HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment To Overcome Fatigue

default
Posted on Sat, 29 Nov 2014
Question: Hello Dr, I believe that I might be struggling with adrenal fatigue. I'm a fitness enthusiast and was accustomed to working out 90 minutes per day (both cardio and muscle training).

About 60 days ago my body totally gave out and since then, I've been unable to exercise on any type of fixed schedule. Lately, it's become much worse. My entire body feels drained of all energy, especially when I start to exercise. Also, my heart rate (both resting and exercising) has been higher than it should be (95-110 resting; 180 when exercising)

I was recently diagnosed with minor anemia and have been taking folic acid to combat. However, this has not helped at all. I had my adrenal system checked and my cortisol levels were above 20 all day long and even higher right after exercise.

Also, a recent TSH test revealed a very low .029 uIU/mL.

Any help or suggestions would be great or any products you might have that would help my condition

Kind regards,
XXXXXXX XXXXXXX
doctor
Answered by Dr. Shehzad Topiwala (4 hours later)
Brief Answer:
Adrenal

Detailed Answer:
Sorry to learn about your symptoms of fatigue.

Are you still on cortisol supplements?

If yes, there are some that raise the level of cortisol in the blood test, while others lower the cortisol in the blood test.
It is a tad complicated to understand this. But essentially, the steroid's that you said you are/were taking can affect the blood cortisol test result in a way that makes interpretation of the test difficult.

Further, one should not suddenly stop steroids. So I need to know exactly what type of cortisol supplements you take or took, and for approximately how long.

When steroids of the cortisol type are abruptly discontinued, they can adrenal insufficiency, and produce symptoms similar to the ones you are experiencing.

Furthermore, steroids like cortisol, in high doses, can lower the TSH as is the case with you.
If you are currently not on cortisol supplements, the the lower than normal TSH merits evaluation for two possibilities that can explain your symptoms. One is an over active thyroid and the other is an underactive thyroid.
When I see someone like you in my practice, I order
CBC
CMP
TSH
Free T4
25 hydroxy vitamin D
Serum cortisol at 8 am

If the Free T4 is high along with a low TSH, the diagnosis is 'Hyperthyroidism'. Further testing is in order when this occurs to determine the cause of this. Treatment is directed at the cause, when found.

If the Free T4 is normal or low, then a rare condition called Secondary hypothyroidism is considered. It refers to an underactive thyroid status due to low pituitary TSH signal. In this situation, more blood tests are ordered such as
Prolactin
Total Testosterone
FSH
LH
Ferritin

I suggest you see an endocrinologist in person to undergo systematic assessment for this, which requires a thorough physical examination.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Shehzad Topiwala (38 minutes later)
thanks doctor!

my doctor has had me on armour thyroid (120 mg) now for about 2 weeks and I've felt even worse! high heart rate, muscle weakness, etc...

the only other I take are natural supplements - "super cortisol control" (now); rhodiola; Phosphatidyl Serine, and glutamine.

I really am hoping my primary refers me over to an endocrinologist because I feel terrible.

thanks again!
doctor
Answered by Dr. Shehzad Topiwala (13 hours later)
Brief Answer:
Follow up

Detailed Answer:
Armour thyroid is not recommended by thyroid experts worldwide. If one is correctly diagnosed with an under active thyroid ('hypothyroidism'), then the distinction between primary and secondary hypothyroidism also needs to made with certainty, as the implications are of utmost importance.
Levo thyroxine alone is the only recommended treatment for hypothyroidism in the vast majority of individuals with hypothyroidism.
Adrenal fatigue is also a myth, the way it is propagated in media. There is no scientific basis for these supplements.
I hope you see a qualified endocrinologist soon, who practices evidence based medicine
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment To Overcome Fatigue

Brief Answer: Adrenal Detailed Answer: Sorry to learn about your symptoms of fatigue. Are you still on cortisol supplements? If yes, there are some that raise the level of cortisol in the blood test, while others lower the cortisol in the blood test. It is a tad complicated to understand this. But essentially, the steroid's that you said you are/were taking can affect the blood cortisol test result in a way that makes interpretation of the test difficult. Further, one should not suddenly stop steroids. So I need to know exactly what type of cortisol supplements you take or took, and for approximately how long. When steroids of the cortisol type are abruptly discontinued, they can adrenal insufficiency, and produce symptoms similar to the ones you are experiencing. Furthermore, steroids like cortisol, in high doses, can lower the TSH as is the case with you. If you are currently not on cortisol supplements, the the lower than normal TSH merits evaluation for two possibilities that can explain your symptoms. One is an over active thyroid and the other is an underactive thyroid. When I see someone like you in my practice, I order CBC CMP TSH Free T4 25 hydroxy vitamin D Serum cortisol at 8 am If the Free T4 is high along with a low TSH, the diagnosis is 'Hyperthyroidism'. Further testing is in order when this occurs to determine the cause of this. Treatment is directed at the cause, when found. If the Free T4 is normal or low, then a rare condition called Secondary hypothyroidism is considered. It refers to an underactive thyroid status due to low pituitary TSH signal. In this situation, more blood tests are ordered such as Prolactin Total Testosterone FSH LH Ferritin I suggest you see an endocrinologist in person to undergo systematic assessment for this, which requires a thorough physical examination.