1

votes

Can you help decipher chronic thyroid, adrenal, gut issues?

Answered on August 19, 2014
Created July 30, 2012 at 10:22 PM

I have been reading for some time and appreciate the time that people take to respond to questions on PaleoHacks so I am hopeful some of you might have a perspective on my unique case.

I apologise in advance for the long and complicated history! I am a 28 year old Australian female, ex-athlete, globetrotter, burning the candle at both ends...and I have been unwell for going on 5 years now (possibly longer at a sub-clinical level).

The chronic and most inconvenient symptoms I currently have are: - severe cold intolerance

  • thinned hair

  • inconsistent digestion (not too bad, but a little up and down)

  • constant upper back and neck pain / tightness + poor recovery from exercise

  • fatigue

  • disrupted and non-restorative sleep

  • impatience / lowered tolerance (i think partly because i'm in pain constantly)

  • sensitivity to noise (even motorbikes) and chemical smells

  • low blood pressure (88 / 60 as tested yesterday)

  • thirst and hunger

  • no menstrual cycle since January 2012 (8 months)

  • painful intercourse

I am still functional, however I have always been someone who would push through almost anything (possibly to my detriment) so i pretty much soldier on. Below is an abbreviated health timeline with my major history, if anyone is kind enough to read further.

Pre-symptoms:

- Glandular fever Year 12 in 2001 at 17 years old. Lasted approx 3 months. Too much sugar in diet. Too much partying and late nights. - 2002 ??? 2006 dual tennis and cross country running scholarship to University in the U.S. Frequent long distance travelling with no recovery time, approximately 30 hours of sport per week (6-7 days per week) with no off season or summer holidays combined with 22 ??? 25 class contact hours per week. No menstrual cycle for two years and hair thinned. Also underperformed in cross country even though training more than ever before (possible because of). Otherwise ???felt??? healthy and never got any common colds, viruses etc. In hindsight I suggest this is where I was laying the foundations for the majority of my current health concerns, running my adrenal glands into the ground and creating massive hormonal imbalances. I was likely malnourished at the cellular level. I ate a lot, however I don???t believe I had the right breakdown of macro and micro nutrients for my activity level (too high in sugar, too low in good fat and possible vitamin / mineral deficiencies). - 2006 ??? 2008 still working out 5 ??? 6 times per week, working full time in busy corporate job and frequent long distance adventure travel with no recovery time. Too much sugar in diet and alcohol binge nights with friends once a week / fortnight. - July 2008 neurological symptoms commenced following whirlwind trip to Japan (possible catalyst that brought underlying health imbalances to surface?). Full body MRI and other neurological tests came back fine. Various blood tests with questionable liver, inflammation etc readings at time but nothing concrete. Diagnosis was foreign viral infection that attacked my nervous system. Seemed to work its way out (in terms of the neurological component) after approx 3 months. Left with wide spread pain and tension, cold intolerance, dry skin and chronic fatigue. - December 2008 spotting in between periods. Ultrasound discovered uterine polyp. Removed late December 2008. No further spotting. - September 2009 - 2010 4 urinary tract infections in 1 year. No history of them prior to, and none since (however since that time have been left with odd urethra sensation of not being able to clear all urine). December 2009 abnormal thyroid screening test result (high TSH) resulted in full thyroid profile and diagnosis of underactive (hypo) thyroid with autoimmune component (high antibodies) + high reverse T3 (approx 600). Treated with T4, then T4 / T3, then straight T3. No improvement in symptoms. Did my own extensive research and overhauled diet (cut gluten, alcohol and sugar at this stage) and lifestyle (cut out intense exercise). May 2010 onward - started treating adrenals (naturally) in conjunction with thyroid. Some improvement in symptoms from 30% function to maybe 70%. Have not been able to improve that last 30% and have had some dips.

Current shedule:

Work ??? 6 days week running own business (looking to sell to focus on recovery), morning and evening sessions (tiring) + back end management during middle part of day

Exercise ??? 2x short weight sessions never to failure. Leisurely cycling 2x week to and from work (approx 30 ??? 40 mins broken up into two parts). Light walking

Nutrition ??? anti inflammatory / autoimmune focus. Plentiful, unprocessed, predominantly organic diet of meat / fish, some nuts / seeds (soaked and dehydrated), lots of vegetables (majority lightly cooked to aid digestion), berries, coconut (milk, oil, flakes), organic eggs. No sugar, alcohol, soy, grains or legumes

Supplements ??? naturopathic herbal tonic to help circulation with some thyroid and adrenal supporting herbs, BioLogic Bladder Tone, BioChem Fat Metaboliser (to help balance fatty acids which are out of whack), krill oil (for fatty acid balance), Thorne Research Choline, Thorne Research L-Carnitine, Vit D3, maca powder and bee pollen (for hormonal and general immune health)

Treatment History:

General - Naturopathic herbs and vitamins for thyroid, immune and adrenal support (past and present). Naturopathic treatment for gut imbalance + candida (2009)

Hormones - Bio-identical hormones ??? progesterone cream (3 months 2010), pregnenelone tablets (3 months 2010), Progesterone tablets + estrogen cream + testosterone cream (2 months late 2011 / early 2012) ??? currently postponed as attempting to treat hormones naturally by overhauling fatty acid metabolism. Question about restarting these as hormones seem to be getting worse judging by lack of periods and painful intercourse?

Thyroid - initially treated with T4 (thyroxine), then T4+T3, then just T3 (tertroxin). No change in symptoms with T4 or combined T4 / T3. Slight improvement with cold intolerance when on straight T3, however no other improvement and reached max dose (started to have hyper symptoms) without resolution of other hypo symptoms. Also tried Metagenics Thyrobalance herbal support with limited success

Adrenals - Dr James Wilson adrenal protocol ??? adrenal glandular, adrenal multi vitamin, adrenal stress (B vits etc), magnesium, B5

Recovery - weekly massage, monthly osteopathy, infrared sauna

My latest blood test results (yesterday) that might warrant some attention are:

Biochem:

Bicarbonate: 32 mmol / L (22 - 31) Urea: 9.7 mmol / L (2.3 - 7.6) eGFR (mL/min): 51 per 1.73sqm (>60) Creatinine: 111 umol / L (40 - 80) AST 33 U/L (0-30)

These are new developments and were in range last tested approx 1 year ago. Possibly my protein intake has increased since then and I do have small portions for breakfast, lunch, dinner (often leftover dinner for breakfast, salmon and stir fry veg for lunch, then different meat / veg for dinner with nuts, veges, coconut based products, "mini meals", bone broth for snacks).

Hormones:

E2: 147 pmol / L (anywhere from 70 - 1300 depending on stage of cycle which I haven't had since January) PROG: < 0.5 nmol / L (1 - 130 depending on stage of cycle) Sensitive Testosterone: 0.7 nmol / L (0.6 - 1.7) Calculated Free Testosterone: 8 pmol / L (8 - 32)

*waiting on latest saliva hormone profile including cortisol, DHEA. Last test were low across the board (cortisol, DHEA, estrogen, progesterone, testosterone - borderline normal).

Thyroid:

Free T3: 3.3 pmol / L (3.5 - 6.5) Reverse T3: 588 (my integrative doc wants it under 150)

I've spent so much money so far on investigating and treating and I would really like to get some traction! I remain ever hopeful that I can correct this and understand it was many years in the making and is such a layered mess that it will take years to correct. It is extremely frustrating however when I throw everything i can possibly think of and each time get little to no results!

I really appreciate any thoughts you might have.

Jen

02b303e1146c3b75ac6f45e6a462351f

on August 02, 2012
at 11:03 PM

Thanks for your responses. With regard to my elevated kidney markers - Creatinine, Urea and eGFR - do you think these could be transient and as a result of sub-optimal adrenal and / or thyroid / hormone function or something more directly related to kidney damage? I am about a month out from my next appointment with the hormone specialist and my naturopath, but am a little concerned as these results have really jumped up from a year ago.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on August 02, 2012
at 05:31 AM

Ok. thanks dsohei

02b303e1146c3b75ac6f45e6a462351f

on July 31, 2012
at 11:23 PM

Weight is approx 60kg and I'm 179cm / 5'11. I'm around 18.9% body fat currently on my BIA scales and 37% muscle mass. My weight has been fairly consistent (within 2-3 kilos) my whole adult life - i haven't lost or gained any significant weight since onset of symptoms. I own and operate a boutique health club running most sessions myself mornings and evening (not working out, but managing small groups of members exercising etc). During my break in the day I have back-end management of the business to complete, as well as cook (since I eat an unprocessed diet), nap and generally try to rest!

05055dcbf12c81f1cce777ec365870af

(1791)

on July 31, 2012
at 10:24 PM

Crowlover, she's got so many bases covered but still pretty carb phobic. If she's not super insulin resistant, then carbs will be anabolic. She probably does have some hpa rewiring to do.

05055dcbf12c81f1cce777ec365870af

(1791)

on July 31, 2012
at 10:22 PM

When u get that time off I would recommend an ayahuasca ritual.

77877f762c40637911396daa19b53094

(78467)

on July 31, 2012
at 02:31 PM

weight, height? nature of role in business?

02b303e1146c3b75ac6f45e6a462351f

on July 31, 2012
at 06:54 AM

Thanks. I definitely prescribe to the "less is more" philosophy these days with exercise and I am attempting to with work (selling my business to take 3 - 6 months off completely). I'm hoping this has been a missing link as while I carefully manage my exercise, sleep, nutrition etc, my work life is still too hectic. I was hoping the rest of the recovery work I was doing would be enough, but this is going on too long.

02b303e1146c3b75ac6f45e6a462351f

on July 31, 2012
at 06:51 AM

Thanks, yes I've spent a lot of time on stopthethyroidmadness in the past! Good site!

02b303e1146c3b75ac6f45e6a462351f

on July 31, 2012
at 06:50 AM

Thanks, although I'm not technically low carb (maybe 100 - 150g per day), I guess this is still lowish as I don't eat grains. I have been thinking of upping them to see if there is an improvement. I also need to replace some protein calories since my latest results showed elevated creatinine and urea and my healthy fat levels are already pretty high, so makes sense to try adding carbs.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 06:48 AM

Dsohei, how will 1000x more carbs help Jennifer? I'm sure you have a reason for your high carb recommendation but you don't say what it is. I'm curious why you are recommending this.

02b303e1146c3b75ac6f45e6a462351f

on July 31, 2012
at 06:45 AM

Thanks, I am familiar with Dr Wilson's information but have not reviewed Pam Killeen so will do so.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 06:43 AM

Dsohei, how will 1000x more carbs help her? Im just you have a reason for your high carb recommendation but you don't say what it is?

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 06:42 AM

?? she said she stopped intense exercise in 2009

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 06:38 AM

This website if very helpful http://www.stopthethyroidmadness.com

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 06:37 AM

I wish you all the best with this. I agree that your autoimmune disease is the "result of other issues" but at this point it causing you to have low thyroid. I personally will never again put up with the myriad of issues from low thyroid.Suffered too much & life's too short. At 800 you have a VERY ACTIVE autoimmune process going on. Most docs have no idea how to impact that. I hope your's does.It sounds like they have a plan for you.With a.i. thyroid disease your blood level is just a snapshot.At any given time it may be much lower (thus your symptoms)or higher.Cortisol is crucial.

05055dcbf12c81f1cce777ec365870af

(1791)

on July 31, 2012
at 04:51 AM

carbs times 1000. starchy AND simple carbs. depending on how you digest them. i for example cannot digest starches well, so i eat simple carbs, juice, sugar. its not your enemy. just eat enough protein, greens, and healthy fats, and then carbs to satiety. when you feel super relaxed - that's a good sign for you, as you seem wired down to the bone.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 12:35 AM

Jennifer I wish you all the best. I hope that u can deal with this in a way that works for u. I refuse to EVER AGAIN put up with all the horrible issues caused by hypothyroid after suffering for years. You have a very active autoimmune process going on & that is why you have a lot of classic low-thyroid symptoms. With a.i. hypothyroid your blood level is just a snap-shot. It can be lower (or higher) at any time and through the day. Are you on Thyroid hrt now? I need to re-read. This website is very helpful Stop The Thyroid Madness www.stopthethyroidmadness.com.

02b303e1146c3b75ac6f45e6a462351f

on July 30, 2012
at 11:46 PM

Thanks for the response. My latest T4 seems ok - 14.0 pmol / L (10l.0 - 19.0). It has been low and normal in the past, T3 has always been lower. Thyroid antibodies have jumped from the 190's to over 800. This is frustrating as I've modified my lifestyle so much. "Burning the candles at both ends" was a reference to life pre-symptoms. Since illness my lifestyle/ diet are very strict. I have been on various supplements, but they aren't working which is why I think I might need to try HRT again. Was hoping to avoid thyroid meds as feel thyroid is a result of other issues rather than the cause..

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3 Answers

1
05055dcbf12c81f1cce777ec365870af

(1791)

on July 31, 2012
at 04:49 AM

well, if you have continued money and ability to get tests, keep doing that, and working with open minded and results driven practitioners. sometimes it takes many years to steer the ship in another direction.

but, being an athlete, you probably know about the anabolic/catabolic continuum. do everything you can to be more anabolic, even if that means "gaining weight". eat much more carbs, do floatation tank therapy, sleep like a cat, a lot.

look at what the most anabolic people do: they eat a lot of the right kinds of food, including carbs. they exercise intensely in very short bursts, they sleep A LOT.

too much = too much, like everything. just enough = massive results.

you already know you have driven yourself into a ditch, yet you keep driving. more stress, more cortisol, more wired/tired mad dog perserverance. lifestyle and behavioral 180 time. be the opposite kind of person you've been for the past 5-10 years. see what you can get away with. minimum effective dose with exercise.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 06:42 AM

?? she said she stopped intense exercise in 2009

05055dcbf12c81f1cce777ec365870af

(1791)

on July 31, 2012
at 10:22 PM

When u get that time off I would recommend an ayahuasca ritual.

02b303e1146c3b75ac6f45e6a462351f

on July 31, 2012
at 06:54 AM

Thanks. I definitely prescribe to the "less is more" philosophy these days with exercise and I am attempting to with work (selling my business to take 3 - 6 months off completely). I'm hoping this has been a missing link as while I carefully manage my exercise, sleep, nutrition etc, my work life is still too hectic. I was hoping the rest of the recovery work I was doing would be enough, but this is going on too long.

0
7a6529ea25b655132fe58d793f95547a

(2040)

on July 31, 2012
at 04:12 AM

Hi Jen take a look into nutritional balancing it can take a while to see results but it works. http://pamkilleen.com/ http://www.drlwilson.com/ . Hope this helps.

02b303e1146c3b75ac6f45e6a462351f

on July 31, 2012
at 06:45 AM

Thanks, I am familiar with Dr Wilson's information but have not reviewed Pam Killeen so will do so.

0
4ef079c57d2140bba4dbf4e30240a645

on July 30, 2012
at 10:37 PM

Jennifer your issues are not rare. Many on here have low thyroid and adrenal fatigue and GI issues....

What is your Free T4? Also, have your been checked RECENTLY for Thyroid antibodies? A current level is important to know. I personally got my Tpo down from 500 to 30 with diet and a high dose antioxidant protocol (ubiquinol, R-La and others).

Your Reverse T3 is way too high.
It will go down when you add some T4 back to your hrt.
You say the combo of T3 and T4 didn't help you... to me that means the dosing was wrong.
Were you on Synthroid (levothyroxine) and dessicated thyroid (Armour or Nature-throid) The absolute best for me has been a combination of the two thyroid meds.

I also take Isocort.
Of course I don't recommend you continue to "burn the candle at both ends" only to take cortisol. I hope you can have less stress too. Over time, I have needed less and less Isocort but that stuff has been a life saver for me.

Your hormones are low. Im sure you know that..... I personally would not count on (or wait for) diet alone. Im too impatient with any more wasted time of feeling better. I hope you get back on the Bio-hrt creams.
Pregnenolone is very effective for many for increasing progesterone levels.
You might need 200mg per day though taken 100mg twice a day. Allergy Research Group makes it.

02b303e1146c3b75ac6f45e6a462351f

on July 30, 2012
at 11:46 PM

Thanks for the response. My latest T4 seems ok - 14.0 pmol / L (10l.0 - 19.0). It has been low and normal in the past, T3 has always been lower. Thyroid antibodies have jumped from the 190's to over 800. This is frustrating as I've modified my lifestyle so much. "Burning the candles at both ends" was a reference to life pre-symptoms. Since illness my lifestyle/ diet are very strict. I have been on various supplements, but they aren't working which is why I think I might need to try HRT again. Was hoping to avoid thyroid meds as feel thyroid is a result of other issues rather than the cause..

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 12:35 AM

Jennifer I wish you all the best. I hope that u can deal with this in a way that works for u. I refuse to EVER AGAIN put up with all the horrible issues caused by hypothyroid after suffering for years. You have a very active autoimmune process going on & that is why you have a lot of classic low-thyroid symptoms. With a.i. hypothyroid your blood level is just a snap-shot. It can be lower (or higher) at any time and through the day. Are you on Thyroid hrt now? I need to re-read. This website is very helpful Stop The Thyroid Madness www.stopthethyroidmadness.com.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 06:38 AM

This website if very helpful http://www.stopthethyroidmadness.com

02b303e1146c3b75ac6f45e6a462351f

on July 31, 2012
at 06:51 AM

Thanks, yes I've spent a lot of time on stopthethyroidmadness in the past! Good site!

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 31, 2012
at 06:37 AM

I wish you all the best with this. I agree that your autoimmune disease is the "result of other issues" but at this point it causing you to have low thyroid. I personally will never again put up with the myriad of issues from low thyroid.Suffered too much & life's too short. At 800 you have a VERY ACTIVE autoimmune process going on. Most docs have no idea how to impact that. I hope your's does.It sounds like they have a plan for you.With a.i. thyroid disease your blood level is just a snapshot.At any given time it may be much lower (thus your symptoms)or higher.Cortisol is crucial.

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