Question for Madwolf about thyroid levels/adrenal testing...

Discussion in 'Fibromyalgia Main Forum' started by keeponsmiling, Aug 20, 2003.

  1. keeponsmiling

    keeponsmiling New Member

    I was wondering if you could interpret my lab results and tell me if my doctor seems to be on track:

    First testing (4/16/03)
    ~TSH - 3.112
    ~reverse T3 - 201 (normal range 90-350)

    I honestly don't even know what a reverse T3 is. LOL Anyways, he started me on Armour 30 mg qd because of my symptoms.

    Second testing (7/24/03)
    ~TSH - 2.380

    No other tests were ordered. He increased my Armour to 45 mg qd at that time. I have an appointment again in 6 weeks, and on my lab slip, he's checked Thyroxine(T4) and Triodothyronine(T3) for me to have drawn. Is that what they call a free T3 and T4?

    I'm also on Provigil 50 mg qd and Prozac 10 mg qd. Energy levels are pretty good right now, but I still can't lose any weight whatsoever. Adrenal testing (saliva) came back showing "Stress adapted with a divergence in response to ACTH." My scale showed high cortisol levels during the night, hence my poor sleep. The only time my cortisol was in the normal range was from around 4 PM to midnight. I also have sleep apnea, and use a CPAP machine.

    Thanks so much for your time. :)


    [This Message was Edited on 08/20/2003]
  2. klutzo

    klutzo New Member

    I am on Armour also, and it sounds to me like your doc is really on top of this and doing the right thing. It can take awhile to get the dose right. I don't know abut you, but Armour has pushed my energy level almost back to normal. I am on 60 mgs. and think this is my correct dose.

    I read on Dr. Bruce Rind's website that regular T3 is the metabolic gas pedal and Reverse T3 is he brakes. If you have a T3 and T4 done you won't need reverse T3, since you can subtract the T3 from the T4 and the number you get is what the reverse T3 would be. Madwolf can correct me if I have this wrong. He will probably say none of this matters and you should go by your symptoms, but I don't want to put words in his mouth!

    Some find a small dose of Cortef in the am will "re-set" your clock so you don't get that big surge of cortisol in the evening that keeps so many of us awake. Then you can slowly withdraw it after a couple of months if this is your only problem.I recently had someone here tell me that her doc prescribed 30 mgs. pregnenolone daily for that evening surge, and it worked just as well as Cortef! That is good news for those of us who can't get our docs to prescribe Cortef.

  3. keeponsmiling

    keeponsmiling New Member

    I forgot to mention that I'm also taking Pregnenalone 25 mg sub-lingual every night before going to bed. I wonder if I should take it in the morning? Hmmmm...

    For sleep, I'm taking Melatonin 5 - 7.5 mg depending on how tired I am. Seems to help quite a bit.

    But I'm still confused over the Cortef thing. Why would I want to stimulate something that already seems to be over-wired?


  4. klutzo

    klutzo New Member

    Pregnenolone is supposed to be absorbed better at night, so if it is not keeping you awake, by all means keep taking it at night.
    The Cortef thing is complicated. Yes, too much cortisol will make you wired, but too much adrenalin will make you even more wired, and when your cortisol runs out your body uses adrenalin instead. I don't think there is any way to really know what's going on without a test, preferrably a fasting 8 am cortisol blood test and a salivary Adrenal Stress Index (ASI). Then you can see exactly where you stand with cortisol.
    Dr. Teitlebaum says most of us are too low in cortisol, but other docs I've read (several) say the problem for most of us is a big spurt of it in the evening, when even the ASI test won't catch it, since the ASI is done at 4 pm and midnight, and this spurt occurs between 6 and 10 pm. I have to admit, I feel best in the evening, but the same thing that makes me feel more awake and alert, also keeps me awake most of the night. Dr. Poesnecker says we may have too high or too low cortisol, depending upon which stage of metabolic fatigue we are in. Too high comes first, followed by too low when we use up all our reserve.
    Ironically, the treatment for both generally low cortisol and for a high spurt in the evening, is a low dose taken in the morning. With the evening spurt, the low morning dose seems to re-set the clock so the spurt stops happening, or at least that is the theory I've read.
    Hope this helps a bit,

    P.S. That is an awful lot of Melatonin! I think it is Dr. Teitlebaum who says 1 mg. is enough as larger doses do not produce better results, and cause more side-effects. The largest dose I have ever seen prescribed is 3 mgs.
    [This Message was Edited on 08/20/2003]
  5. keeponsmiling

    keeponsmiling New Member

  6. keeponsmiling

    keeponsmiling New Member


  7. pinkquartz

    pinkquartz New Member

    i have had th eproblem of feeling most awake at bedtime for the last ten years.

    so far taking low dose cortisol hasn't stopped it...though i am slowly starting to have less of the wake up or rather its more subtle.
    when i did my saliva test the cortisol was only in the normal range at midnight...but it still wasn't what you could call a high reading , so i wonder if its like a balance thing in our brain and we feel much more awake at midnight without actually producing much extra cortisol.

    if this makes no sense i am sorry, it does to me but i am so tired i could be saying anything LOL