals respond to stress your cell metabolism speeds up, burning many nutrients. With adrenal fatigue, the cells have used up much of the body’s stored nutrients, creating a nutritional void. Good quality food is the best source for replenishing these nutrients. 

When to Eat

Eating frequently is helpful for the balance between adrenals and  blood sugar. Basically, if you feel hungry, it’s too late. Your blood sugars are starting to drop and the adrenals are being stressed. Here is a quick guide for when to eat to support adrenals:

  • In the morning, eating soon after waking is important for people with adrenal fatigue. For me, and others with adrenal fatigue, eating before 10:00 AM can make a big difference in our energy.
  • For lunch, eating before noon, ideally between 11-11:30 AM is best
  • Between 2-3 PM eat a nutritious snack to sustain your body during the afternoon. Typically, cortisol dips between 3-4 PM. If you wait until 3:30 PM for a snack, most likely you will crave sugar or caffeine!
  • For dinner, eating between 5 and 6 PM is best
  • Late evening before bed, a small service of good fat and protein can help with sleep

What to Eat and Drink

For those of us experiencing adrenal fatigue, a good meal and snack combines fat, protein and complex carbohydrates (vegetables). This combination helps provide a steady stream of energy throughout the day. Sugary snacks or highly processed foods convert too quickly, and do not provide lasting energy. They can also cause sugar crashes, or hypoglycemia.

Salt

In most cases of adrenal fatigue, good salt is beneficial. Interestingly, cravings for salt can be an indicated of adrenal weakness. Unless you are one of the rare people with adrenal fatigue and high blood pressure, add some salt to your food 1. Sea salt or Celtic salts are preferred because they have more beneficial nutrients (and they taste good).

Proteins

Good quality protein such as grass fed beef, fish, free range chicken, omega-3 eggs, dairy from grass fed cows (and/or raw mild) and various plant sources (legumes, nuts and seeds) are beneficial in supporting adrenals. Try to avoid processed proteins such as packaged lunch meats and processed cheeses. Proteins generally have more nutritional value and are easier to digest when eaten lightly cooked or raw.

Vegetables

Vegetables are an important part of supporting adrenals. With each meal aim for 2 vegetable servings of a wide variety of vegetables, especially those that are naturally highly colored (bright green, red, orange, yellow or purple). Vegetables provide essential vitamins, minerals, antioxidants and a high amount of fiber. It is a good idea to vary how you prepare vegetables, because different nutrients are made available through different cooking methods. Personally, my body has much more energy eating raw, rather than cooked, vegetables.

Fruit

Dr. Wilson notes that people with adrenal fatigue and blood sugar problems should go lightly on fruits, especially in the morning. Personally, with struggling adrenals, if I ate fruit in the morning I felt pretty nauseous and ill by lunchtime. With stronger adrenals I can eat a little fruit in the morning if accompanied by protein and a little fat.

According to Dr. Wilson, fruits contain a significant amount of fructose and potassium, which is a detrimental combination for those with exhausted adrenals. However, Wilson says it is preferable that any fruit that you do eat is organically grown. Hey, we do the best we can. Below is a short list of fruits people with adrenal fatigue tend to do well with, and ones to avoid or notice if they make you feel bad:

Preferred fruits:

  • Papaya
  • Mango
  • Plums
  • Pears
  • Kiwi
  • Apples
  • Grapes (a few)
  • Cherries
  • Strawberries
  • Blueberries
  • Blackberries

Fruits that might make you feel bad:

  • Bananas
  • Raisins
  • Dates
  • Figs
  • Oranges
  • Grapefruit

Easy Guidelines

Here are some easy guidelines which are simply and make loads of sense!

  • Eat a wide variety of whole, natural, unprocessed foods
  • Combine a healthy fat, protein and carbohydrate source with every meal
  • Eat lots of vegetables, especially the brightly colored ones. Raw is even better
  • Salt your food to a pleasant taste using good salt like Real Salt or Himalayan Salt
  • Eat mainly whole grains (avoiding gluten)
  • Combine grains with legumes (beans), or legumes with seeds or nuts to form a complete protein
  • Avoid fruit in the morning
  • Mix 1-2 tablespoons of fresh essential oils (cold pressed olive, grape seed, safflower, flax, etc.) into grains, vegetables and meats daily. Or try avocado with meals.

 

 

Notes:

  1. James L. Wilson, “Adrenal Fatigue” ↩
Miss LizzyFoods for Adrenal Fatigue Recovery

Adrenal Fatigue Symptoms

Miss Lizzy
Below are some of the Adrenal Fatigue symptoms. There are similarities between Adrenal Fatigue and Hypothyroidism. It’s possible to have both conditions, or one condition but not the other. 
According to Adrenal Fatigue.org, if you are regularly experiencing one or more of the following this could mean indicate fatigue:
  • You feel tired for no reason.
  • You have trouble getting up in the morning, even when you go to bed at a reasonable hour.
  • You are feeling rundown or overwhelmed.
  • You have difficulty bouncing back from stress or illness.
  • You crave salty and sweet snacks.
  • You feel more awake, alert and energetic after 6PM than you do all day.

In addition, the folks at Stop the Thyroid Madness have compiled this list of more specific symptoms related to adrenal fatigue which can also be found in the Stop the Thyroid Madness book. Not all symptoms apply to everyone but if you have a good percent of symptoms it is worth exploring more.

  • Continuing hypothyroid symptoms with a high free T3
  • Shaky hands or general shakiness
  • Diarrhea
  • Bad palpatations
  • Higher heart rate
  • Pounding heart
  • Feeling of panic
  • Craving for salt or salty foods
  • Weakness or feeling a lack of stamina
  • Lethargy (everything feels like a chore)
  • Difficulty even doing every day tasks
  • Tasks seem to take longer and feel much harder
  • Decreased sex drive
  • Inability to handle stress
  • Inability to handle interactions with others
  • Inability to focus
  • Rage or sudden angry outbursts
  • Emotionally hyper sensitive
  • Mild depression and/or feeling less happiness, not much seems to interest you
  • Increase PMS. Bloated, tired, crabby, cramping, and craving chocolate
  • Overreacting (this is hard to measure in ourselves)
  • Highly defensive (this is hard to measure in ourselves)
  • Feeling paranoid about people or things
  • Exacerbated reactions to daily stress
  • Impatience
  • Easily irritated
  • Mild to severe hypoglycemic episodes
  • Symptoms increase if meals are skipped.
  • A strong need for snacks, colas and coffee just to keep from collapsing.
  • Nausea in the face of stress
  • Taking days to recover from even minor stress
  • Taking days to recover from a dental visit
  • Flu-like symptoms
  • Headaches
  • All over body ache
  • Super-sensitive skin
  • Extreme fatigue
  • Scalp ache
  • Hyper or jittery feeling
  • Clumsy (drop things, bump into things)
  • Confusion
  • Suddenly feel extremely hungry
  • Low back pain
  • Feeling dull
  • Cloud-filled head
  • Jumpiness (easily startled)
  • Muscle weakness
  • “Air hunger” or feeling breathless
  • Dizziness
  • Light headedness (especially standing up quickly)
  • Motion sickness
  • Coffee putting patient to sleep
  • Vomiting even running up the slightest incline
  • Almost passing out every time patient gets up
  • Dark circles under eyes
  • Waking up in the middle of the night for several hours
  • Difficulty falling asleep
  • Difficulty waking up in the morning
  • Frequent urination
  • IBS symptoms
  • Worsening allergies
  • Don’t really wake up  and feel alert until 10 AM
  • Between 3-4 PM you feel sluggish or very tired, sometimes requiring a nap
  • After 6 PM and dinner, you start to feel alive again

If you have any of the above, read more about Adrenal Fatigue testing and treatment options.

Miss LizzyAdrenal Fatigue Symptoms

Latest Update on My Medicine for Hypothyroid and Adrenal Fatigue

Miss Lizzy

Hi my friends,

It’s been a while since I’ve posted about my medicine, and it’s been an interesting year! So I wanted to share what I’ve learned. First, I want to say wow – it’s all a big experiment! And that’s tough sometimes because I want the answer right now. But the only way to learn is try, test, observe and somehow be patient along the way. So my dear friends, keep at it and you will find answers too. Here is my medicine and general update…

Update on Thyroid Medicine

For a year I have been on the Thyroid compound prescription I special order from Collier’s Pharmacy (details below) in Arkansas. I continue to love it. On the new compound medicine, I take 180mgs day which seems like the right dose for me. On Naturthroid, when I raised above 130mgs I had super freaky hyper and hypo symtpoms. Yet on the compound I can take 180mg beautifully. Weird, isn’t it? So I am super happy to report feeling great now though on the compound. We affectionality call it “The Miss Lizzy Compound” — you can ask for it by name at Colliers. Neat.

Update on Hydrocortisone

The other super big change…I weaned off Hydrocortisone! This was a huge step. I started Hydrocortisone three years ago to help with low cortisol and adrenal fatigue. And Hydrocortisone definitely helped me. But I was always a little worried that the Hydrocortisone was causing some weight gain, and perhaps had something to do with hair loss, though I wasn’t totally sure. This summer I decided it was time to try weaning off Hydrocortisone. Here is what I did:

  1. On STTM Janie felt she had avoided adrenal fatigue because of the high doses of Vitamin C she took daily. So I increased my Vitamin C to 2k mgs a day along with 1k mg Bioflavonoid (per Dr. Wilson’s suggestion). And btw — chewable vitamins really make it much more fun!
  2. I started the process of decreasing my Hydrocortisone by 2.5mgs a week.
  3. If I was stressed during the process, I would hold the dose, and then continue when I felt ready. The idea was to take care of my body and not cause shock.
  4. If had I felt any adrenal fatigue symptoms, I would have stayed on the Hydrocortisone but luckily it seems my adrenals are really well healed now! YAY!!!

It took about 3 months to fully wean off the Hydrocortisone (long time, I know!). And I happy to report, I feel great. It was definitely worth it for me to be on the Hydrocortisone but it was time to try without. It’s been two full months, and so far I seem to be keeping my weight down with greater easily. Over the coming months I will be observing weight gain/loss and hair volume/regrowth to see if the Hydrocortisone might have be related. And of course I will share what I learn!

xxoo

Lizzy

~~~~

Here is the info for Collier’s. The pharmacist Rodney at Colliers is SO awesome. He gave us his direct phone extension for ordering the compound (479) 935-4336. Ask for “The Miss Lizzy Compound” and he will hook you up. (A doctor’s prescription is of course needed and he can explain what to do.)

Miss LizzyLatest Update on My Medicine for Hypothyroid and Adrenal Fatigue

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