| ||||||||
|
| Men's Health Forum: This is a discussion on Adrenal Thread within the Anabolic Steroids forums, part of the extensive steroid information at MESO-Rx; I have a couple of questions for you guys, Chris and SWALE: 1) My pre-treatment thyroid results were TSH 2.27 ... |
| |||||||
![]() |
| | LinkBack (7) | Thread Tools | Display Modes |
| |||
|
I have a couple of questions for you guys, Chris and SWALE: 1) My pre-treatment thyroid results were TSH 2.27 (.35-5.5), FT3 3.1 (2.3-4.1), Total T4 6.5(4.5-12). This was also before I started testosterone replacement, as my Total T was low. Unfortunately I was dieting at the time as well. BOTH could have an impact on my thyroid function, right? 2) My AM Cortisol was a little low at 17 and my DHEA was also VERY low. Could fixing these alone improve my thyroid function? 3) It seems that the adrenal function is often overlooked here. Could you clarify how important this is and how to interpret ranges and results? Also, SWALE any comments are appreciated! I know you treat high cortisol with PS, but how do you determine what is high? From what Chris has said, normal cortisol for men is often above the upper limits. Thanks Chris |
| Sponsored Links |
| |||
|
Mariqanco--Do SSRI's increase T4 to T3 conversion (outside of their ability to through stated purpose of reducing stress for the patient)? SPE--That is not a low cortisol level. Hypothyroidism is linked to adrenal fatigue in that the adrenal glands have been trying to, through stress hormone production, make up for the lack of thyroid. Once the adrenals burn out, then both are left in a deficient state. This is also why adrenal function must be evaluated first prior to treating the deficient thyroid. An uncovered adrenal deficiency could literally kill a patient if thryroid supplementation is initiated first. |
| |||
| Quote:
|
| |||
| Quote:
|
| |||
| Quote:
|
| |||
| Quote:
|
| |||
|
My understanding was that the gold-standard cortisol test is a 24-hour urine cortisol/creatine test. I've read posts that saliva testing can be tricky depending on when exactly you take it and what you've recently put in your mouth. Plus, the higher variability of that test seems to be in question by some endos so I've rarely heard any doctor want to use it over a 24-hour urine test except as a screen to rule IN a cortisol problem. It's probably good at detecting people that have very high, or very low, cortisol levels but maybe not as good as a 24-hour urine when someone may be closer to the normal range. I have no professional exp other than reading about it and talking to a few endos about it. Obviously it's not a bad first test but I'm not sure how conclusive it is when it results in near normal levels. It certainly is cheaper and less of a hassle. I ended up having a 24-hour urine myself because I wanted to be sure. |
| |||
| Quote:
|
| ||||
| Quote:
As another example, often the "normal range" for TSH (thyroid stimulating hormone) is between 2.0 to 5.0. The problem is that this norm was arrived at without excluding people with hypothyroidism. Thus the numbers are skewed. Using the normal range, a TSH under 5.0 would be thought of as being normal and not hypothyroid. But that is not the case. If the Free T3 and Free T4 are checked, often such a person would be hypothyroid. As a result, I use a TSH of > 2.0 to determine hypothyroidism - verifying it wiht the Free T3 and Free T4. In other words - the TSH is essentially useless in determining hypothyroidism. It would be best to just check Free T3 and Free T4. When it comes to hyperthyroidism, the TSH is also not very useful. It often a TSH near zero stirs alarm when no alarm need be there. The TSH is the brain's idea of how much thyroid hormone activity there is. It is not necessarily how much thyroid hormone is actually there - because there can be a disconnect in disease states. A truer measurement of hyperthyroidism is the Free T3 and Free T4.
__________________ Any statement I make on this site is for educational purposes only and will change as medical knowledge progresses. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, please ask your doctor. Thank you. |
| ||||
| Quote:
Thyroid function and serotonin activity are highly linked. Both need to be addressed to optimize function. T3 (the active thyroid hormone created from T4 in the liver by the 2D6 enzyme) desensitizes presynaptic serotonin autoreceptors - thus leading to an increase in serotonin production. Giving T3 induces serotonin production. Similarly, in hypothyroidism, serotonin production is reduced. T3 augments the effects of serotonin-increasing medications (such as the SSRIs) by the additive effect both have on desensitizing presynaptic serotonin autoreceptors. Serotonin stimulates hypothalamic TRH production, leading to an increase in TSH production from the pituitary. Adequate serotonin production is necessary to maintain thyroid hormone levels. Increasing serotonin levels with an SSRI may thus help improve thyroid hormone production. A caveat: Theoretically, an excess serotonin may lead to the opposite reaction. For example, excess serotonin leads to reduction in dopamine production, which then leads to increased norepinephrine production, leading to an increased stress response and cortisol production. High levels of cortisol (which can also be caused by high stress levels, low testosterone, etc.) can directly lead to suppression of pituitary TSH secretion, and impair conversion of T4 to T3, and can impair serotonin function (by reducing serotonin receptor density, increasing serotonin uptake via increase in serotonin transporter production, and by increasing tryptophane oxygenase production in the liver - thus reducing tryptophan, the precursor to serotonin). It may be thus important to have an idea of serotonin levels (unless one has a good clinical feel as to a patient's clinical response to assess serotonin levels - as a psychiatrist may have) by measuring urine serotonin levels. This, somewhat, correlates with brain serotonin levels, though I am still assessing this for clinical utility.
__________________ Any statement I make on this site is for educational purposes only and will change as medical knowledge progresses. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, please ask your doctor. Thank you. |
| |||
| Quote:
The following is from the book "Adrenal Fatigue: The 21st Century Stress Syndrome" by Dr. James Wilson page 83: Regarding Saliva Cortisol testing: "It is the best single lab test available for detecting adrenal fatigue and has several advantages over other lab tests in determining adrenal hormone levels." For the rest of the passage, please read the book (it's too long to type). |
| ||||
| Quote:
Here are some costs for comparison between blood and saliva tests: Salivatest.com/ZRTLabs - Cortisol x 2 (AM/PM) Saliva Test $60 - Cortisol x 4, DHEA x 4 Saliva Test $150 LEF.org/Life Extension Foundation - Cortisol x 2 (AM/PM) Blood Test $72 members, $96 non-members - Cortisol x 1 Blood Test $39 members, $52 non-members - DHEA-S x 1 Blood Test $61 members, $82 non-members Sanesco.net/Sanesco International - Cortisol x 4, DHEA x 2 Saliva Test $89 Quest Diagnostics - Cortisol x 1 Blood Test $127 - DHEA-s x 1 Blood Test $136 The blood test give an idea, when combined with other lab tests about the presence of adrenal fatigue. One can do four blood tests in a day to get better sensitivity - but then what patient wants to get poked with a needle four times in a day? The saliva tests - involving multiple samples in a day - are much more sensitive in helping diagnosis adrenal fatigue than an AM/PM Cortisol blood test along with a single DHEA-s. Be-that-as-it-may, some patients cannot afford to pay out of pocket, even for a saliva test, yet they have health insurance coverage - even if it is Medicaid or Medicare. I will take whatever test I can get to help the patient. Some patients don't have health insurance at all and are poor but not poor enough to get government health insurance. In this case, I use my clinical skills and experience to arrive at the diagnosis and treatment. With informed consent, I would treat the person if the benefits of treatment outweigh the risks - of course, if not, I would not. Medicine, most of the time, is an art. As we generally learn in medical school, 90% or more of the diagnosis is arrived at by the history and physical - when one has clinical-saavy and medical street-smarts. It certainly is nice though to get labs. It gives you clear road-signs and specific goals to achieve. Whether or not it can be done depends on the patient.
__________________ Any statement I make on this site is for educational purposes only and will change as medical knowledge progresses. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, please ask your doctor. Thank you. Last edited by marianco; 02-12-2006 at 01:26 AM. |
| |||
| Quote:
|
![]() |
| Thread Tools | |
| Display Modes | |
| |
LinkBacks (?)
LinkBack to this Thread: http://forum.mesomorphosis.com/mens-health-forum/adrenal-thread-134240195.html | ||||
| Posted By | For | Type | Date | |
| hope i made the right decision - Bodybuilding.com Forums | This thread | Refback | 03-21-2007 04:09 PM | |
| Stop The Thyroid Madness :: View topic - Slight Vent/Looking for new DR in BayArea | This thread | Refback | 10-11-2006 05:23 PM | |
| Stop The Thyroid Madness :: View topic - Slight Vent/Looking for new DR in BayArea | This thread | Refback | 10-11-2006 05:17 PM | |
| Diminishing Energy Between Work And Home. - Mind and Muscle Forums | This thread | Refback | 10-01-2006 01:10 PM | |
| Krooninen väsymysoireyhtymä :: View topic - Kiinnostava testi | This thread | Refback | 09-27-2006 05:36 AM | |
| Kilpirauhasfoorumi :: Näytä viesti - Adrenal fatigue eli lisämunuaisten uupumus | This thread | Refback | 09-26-2006 08:28 AM | |
| Kilpirauhasfoorumi :: Näytä viesti - Adrenal fatigue eli lisämunuaisten uupumus | This thread | Refback | 09-24-2006 03:39 AM | |
Similar Threads | ||||
| Thread | Thread Starter | Forum | Replies | Last Post |
| Reconsidering the closed thread | ||||