T Nation

Tested for Adrenal Fatigue....


#1

I'll keep this brief as possible. Went to a recommended naturopathic doctor to investigate the possibility of adrenal fatigue or some other problem that would mimic the symptoms. Onset of symptoms roughly two years ago.
General symptoms were:
Afternoon â??lowâ?? (feelings of sleepiness or clouded thinking) from 2 to 4 p.m.
A burst of energy at 6 p.m. when you finally feel better from your afternoon lull
Sleepiness around 9p.m. to 10 p.m. However, you resist going to sleep
Cravings for foods high in salt and fats
Sensitivity to cold and feeling chilled
Mild depression
Mood swings
Mental fog
Memory problems
Lack of energy and feeling rundown
A decreased ability to handle stress
A decreased ability to recover from illness
Muscular weakness
Increased food allergies
Lightheadedness when getting up from a sitting or lying down position
Decreased sex drive
Frequent sighing
Inability to handle foods high in potassium or carbohydrates unless theyâ??re combined with fats and protein
You crave sugar

In addition:
- Weight loss, inability to maintain or build muscle mass and weight gain around the abdomen. (I've lost roughly 10 pounds over the last few years and gained noticeable belly fat). No significant changes in diet, exercise or lifestyle.
- My joints ache regularly
- it's up, now it's gone...very frustrating.
- Nocturnal and morning wood...there but hit or miss.

A little about me:
I've been a firefighter for the past 5 years. The job has many advantages, but also leaves one vulnerable to both acute and chronic stress. This is both in the form of the very nature of the job, but also in that your baseline recovery and sleep cycles change dramatically.
I consider my diet to be well in order (Grass fed beef, organics, complex carbohydrates and lots of veggies) and like most here have followed T-Nation workouts for some time with what I would consider moderate success (I'd consider myself an intermediate).

36 y.o., 6'0 ft tall, no kids, new girlfriend.
At 31 y.o. I was roughly 185, 9% body fat (this was done at sports medicine clinic)
At 36 y.o. I'm at roughly 178, 12% body fat ( this is a guess...)

SO,

Labs from Labcorp gave the following numbers (after reading the stickies I realize they are somewhat incomplete and I will post those numbers when I get them).

RESULTS (reference interval in parentheses)

Thyroid
TSH 0.871 uIU/mL (0.450-4.500)
FT3 2.6 pg/mL (2.0-4.4)

Cortisol 12.7 ug/dL (2.3-19.4 (AM 6.2 -19.4, PM 2.3 - 11.9) Test taken at 5:00 p.m.)

FT 7.2 pg/mL (8.7-25.1)
DHEA-S 300.3 ug/dL (88.9-427.0)
SHBG 43.2 nmol/L (16.5-55.9)
Insulin 11.3 uIU/mL (2.6-24.9)

Vit. D 28.4 ng/mL (32.00-100.0)

General health labs â?¨
-CBC: Complete Blood Counts â?¨
-Hematocrit
-Lipids â?¨
-Glucose â?¨

All the above within normal ranges...

OK, so...

Given the above labs, my doc wanted to put my on a compounded prescription of Test/Chrysin 75mg/ML Versa-CRM, 2 mL per day. In addition he prescribed DHEA, 25 mg daily and Vit D. 10,000 iu daily (two months), then 5,000 iu daily.

Given that I didn't know anything about TRT and neither expected to have low T nor to be given such a prescription, I am REALLY concerned about starting this up. Before doing any research, I was unaware that TRT meant shut down of endogenous T. Knowing this gives me great pause.
The doc basically said my FT is in the range of what he normally sees for men in their 60's. I've read some of what has been posted on this forum and there are some very frank and honest opinions about diving into the murky waters of TRT.

My interest in posting was to:
-reach out to a community of folks with similar experiences
-get some possible advice/ help interpreting my labs
- Find resources to get more information
- Specifically, information in regards to chronic and acute stress, and how this may be effecting my Test. levels.
- What could other causes be and how can I rectify those without exogenous testosterone?
- SHOULD I BE DOING MORE LABS BEFORE CONSIDERING TRT? Maybe the 24 hour urine test? Is the doc being overzealous?
- Any other advice??

Thanks to anyone willing to read this and comment. I'll be doing my best to put Google to work as well.


#2

Missed some of the required info...

In your case/thread opening post:
-age 36
-height 6'0'
-waist 33'
-weight 177
-describe body and facial hair - No back hair, moderate hair on arms, legs, chest and undercarriage
-describe where you carry fat and how changed - fat around middle has increased coupled with inability to maintain or build muscle mass
-health conditions, symptoms [history] - some anxiety/depression, not currently being treated but have in the past.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - No meds at the moment
-testes ache, ever, with a fever? -Never had this...

Thank You!


#3

your free T3 is horrible even though your TSH looks normal.

you need more thyroid tests (free T4, free T3, Reverse T3, ferritin, thyroid antibodies, thyroid peroxid?, 8am cortisol).

with your schedule and high night cortisol level, i would suggest getting a saliva x4 daily cortisol test (done by LabCorp or Quest).

don't jump into HRT quickly. less is more. plus changing four or five things at once means you don't know what is causing any new symptoms you might develop. It is best to only change or add one thing at a time. re-test, then maybe add another element... slowly....

you also really really need to test for Estradiol prior to starting on HRT to get a baseline.

start the VitD immediately...

all within "normal" range.... AAAAAAAAAHHHHHHHHHHHHH!!!!!!!!!!!!!!!

check out stopthethyroidmadness.com/things-we-have-learned

if you have a thyroid/adrenal issues, fixing those could result in a natural boost to your testosterone... might not, but if HRT can be avoided, it should.


#4

Thanks PureChance.
I will look into the labs you suggested, saliva tests as well as read up on the websites you sent.
Started the Vit D yesterday, what do you think about the DHEA?


#5

Your dhea looks good, i would be concerned that more might increase E2 levels. Im guessing its in the suggested labs to get. Pregnenolone can help with fatigue also but has less effects on dhea then dhea itself, but can help other hormones if potentially low. I found pregnenolone increased my cortisol, total and freeT levels but little effect on dhea or progesterone, but did help with energy, too much worsened my insomnia, but everyone reacts differently. Your cortisol looks ok too. Like already mentioned its probably related to thyroid and testosterone then adrenal problems.

I know its not 100% accurate, but is your morning body temp when u first wake up low as well, cant indicate low thyroid issues too.

I understand your situation with the shift work, it really pounds the body, i have 20 yrs as a paramedic and its done a number on me.

good luck.


#6

SHBG is high, infers a problem with elevated E2 which would decrease T levels.

Iodine?


#7

Thanks again for all your comments and help. I'll post full labs soon, been busy with work this week and haven't had the time, but I can understand that you'd need them to fully comment. I'll be meeting with my doc and will bring up the additional tests this friday. I fully agree and can only hope that this problem is related to an adrenal issue that could be handled with certain supplements/meds and lifestyle changes...


#8

That's an interesting idea. Are you implying that more iodine in the diet would possibly reduce E2?


#9

Took my temperature in the morning and at night over the last few days and found no significant difference. I will say however, I get cold a lot easier now then I ever did in the past; cold extremities too...
Really appreciate your comments and sympathy...congrats on making it 20 years as a medic, that is impressive.
Holding off on the DHEA, will bring up your comments with the doc this friday.


#10

no significant difference.... meaning what? your body temp stays constant at 98.6 first thing in the am and late at night?


#11

first page of original labs


#12

2


#13

3rd and last


#14

Ahh, good point. If I remember correctly, the readings were 98.4 and 98.6, but I'll do them again tonight and tomorrow and confirm.


#15

if your body temp is at 98.4 first thing when you wake up, something is up... not sure if that is a symptom of hyperthyroidism... normal body temp upon waking is typically 97.3-97.6(i think?)

when was the blood drawn? if at 8am then your cortisol is low (ideal is 15-20 for 8am).


#16

Blood draw was at 4:55 p.m.


#17

[quote]PureChance wrote:
your free T3 is horrible even though your TSH looks normal.

Was curious why F T3 looks horrible to you....pardon my ignorance on that, but the number (2.6) is well within the reference interval (2.0-4.4)....what am I missing there?

thanks


#18

check out the blood sticky.

ideal Free T3 depending on your doctor, forum, advisor, etc. should be 3.3 to 3.9.

so yes you are within the 'normal range' just like people with a 4.9 TSH are within the 'normal lab range' although we know that TSH > 1 signals a possible problem and TSH > 2 signals a problem.


#19

I would definitely supplement D. You could also try trans-dermal Magnesium to boost DHEA. Boosting DHEA should boost T a bit. I take it at night with Zinc and b-12. Has me sleeping like a baby. Zinc should also help with elevated E2 if it's really an issue.

If you get E2 tested/sorted and SHBG is still high, you try supplements to lower that a bit.

I wouldn't mess with test until you get some basics sorted.


#20

Thanks for the advice. I've got the Vit D on board, ZMA at night and taking 25mg DHEA daily as well. So far, I've been feeling better. I recently did a 24 hour hormone analysis and shipped it off to the lab. I'll get those results in a week or so and hopefully those labs will give me a more complete picture of what's going on. From there I hope to supplement as well as make lifestyle changes to get me more balanced. I wholeheartedly agree that I need to get the basics figured out before jumping on Test.
Just waiting on the results and then I'll post results.