I began taking hydrocortisone (Cortef) today for adrenal fatigue. My endo placed me on 20 mg with two doses of 10 mg each (at breakfast and lunch -4 hours apart). The trouble is that she only would order two saliva tests (midnight- ok cortisol and 8 am- low cortisol) in order to make this judgement. I asked for the 24 hr saliva (4 times), but I took what I could get lab wise. She had checked the level of cortisol in my blood at the end of July around 4 pm and it was high. Anyway, I’m supposed to let her know after 7 days if my symptoms have improved while on HC. If they haven’t then she feels my symptoms are not an endocrine problem- not from adrenal fatigue.
Is there anyone here who is currently taking or has taken HC for adrenal fatigue or insufficiency? Also, my BG levels have been high all day today and tonight. I asked my endo yesterday what effect taking HC might have on my BG levels and she said that it would probably not have much if any effect…if so, to play it by ear (use a temp. basal rate) on my insulin pump. I began doing that this afternoon, but I’m still too high.
I have late onset of type 1 diabetes; Hashimoto’s thryoid disease and what I feel is adrenal fatigue. I have been taking levothyroxine since November, 2010 to treat my hypothyroidism. My FT4 is okay, but my FT3 is low. My endo refuses to let me try desiccated thyroid. I can’t find any endo in my area who will prescribe desiccated thyroid meds. I’m very frustrated as I haven’t felt well in over a year and am feeling worse as time goes by.
Thank you for any comments/suggestions to help guide me along 
Well, I read in Merck’s Manual (a relatively old copy) that people who are being treated for Addison’s disease (adrenal failure) and Type 1 diabetes DO have a harder time controlling their BG levels. And that Addison’s disease is auto-immune, too. I’m not a doctor, so I’m not diagnosing anything, but if that is the case, your higher BGs are what I would have expected.
So, it’s time to do your homework and read up on Addison’s disease (and Cushing’s disease if you’re interested in other adrenal problems), so that you can talk to your doc armed with facts.
Good luck!
A person can have adrenal insufficiency or adrenal fatigue without having Addison’s or Cushing’s.
You can order your own 24-hour salvia test. It’s not that expensive. I’ll send info about a lab, if you’re interested.
I also have late onset T1 & Hashimoto’s. Am going to get my adrenals tested soon because I believe it’s a factor in my thyroid issues.
Without sufficient cortisol, the cells can’t uptake thyroid regardless of how much thyroid supplementation is taken. Levothyroxine is terribly ineffective. I share your pain about not finding a doctor to prescribe dessicated thyroid. Am going through that myself. My T4 is fine, but T3 is consistently low. I’m taking liothyronine (T3), but would prefer dessicated & T3. Been an uphill battle.
I read a suggestion to find a doctor to prescribe dessicated that I thought was clever. Ask your pharmacist who prescribes dessicated. Here’s a web site a Tu member sent me http://www.thyroid-info.com/topdrs/index.htm. Hoping there’s a doc listed in your area. I live in an area with few endos, so I’m researching doctors of osteopathy since they’d be open to natural thyroid. Perhaps that’s an option for you.
My doctor said that increasing thyroid wouldn’t effect BG. That’s not been my experience or that of others. So, go with what you’re experiencing with HC & make the adjustments you need.
Thanks Judith for your reply. I changed out my site last night and ended my temp. basal rate before going to bed…My BG levels were okay this morning. I’ll monitor them through the day- thank goodness it’s Saturday
Yes, It’s good to be armed with facts, Natalie. My endo at first thought I had early Addison’s, but changed her mind due to my labs. I’m the one who is pushing her to test for and consider adrenal fatigue (rather than failure) and treating it since I’ve read that occurs quite frequently and affects the effectiveness of thryoid meds. I feel she’s expecting a lot in only one week, but we’ll see. Thanks for your response
Gerry, It seems like we may have a lot in common! I totally agree with you. I wanted to order my own salivary labs and almost did a couple of days ago before starting on HC, but I felt desperate since I was back at work and feeling so sick. I’ll have to be off of HC for two weeks before I can test my saliva again. I feel that I need a full picture to see what is going on throughout the day and night. I have checked out the top doc’s site before and found an endo in my area, but she’s not taking any new patients. She was also the endo my pharmacist recommended-ugh! I feel your pain in the search to find a MD willing to prescribe desiccated thyroid. I think with T1 and Hashimoto’s we need an open minded physician who understands symptoms and how to look deeper using the right labs with knowledge. Thanks for your reply and good luck to you
Not sure about HC but anytime I have ever taken cortisone or steroid injects for tendon issues it jacked with my sugars for about 3-4 days.
Some info on thyroid hormones:
http://www.endocrineweb.com/conditions/thyroid/thyroid-gland-function
http://thyroid.about.com/cs/testsforthyroid/a/freet3.htm
You may want to ask your endo if any test has been done for
your TBG level. Ususual values cause no known problems except
for affecting the accuracy of the tests for the other thyroid
hormones.
http://www.ehow.com/facts_5095888_t.html
http://www.endocrineweb.com/conditions/thyroid/hypothyroidism-too-little-thyroid-hormone
http://thyroid.about.com/od/hypothyroidismhashimotos/a/tshnormal_2.htm
FT3 measures the more active form of thyroid hormone and
therefore needs to be kept normal. Have you asked your
endo if Thyrolar or Cytomel is available in your area, and
if either is a suitable treatment for bad FT3 values?
Dessicated thyroid is no longer the only possible treatment
for low FT3 readings, but I’m not sure your endo is aware of
these other two.
Months ago, there was a recall on dessicated thyroid due to
some type of contamination. Perhaps your endo simply no
longer trusts it.
Also, some endos seem to assume that keeping FT4 at a normal
value is sufficient and FT3 is less important. I hope this is not
true for all the endos in your area.
Since T4 is converted to T3 in normal individuals, maybe the endos are ignoring the possibility that the mechanism is not functioning properly in some people? Also, what’s total TBG?
Hi Natalie…what’s total TBG?
I don’t know – I got it from Robert Miles’ post above, so I’m asking the same question!
Thanks for the links and info Robert…I need to go through them all, but have read a few.
My endo actually used to take Armour for hypothyroidism, but switched to synthetic. She believes there are issues with quality control (can’t compare one lot to another) and that it simply isn’t safe (risk of mad cow disease). In 2005 there were issues with stability and more recently in 2011 there was mislabeling that occurred. Funny thing is that even the synthetic Levothyroxine drug I currently take has had the same issues-ha! If you go to the FDA website, you’d be very surprised to read all of the recalls and violations that occur with food and drugs.
This one is re: Armour and other products:
http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm242808.htm
Here are some important values for my most recent lab work:
TSH- 0.630 - this one fluctuates
Free T4- 1.31- okay, could be a bit higher
Free T3- 2.3 - too low
TPO Ab- 88- it’s been higher before
Years ago, she said I had Graves disease (1998) no meds prescribed. Fall, 2010 she said I had hypothyroidism and started me on Levothyroxine 25 mcg. In July, she said I have Hashimoto’s disease.
I’m sick of being sick and at this time do not think the T4 only meds have helped me one bit. Now, it seems I have some adrenal issues and am being given hydrocortisone with what seems to be a good starting level (20 mg), but feel the dosing is wrong.
The best thing we can do is to prepare ourselves with information and experience from others. Knowledge is power. I’ll certainly consider adding a T3 synthetic drug, but right now I’d rather try desiccated thyroid if I can find a doc who can figure out my adrenal issues and treat them as well.
I greatly appreciate your response!
lol!
Natalie, I was thinking you wanted me to tell you what my total TBG was- that’s why I got a good laugh at myself. I should have explained my laughter. I’m thinking maybe it is Thyroxine binding globulin? We live in a world filled with acronyms don’t we?
http://en.wikipedia.org/wiki/Thyroxine-binding_globulin
I know I shouldn’t use Wikipedia, but I sometimes go there when I want to find out about something quickly. That’s my confession for the day 
I know your postings are from Aug., but I wanted to reply. I am 64+ now, but became type 1 diabetic at age 30. At age 32 I was diagnosed with Addisons Disease and 30 mg. of Hydrocortizone seemed to work for me. I now take 10 mg AM and 10 mg noon. I can tell you the more cortizone you take, the more insulin you will need to maintain good BG levels. Well, at age 63 I was diagnosed with thyroid problems. I am on Levoxyl .025 mg M-Th and .050 on Fri, Sat. & Sun. I'm not really happy about this because I continue to lose hair, hails are thin and cracking, I'm a mess mentally (Ms. Grouch) and tired... My thyroid tests reveal 4 which the doctor says is normal. I'm not really happy about this...Don't know how to get her to realize there's more than statistics to making a person well. I need to find out another type of thyroid med that will work for me. Hope this is posted...I haven't noticed any recent activity.
Hi Suz, It sounds like you've been through a lot in the past 34 years, but you're still alive and kicking! I do know what you mean about labs looking "normal" when you feel anything but normal! Because of my decreasing health I eventually went to different physician (not an endocrinologist) who put me on Armour which is natural thyroid since the synthetic Levothyroxine (T4 only) drug was not working for me at all! I feel much better and I am not so fatigued either :) I also went on a gluten free diet. That is something you might want to consider. I find that endocrinologists are not very willing to prescribe natural thyroid. As others have posted, it's really important to have your Free T3 and Free T4 tested. The Free T3 should be in the upper range of "normal." Post your thyroid lab results (if you feel comfortable doing that) for us to see. This community is so helpful! I would say find a different physician, but when it comes to endocrinologists who prescribe natural thyroid medication....that's a challenge! I'm in that situation right now. I'm glad you're with us :)
Ya I've taken cortef for adrenal fatigue before, it does make your sugars higher. Hashimotos is so hard to deal with, way harder than diabetes. I know what your going through and its not fun, I've been through the worst trying to deal with my hashimotos. I would have your reverse T3 checked because that will tell how well your using the T4 med, if your reverse T3 is high then it means active T3 isn't getting to your cells and you would probably have to back down on your T4 med and add in T3. I figured out that adrenal fatigue is mostly about diet and supplements. The way I got over mine is I stopped eating all gluten, it takes a while but over time your adrenals will go back to normal if you stay on a gluten free diet. Also taking a vitamin b complex, vitamin c, magnesium and omega 3's really help. Another thing that will really help is working out everyday, for me anytime I work out and get my body temperature up I feel a lot better.
Heres what works best for me: gluten free diet, adding in T3 to T4, b vitamins/magnesium/vitamin c/omega 3's, working out.
I'm sorry I missed your post and am just now reading this, Tony! I'm no longer on cortef- actually, I took myself off slowly after only about 10 days of use.I'm seeing a preventative medical physician and will see a new endo later this month. My preventative doc has me on some great supplements, too. I added gluten back into my diet at the end of Dec, but not in a big way. I didn't notice any great effect after 2 months being strictly gluten free. I may go back to the gluten free diet, though. Right now I'm being tested for Lyme disease. I live in the woods and over the Christmas break my neighbor tested positive for LD. I'm glad to know how supplements and exercise have worked for you! I've been able to practice yoga again and I've been sleeping much better :) Take care and thanks again for your response.
The FT3 is the more active form; leaving it too low will cause problems.
There are now three medicines for treating low FT3.
You could ask your endo to look up the names of the other two and decide if either of those would be reasonable to prescribe to you.
For the names of the other two, go back to the August, 2011 portion of this thread.