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Re: Thyroid and cortisone BarbaraCat

Posted by Cairo on July 20, 2004, at 11:22:36

In reply to Re: Chronic pain -best med and weird reactions Cairo, posted by BarbaraCat on July 19, 2004, at 18:04:53

> HI Cairo,
> I never heard about T3 shutting the feedback loop down, but maybe your doctor is on to something. My personal feeling is that this is an ideal opportunity to see if adding T3 would make a difference. Have you had your thyroid antibodies checked for hashimoto autoimmune thyroiditis?
>
> The other thing is, like you mentioned, your adrenals. Your holistic doc can order an adrenal stress index to check the state of your cortisol. I was hoping mine was off since I'd been feeling so bad, but it wasn't. However, my husband's was very low, which explained the weird symptoms he was getting with slow healing, dragging energy. She has him on a natural cortisol supplement and he's slowly getting back to normal.
>
> Heavy metals are another area, but huge. Hope you don't have to go down that road. - Barbara
>
>


Both T3 and T4 would negatively feedback to the thyroid causing it to release less of it's own IF the thyroid gland is functioning. Same for exogenous cortisone:

http://courses.washington.edu/conj/bess/feedback/newfeedback.html

So if hypothyroid/adrenal functioning is due to factors other than a thyroid/adrenal gland that can't produce enough of it's own, you don't want to tell your functioning gland to produce less, hence the caution. I realize that there may be non-tumor reasons for this hypofunction such as nutritional deficiencies, but you would want to correct those rather than giving T3 or T4.

IMHO, those FMS patients who do great on thyroid long term have an underlying thyroid issue that presents with FMS-like symptoms and are technically not FMS. T4 doesn't do anything for my muscular complaints and there are probably receptor or other issues. I personally would not do the high dose thyroid route as Dr. Lowe advocates.

Giving exogenous cortisone can also rev up your metabolism, taxing an already tired thyroid and making things worse.

Elevated cortisol due to stress (and I think many of our du jour ailments are due to stress), can affect many different systems and target tissues. My Rheumatologist, who is the sharpest diagnostician I've met, said that while supporting with meds is important, the root may be higher up in the hypothalmus, amygdala, etc. and stress reduction of all forms (meditation, CBT, physical exercise, removing dietary stressors, etc.) is crucial. Easier said than done when you feel like crap. The world doesn't stop for you to always do what you need.

Regarding checking adrenal function, there are several ways. 8am, 4pm and 11pm cortisol levels can indicate if you are normal, low or high. But some FMS patients present with normal levels initially; they have enough floating around, but in response to any stressor, they can't produce enough. Hence, some look like they have Addison's disease; their glands are working fine, but the feedback is not working right. Checking cortisol levels 30 and 60 minutes after administering ACTH can also show if you can mount an adequate response.

Instinctively, support with low dose and/or prn cortisone makes sense at least for awhile, but go to JR Becker's post about atypical depression and cortisol to read his caution:


http://www.dr-bob.org/babble/20000420/msgs/31619.html
http://www.dr-bob.org/babble/20030525/msgs/230047.html

If it were this easy, we'd be hearing more about people being "cured" of FMS by supplements and meds. I think they help, but darn if it isn't only partially helpful, at best. Though sometimes I wish I could go off all meds and try one thing at a time, a sort of medication tabula rasa.

BTW, had all my amalgam fillings out and mercury testing doesn't show elevated levels.

Hope you have a good week!

Cairo



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URL: http://www.dr-bob.org/babble/20040719/msgs/368230.html