Low adrenals, sick euthyroid, B12 defficient

[alanc]

Hi guys,

I am new to the forum but have been reading and learning from here for a while now.

For the last few years my health has been slowly getting worse which i put down to stress of life etc and getting older (i'm 31). My symptoms are standard for hypothyroid/adrenal fatigue/B12 deficiency and I have become so chronically fatigued that I can't do much at all, I also reported to the doc that I had a reduced libido, have put on fat around waist and chest and have platar faciatis. So i went to doc and got some blood tests done and was told that I am all in range and diagnosed with ME(CFS/Fibromyalgia). Not happy with this I got a copy of my blood test results and started researching. I was hoping for some of your views and thoughts on the results and my interpretation of them to give me some more information to put to the doctors (now on my 3rd who will not bother with me as tests are within normal range).

First bloods:

Albumin 53 g/l (36-52) High
Bilirium 17 umol/l (0-22)
ALT 16 IU/l (0-55)
A.Phos 126 IU/l (25-110) High
Adjusted calcium 2.26 mmol/l (2.1-2.6)
Glucose 4.3 mmol/l (3-11.1)
CK 98 IU/l (1-170)
TSH 1.7mIU/l (0.2-5.0)
Free T4 16.3 pmol/l (9 – 21)
T3 1.6 nmol/l (1.3 – 3.0)
Serum B12 552 ng/L (190 – 900)
Serum Ferritin 189 ng/ml (20 – 300)
Serum Folate 19.3 ng/ml (4.6 – 18.7) High
SHBG 24.4 nmol/l (6 – 45)
Testosterone 11.19 nmol/l (10 – 36)
Haemoglobin 15.4 g/dl (13.5 – 18)
Red Cell Count 4.42 x10^12/L (4.5 – 6.5) Low
Haematocrit 0.419 L/L (0.42 – 0.54) Low
MCV 96.7 fL (80 – 100)
MCH 32.2 pg (27 – 32) High
MCHC 33.3g/dL (30.0 – 36.0)


A long with these test i also have:
Basal temp 35.8C
Resting heart rate 46 bpm
Failed iris contraction test

I then asked for some further test to get my cortisol, FT3 and RT3 tested. I didn't get FT3 or RT3 but did get cortisol and retested everthing else again.

My results were all similar except:
testosterone had risen to 18.9 (10-39)
TSH fell to 0.98 (0.2 - 5.0)
cortisol 298nmol/l (280-720)

My interpretation of these bloods and my symptoms are:

1. Megaloblastic anemia due to B12 deficiency- low red blood, high mcv/mch, high folate.
2. Adrenal fatigue - low cortisol, low T, failed iris contraction
3. Hypothyroid - Reduced metabolic rate, low basal temp, 46bpm resting heart rate

My thoughts are that B12 deficiency causes poor T4 to T3 conversion. T3 required for the production of pregnenolone from cholesterol. Preg required in the production of cortisol and test. So I believe that i need to boost my B12 and adrenals as the first stage and then look at boosting T3 after that. I was thinking of B12 supplement and preg cream to combat amenia and low adrenals then once the levels have stablised taking T3 or Armour to boost thyroid and metabolic rate.

What do you guys think? Any help would be much appreciated.

 

[ssbackwards]

ask about leptin and how it contributes to things like fibromyalgia. Leptin raises TNF-a and Nf-kb which are inflammatory markers.

also things like agouti and agouti related protein can show raised t3.

Id suggest adding calcium into diet, alont with pantethine, ALCAR and coq10. space out meals a little longer and buy a good nutrient repartitioner that has either ALA, HCA, Chromium, Gymnemma, Banaba, Berberine (this is great). etc.

even a cinnamon extact.

These things escpecially berberine can help with those inflammation factors. And since leptin is a major endocrine hormone its important to try and keep circulating levels to a minimum. The Pantethine will help clear blood triglycerides and alcar wil help with leptin passing through blood brain barrier (this is good to regulate agout and agrp)

 

[The Matrix]

Hi guys,

I am new to the forum but have been reading and learning from here for a while now.

For the last few years my health has been slowly getting worse which i put down to stress of life etc and getting older (i'm 31). My symptoms are standard for hypothyroid/adrenal fatigue/B12 deficiency and I have become so chronically fatigued that I can't do much at all, I also reported to the doc that I had a reduced libido, have put on fat around waist and chest and have platar faciatis. So i went to doc and got some blood tests done and was told that I am all in range and diagnosed with ME(CFS/Fibromyalgia). Not happy with this I got a copy of my blood test results and started researching. I was hoping for some of your views and thoughts on the results and my interpretation of them to give me some more information to put to the doctors (now on my 3rd who will not bother with me as tests are within normal range).

First bloods:

Albumin 53 g/l (36-52) High
Bilirium 17 umol/l (0-22)
ALT 16 IU/l (0-55)
A.Phos 126 IU/l (25-110) High
Adjusted calcium 2.26 mmol/l (2.1-2.6)
Glucose 4.3 mmol/l (3-11.1)
CK 98 IU/l (1-170)
TSH 1.7mIU/l (0.2-5.0)
Free T4 16.3 pmol/l (9 – 21)
T3 1.6 nmol/l (1.3 – 3.0)
Serum B12 552 ng/L (190 – 900)
Serum Ferritin 189 ng/ml (20 – 300)
Serum Folate 19.3 ng/ml (4.6 – 18.7) High
SHBG 24.4 nmol/l (6 – 45)
Testosterone 11.19 nmol/l (10 – 36)
Haemoglobin 15.4 g/dl (13.5 – 18)
Red Cell Count 4.42 x10^12/L (4.5 – 6.5) Low
Haematocrit 0.419 L/L (0.42 – 0.54) Low
MCV 96.7 fL (80 – 100)
MCH 32.2 pg (27 – 32) High
MCHC 33.3g/dL (30.0 – 36.0)


A long with these test i also have:
Basal temp 35.8C
Resting heart rate 46 bpm
Failed iris contraction test

I then asked for some further test to get my cortisol, FT3 and RT3 tested. I didn't get FT3 or RT3 but did get cortisol and retested everthing else again.

My results were all similar except:
testosterone had risen to 18.9 (10-39)
TSH fell to 0.98 (0.2 - 5.0)
cortisol 298nmol/l (280-720)

My interpretation of these bloods and my symptoms are:

1. Megaloblastic anemia due to B12 deficiency- low red blood, high mcv/mch, high folate.
2. Adrenal fatigue - low cortisol, low T, failed iris contraction
3. Hypothyroid - Reduced metabolic rate, low basal temp, 46bpm resting heart rate

My thoughts are that B12 deficiency causes poor T4 to T3 conversion. T3 required for the production of pregnenolone from cholesterol. Preg required in the production of cortisol and test. So I believe that i need to boost my B12 and adrenals as the first stage and then look at boosting T3 after that. I was thinking of B12 supplement and preg cream to combat amenia and low adrenals then once the levels have stablised taking T3 or Armour to boost thyroid and metabolic rate.

What do you guys think? Any help would be much appreciated.

Let me sum this up very easily
Check vitamin d 25 OH this can cause imbalance in alkaline phosphotase.
For b-12 indicator I have dr's use methylmalonic acid serum as indicator
Elevated folate your are pooling in the blood probably due to b-12 deficiency which first needs to be identified.
Then once b-12 imbalance is identified then you need to find out why?
Your coritsol levels are low which can also cause other imbalances with in the thyroid and hormonal cascade.
Preg would not be a bad choice but look at other factors before starting to play with hormones precursors. Too many people make themselves worse by reading something on line as a result by the time they get to the dr they are all out of balance making our job (Physician consultant and DR) extremely difficult.

 

[alanc]

Thanks for your input guys.

I have asked for a MMA (urine or blood) test from my doctor but they refuse as my B12 serum level is fine. I have provided documents and print outs regarding the high level of false negatives from B12 serum tests but I am hitting my head against a brick wall trying to get through to them. They won't accept that I have possible megaloblastic anemia as I am "only just" out of range.

ssbackwards - Agree with the importance of B vitamins to support the adrenals and found a site (adrenalfatigue.org) which goes into detail about the importance of B3, B5 and B6.

Matrix - I had an intial look into vit D and its relationship to a proper functioning thyroid seem quite pertinent to my me. Could you advise on what potential other factors to investigate before starting to play with hormones precursors, that I could check out along with those already mentioned?

It is starting to look like this could all be related to a malabsorbtion issue.

Thanks again.

 

[The Matrix]

Thanks for your input guys.

I have asked for a MMA (urine or blood) test from my doctor but they refuse as my B12 serum level is fine. I have provided documents and print outs regarding the high level of false negatives from B12 serum tests but I am hitting my head against a brick wall trying to get through to them. They won't accept that I have possible megaloblastic anemia as I am "only just" out of range.

ssbackwards - Agree with the importance of B vitamins to support the adrenals and found a site (adrenalfatigue.org) which goes into detail about the importance of B3, B5 and B6.

Matrix - I had an intial look into vit D and its relationship to a proper functioning thyroid seem quite pertinent to my me. Could you advise on what potential other factors to investigate before starting to play with hormones precursors, that I could check out along with those already mentioned?

It is starting to look like this could all be related to a malabsorbtion issue.

Thanks again.

I will pretty much bank its malabsorption. If you are interested I can recommend some one who does intracellular testing which will give you answers. I pretty much know what they will find since I have dealt with hundreds of these cases with Dr's before. So it just a way of saving you alittle money and hastle of going through insurance. Funny that Dr have no clue that elevated b-12 and folate with functional deficiency is related to small bacteria overgrowth. I am not pulling this out my ass because I have seen it numerous times in these cases and when dr's run specific test they are scratching their heads. "I'll be damned" ...Sorry to break the news 90% of the drs consult with have patients with compromised GI tracts and never even know it till I get start digging. Mean while these people have been suffering for several years with out resolution from other therapies (antidepressants, HRT, nutritional intervention,ect). I use functional testing to help identify where the imbalances may be in order to not waste months playing guessing games.

SS- great answers but it's over analyzing things. Keep it simple Bro

As with many other forums (cough cough) they turn a simple answer or question into a total enigma needing an PH.D degree to understand it. The end result is people not getting the proper suggestions, but rather frustrated and more confused. When dealing with general population as well as medical professionals they could care less about how things work on a cellular level, and care about presenting it in a simple 30 seconds elevator speech. As long as I what i suggest sounds logical and can be medical validated medical professionals it fine. If they have questions then I will have the research to back it up. Medical professionals want quick, concrete response shown to have therapeutic out come along with potential symptoms to watch out for on rare occasions.

I used to do the same thing until I learned to narrow things down to its simplest form. You get a much better response.

 

[alanc]

Thanks Matrix, that makes alot of sense.

Do you have any experience of treating SIBO? It looks like one should treat with antibiotics to treat the bacteria and then pro-biotics to try and keep the bacteria at bay? And then there will be the lasting effects that I am dealing with now in regard to low adrenals and sick euthyroid, should I treat for that with the aim of bringing my metabolic rate and adrenal output back up to par or would you treat the SIBO and then leave the body to sort itself out?

Another theory which I have looked at is that the hypothyroid condition has caused the reduction in the metabolic rate which has caused the intestinal function to decrease which can then lead to problems causing malabsorbtion (possibility that the metabolic slow dow, has affected the intestinal muscles?) Is this something you would consider. It seems to be a bit of vicious circle/ chicken and egg type scenario and whether the problem started by malabsorbtion or the malabsorbtion was caused by the thyroid condition in the first place.

 

[The Matrix]

Thanks Matrix, that makes alot of sense.

Do you have any experience of treating SIBO? It looks like one should treat with antibiotics to treat the bacteria and then pro-biotics to try and keep the bacteria at bay? And then there will be the lasting effects that I am dealing with now in regard to low adrenals and sick euthyroid, should I treat for that with the aim of bringing my metabolic rate and adrenal output back up to par or would you treat the SIBO and then leave the body to sort itself out?

Another theory which I have looked at is that the hypothyroid condition has caused the reduction in the metabolic rate which has caused the intestinal function to decrease which can then lead to problems causing malabsorbtion (possibility that the metabolic slow dow, has affected the intestinal muscles?) Is this something you would consider. It seems to be a bit of vicious circle/ chicken and egg type scenario and whether the problem started by malabsorbtion or the malabsorbtion was caused by the thyroid condition in the first place.

I have dealt with this from a clinical stand point numerous times also a personal standpoint. There are quick and efficient ways of doing things or other ways of wasting time and money.

 

[alanc]

What would be the best approach? Also how would I ensure adequate supplementation of vitamins and minerals going forward given that oral supplements may not be absorbed adequately, is there vitamin injections that can be regularly taken?

 

[The Matrix]

What would be the best approach? Also how would I ensure adequate supplementation of vitamins and minerals going forward given that oral supplements may not be absorbed adequately, is there vitamin injections that can be regularly taken?

Proper evaluation with both.direct.and functional.testing. It took.me.years to.find out how.toexplore this area because had no clue because conventional testing was not showing up. Why i was.labeled hypochondriac. You.have to go deeper at the cellular.level to get your answers. When dealing with Dr i use what ever is with in the Dr patients capability and price range to.get the best diagnostic data.

 

[alanc]

Thank for your input, much appreciated

 

[The Matrix]

Thank for your input, much appreciated

Where you located you may want to find a functional medicine dr in your area to help you with this

 

[alanc]

Thanks, I have an appointment with an endocrinologist on 1st Nov, it's hard enough to get a referral to an endo never mind anyone else, so I will see how it goes first. Having looked into SIBO a bit more I do think that I have quite a few of the other symptoms. I'll let you know who my endo visit goes.

 

[The Matrix]

If.you.need help looking into gi issues i be glad to assist where.to go

 

[chedapalooza]

Do u know what a total cortisol level of 12.6 means? And tsh of 1.84? Thnks!

 

[The Matrix]

Do u know what a total cortisol level of 12.6 means? And tsh of 1.84? Thnks!

Not enough data ...

 

[chedapalooza]

Not enough data ...

Tsh 1.84
T3 uptake 34
Total t4 6.7
Free t4 1.2

That's it related to thyroid.. Only thong w cort was total cortisol 12.6....

It wasn't done by an endo.. That apt is dec 1.. :/ so far

Edit- b12= 1002

 

[The Matrix]

Tsh 1.84
T3 uptake 34
Total t4 6.7
Free t4 1.2

That's it related to thyroid.. Only thong w cort was total cortisol 12.6....

It wasn't done by an endo.. That apt is dec 1.. :/ so far

Edit- b12= 1002

Stil not enough data..
ft3, rt3 ferritin, vitamin D 25 oh.
cortisol salvia test 4 point - labcorp
I require indept testing in order present to help their Dr to make the best evaluation.

 

[chedapalooza]

Stil not enough data..
ft3, rt3 ferritin, vitamin D 25 oh.
cortisol salvia test 4 point - labcorp
I require indept testing in order present to help their Dr to make the best evaluation.

Ok. Well I'll have to wait til December 1st for my appointment , thanks anyway. Hopefully u can help me out after I get solid tests done

 

[The Matrix]

Ok. Well I'll have to wait til December 1st for my appointment , thanks anyway. Hopefully u can help me out after I get solid tests done

Good luck with endo you most likely not get half the information you need.

 

[chedapalooza]

Good luck with endo you most likely not get half the information you need.

:/

Why do y say that.. What should I tell him/ask for?

I plan on telling him about my supplement/past gear use n inquiring about my hormones, pituitary, thyroid, cortisol..

 

[chedapalooza]

:/

Why do y say that.. What should I tell him/ask for?

I plan on telling him about my supplement/past gear use n inquiring about my hormones, pituitary, thyroid, cortisol..

 

[alanc]

Matrix,

I paid for a private VitD test before my endo consultation next week. My results are:

Total Vitamin D = 32.8 nmol/L (15-30 deficient/30.1-50 insuficiency/greater 50 adequate)
Vit D3 = 30nmol/l (no range given)
Vit D2 = less than 2.8 nmol

So it appears that you were correct to check it as it shows insufficient and borderline defficiency of total VitD.

I'm not sure how the D3 and D2 levels look as there was no reference range.

 

[The Matrix]

Matrix,

I paid for a private VitD test before my endo consultation next week. My results are:

Total Vitamin D = 32.8 nmol/L (15-30 deficient/30.1-50 insuficiency/greater 50 adequate)
Vit D3 = 30nmol/l (no range given)
Vit D2 = less than 2.8 nmol

So it appears that you were correct to check it as it shows insufficient and borderline defficiency of total VitD.

I'm not sure how the D3 and D2 levels look as there was no reference range.

Optimal is 65-70.
Adequate does not mean healthy.
Work on getting other factors in line before even thinking of moving into HRT. Your GI tract is utter mess and needs to be rebalanced, vitamin D has a pronounced effect on LH signaling as well as vitamin E, A, and even k to some degree potentially. I would focus on getting your absorption in check rather then dealing with hormones at this point.

 

[alanc]

Optimal is 65-70.
Adequate does not mean healthy.
Work on getting other factors in line before even thinking of moving into HRT. Your GI tract is utter mess and needs to be rebalanced, vitamin D has a pronounced effect on LH signaling as well as vitamin E, A, and even k to some degree potentially. I would focus on getting your absorption in check rather then dealing with hormones at this point.

I agree, I think my next stage is request a full test of all vitamins and minerals to get an understanding of what is deficient and then supplement with those i guess. What sort of things do I need to do to rebalance the GI tract other than antibiotics to combat SIBO?

 

[The Matrix]

I agree, I think my next stage is request a full test of all vitamins and minerals to get an understanding of what is deficient and then supplement with those i guess. What sort of things do I need to do to rebalance the GI tract other than antibiotics to combat SIBO?

There are multiple ways of doing this. I talked to an MD who I will be working. He wanted me to design protocol to deal with the gut. I basically told him there really is no possible way to do this because each case is individual based. As with many anti aging places use cookie cutter approaches rather then taking inconsideration of bioindividuality. Deal with the gut sounds simple because find and simple remove with antibiotics. We wish it was that easy, but rather it because an art to dealing with these intricate issues. The normal approach almost ended up me tearing my shoulder tendons because I have a genetic predisposition to quinolones drugs. After researcher this for several months I had to come up a way to go around this which involved balancing the neurotransmitter and immune system in order to help kill off the bad bacteria. Then I had to support altered liver pathways in order to help deal with the toxic die off other wise this approach would have been a complete failure. Again each approach is different and individualized. There are several ways to skin a cat, but knowing what i know now i will take the slow and steady pathway.

 

[alanc]

Hi Matrix,

To update, I saw the endo and he arranged some further blood tests. Turned out he just did the same blood tests over again and reported that they were all normal and that i may respond to a treatment of antidepressants, f**king pointless. I'm really disgusted at the state of healthcare in the UK.

Anyway all the test were pretty much the exact same except my cortisol level was even lower, down to 261nmol/l which i put down to getting the blood taking at 2pm.

I'm pretty convinced I had malabsorption issues and am B12 deficient. I guess it's up to me to self manage my condition now and will start with B12 shots and high B compelx and vits and minerals. i will be requesting a hyrogen breath test to check for SIBO but doubt they will carry it out.

I think the SIBO probably caused by low stomach acid and need to work out whether the low acid and sibo is caused by B12def or the low stomach acid and sibo is causing the B12def (chicken or the egg) Autoimmune tests for If antibodies and parietal cell antibodies would help diagnose if the B12def was causing low acid, and if the antibodies are ok it would suggest the SIBO causing the B12def.

I am really at loss of where to go with this apart from self treatment.

 

[The Matrix]

Hi Matrix,

To update, I saw the endo and he arranged some further blood tests. Turned out he just did the same blood tests over again and reported that they were all normal and that i may respond to a treatment of antidepressants, f**king pointless. I'm really disgusted at the state of healthcare in the UK.

Anyway all the test were pretty much the exact same except my cortisol level was even lower, down to 261nmol/l which i put down to getting the blood taking at 2pm.

I'm pretty convinced I had malabsorption issues and am B12 deficient. I guess it's up to me to self manage my condition now and will start with B12 shots and high B compelx and vits and minerals. i will be requesting a hyrogen breath test to check for SIBO but doubt they will carry it out.

I think the SIBO probably caused by low stomach acid and need to work out whether the low acid and sibo is caused by B12def or the low stomach acid and sibo is causing the B12def (chicken or the egg) Autoimmune tests for If antibodies and parietal cell antibodies would help diagnose if the B12def was causing low acid, and if the antibodies are ok it would suggest the SIBO causing the B12def.

I am really at loss of where to go with this apart from self treatment.

pm me man let get this taken care of..