Help with lab results and treatment - thyroid, adrenal
Yep, it's another thyroid and adrenal fatigue thread! I've been unsuccessful trying to figure this out from textbooks, websites, and health message boards so thought I'd ask here.
For about two years I've suspected I have adrenal fatigue. My life stress would lend itself to AF development (moved 12 times and worked in 5 different places in 3 years, and underate and overtrained for much of that time), and all of my physical symptoms correspond exactly to AF as described by people like Dr. Lam and Dr. Rind. Primarily I feel exhausted, cold (body temp. 95.0 - 96.8 and declines during exercise), have low blood pressure with fainting upon standing, and so on.
I was finally able to see a naturopathic doctor last week. We ran some lab test and my results indicate hypothyroidism:
Free T4 0.78 (range 0.89 - 1.77)
Free T3 2.0 (range 2.3 - 4.2)
Fine, so this looks like a classic case of low thryoid, perhaps caused by weak adrenals. BUT the lab tests don't match Dr. Rind's adrenal fatigue predictions. He says TSH would be low (the body is trying to slow down thyroid production) and that FT3 and FT4 should be low but about equal in terms of their magnitude of deviation from the optimal values. My FT4 is relatively higher than the FT3, though, meaning that T4 is not getting converted to T3.
So maybe this is just hypothyroidism without adrenal fatigue? However, I have always been underweight with very low body fat (not skinny-fat), and for several months I've been ravenously hungry despite eating 3500-4000 calories a day and not exercising due to fatigue. Yet I have hardly gained weight after about three months of eating like this. How could hypothyroid with lowered metabolic rate not cause weight gain? So I'm not convinced this is "regular" hypothyroid.
My blood results also showed an anemic state (RBCs 11.8) and elevated WBCs (11.0), espcecially monocytes. Low RBCs could be due to an overall slowed metabolic rate, and perhaps there are inflammation or infection problems as well.
I'm at my wits' end and feeling sicker and more fatigued by the day. Lately I am in bed by 7:00 PM and having crying spells from exhaustion. Still waiting to hear back from the doctor regarding the lab test results, so any background knowledge I can obtain in the meantime would be most helpful.
Anyone else had similar symptoms and lab results? And has anyone ever truly overcome adrenal fatigue (if that's even what's going on)?!
Stop trying to diagnose yourself! Isn't this doctor suggesting that you take thyroid meds (hormones?). Yes, of course, you're 'fatigued,' you don't have enough T4 OR T3. With those levels, I'm amazed that you can get out of bed at all!
You are right that this is an anomaly. With low thyroid, the BP is usually high, not low. And, yes, your metabolism should be extremely slow (the fatigue) because of the very low T3--BUT that should cause you to gain weight--which hasn't happened.
It seems to me that the first thing should be to get your thyroid hormone level back to optimal range--which you cannot do without taking supplemental hormones to replace those that your body isn't producing. It may take a while to relieve symptoms if your doctor only gives you T4 (for the body to convert to T3), as it takes 4-6 weeks for the T4 to be fully effective (although you experience very gradual change during that time).
You haven't listed any results from the adrenal test, which I'm assuming you also had done. If the doctor isn't concerned about adrenals, then you should see whether optimizing your thyroid alleviates all the symptoms, and, if not, investigate further.
Everyone isn't 'textbook,' and it's certainly possible that there's something else going on, but as someone who is hypothyroid, I can tell you that the influence of this tiny gland on your body is incredible and that could be the cause of all your symptoms. Only once it's stabilized will you know whether you need to look for something else. Keep in mind that ALL the symptoms of 'adrenal fatigue' are identical to those of hypothyroid, so there may be nothing at all wrong with your adrenals. My own adrenals have tested fine.
Check out the book Why Do I Still Have Thyroid Symptoms?
When My Lab Tests are Normal by Datis Kharrazian
When thyroid tests come back like yours-- "normal" range TSH, below range free Ts--it may be indicative of secondary hypothyroidism.Secondary hypothyroid indicates an issue with the pituitary or hypothalamus. If your thyroid problems are originating from your brain(pituitary) it's possible other hormones driven by the pituitary/hypothalamus may also be at issue. This includes adrenal hormones like cortisol.
Did you have adrenal tests run?
Thanks for your responses.
It's been a week since I sent the doctor the test results and I still haven't heard back, so that's the main reason I'm seeking some guidance here. I'll give her another call today so that we can move forward with treatment.
Not having health insurance or a whole lot of money I'm trying to avoid a wild-goose chase scenario of tests. I'm not convinced that salivary cortisol testing is an accurate measure of adrenal health so I haven't done those tests. If they are considered valid and if verification of poor adrenal health lead to a specific treatment I'd do the tests... a big concern, though, is that the "experts" on adrenal fatigue (Rind and Lam) don't really have a specific course of treatment... take adaptogens or avoid adaptogens, take thyroid replacement or don't take thyroid replacement because doing so would further stress your system, etc. I feel like wading through these waters alone is no worse than trying to make sense of conflicting medical advice! :-(