Update: Hormones

I have an update following my recent appointment with Joanie. She reviewed my hormone level lab results which tested my Progesterone, Testosterone and Estrogen levels.  I forgot to ask for a copy of my labs for my records, so I cannot provide the reference ranges right now, but I do remember most of the information:

Luteal Phase (time of my cycle when labs were drawn)

Estrogen: high end of the reference range

Testosterone: normal range

Progesterone: lowest possible number on the reference range

I have been taking bio-identical progesterone since April of last year, without it I don’t know if I my levels would even be on the chart! Obviously my progesterone levels continue to be extremely low and my estrogen levels very high. I am hopeful that as I continue on Armour and continue to heal my adrenals that my body will be able to naturally refuel my deficient hormone levels.

It is no wonder that I have not been able to carry a pregnancy with such low levels of progesterone.  I am left to wonder if my body will ever heal itself in such a way that I can support a pregnancy naturally. This is one of the many questions I have for Joanie in a few weeks.

I have increased my zinc to 2,000 mg a day and Joanie has added Morinda Supreme to my regime again as my Candida continues to rear its ugly head.  I have also started to have some small rash breakouts on my skin.  When I showed the rash on my leg to Joanie she said immediately that it is likely the Candida.  She wrote a prescription for an antifungal cream and I left her office totally grossed out at myself. 

She also referred me to a new chiropractor and I will be calling to schedule an appointment soon. I think that is it for now. I have updated my treatment page.

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Good Things

I have waited to write any updates until I believed that the changes I felt were real and a sign that I am making progress.  I think I’m ready to fill you in and will have a post up very soon. 

Until then I have updated my treatment page from my appointment this morning with Joanie. 

It’s good, my friends.

Progress

A lot has happened in the month of August so far, and it’s still early in the month.  I have a lot to cover in this post.

Before I dive in, let me review the last few months.

In April I met my NP and discussed my health history and symptoms.  She ordered blood work which looked at everything: TSH, Free T-3 and T-4 and Reverse T-3, Iron, B12, Vitamin D. Pretty much a laundry list of things. I changed my diet by eliminating dairy, gluten and simple carbs from my diet, started a probiotic and Morinda Supreme as she diagnosed me with candida and “leaky gut”.  I know, that just sounds gross, and it really is. 

If there is one thing I learned quickly, it’s that your guts have A LOT to do with how you feel.

There was a delay at the lab and so my results took twice as long to get back. When I met with her in late May, at that time, my blood lab results were “relatively good” and she determined that I was not hypothyroid just really stressed and low in my Vitamin B’s and Vitamin D.  She did agree to start me on Lugol’s Iodine solution (6 drops, daily) to see if that would help my fatigue, anxiety, weight, etc when I pressed her for an explanation as to why I felt so drained and agitated all the time and my temperatures were low.  She also increased my B Complex, and Vitamin D3. 

Over the next few weeks, I did notice a subtle improvement in my energy (any improvement was noticeable) but I still struggled with nearly constant anxiety and all the fun stuff that comes with that: avoidance, irritability, exhaustion. 

It was a really discouraging couple of months.  I expected that my blood work would have bright flashing hazard lights indicating thyroid issues and it was a huge let down when that didn’t happen but my symptoms persisted.

I was encouraged by my husband to continue to look for help for my anxiety and depression and so I entered counseling to help me process everything that was going on: my grief from the pregnancy losses, my health, my vocation, the challenges I experience daily just getting out of bed.  All along I have said that I just want to be healthy and find out what the problem is. I am willing to recognize that the last few years certainly justify feeling depressed and I am not a stranger to the benefits of counseling as I have found great healing and renewal through this process in years past. 

It’s work, though!  Whew!

So far, counseling has brought me some great insight and my therapist  is a very kind and genuine woman.  Her office is my safe haven where it’s all about me and I can let out all my thoughts my complaints and frustrations. It’s also a place where I learn new ways of coping and looking at things. I am committed to working on my whole self: body, mind and spirit.

In July, my husband, who is also treated at the clinic I go to, had an opportunity to mention to my provider what he sees me struggle with and she told him that we should do a saliva test to check for Adrenal Fatigue.  I had an appointment with her the following week and we agreed to do the test. 

On August 1st I had an appointment to find out the results from the saliva test.  Before she started to explain she looked at me and said, “I don’t know how you get out of bed in the morning.” I chuckled and said, “Well, it’s not pretty.”

Trust me. It isn’t.

I have been reading a lot about adrenal function and cortisol.  As I understand it, cortisol is one of the hormones the adrenal glands release to prepare us for challenges, including “fight or flight” situations. Cortisol, also known as a “stress hormone,” works by increasing blood pressure and blood sugar (for energy). These are helpful physiological responses in the heat of a stressful situation, but if they continue throughout much of the day, weeks or years, the body will suffer. Sustained levels of cortisol can destroy healthy muscle and bone, slow down healing and cell regeneration, disrupt metabolism and digestion, and compromise your immune system.

To help me explain my results, I took a picture of the graph that shows my “Circadian Cortisol Profile:”

image

 

The light grey shadow you see is considered normal range.  As you can see, I start the morning out low and just keep crashing.  Even though I am considered normal range by 4pm and midnight, she explained that I am still so low for “normal”.  I struggle throughout the day with energy, my anxiety is highest in the morning and then I feel more fatigued through the afternoon and evening.  I wouldn’t consider the way I feel as normal, either.

The saliva test also tested my Cortisol-DHEA Correlation. My results are in the picture below:

  
image

In order to explain this accurately, I’m going to refer you to this link: DHEA and Adrenal Imbalance, by Marcelle Pick, OB/GYN NP

Results showed I am in what is considered “Zone- 4- Maladapted Phase II”.  I’m just going to quote directly from my lab paperwork: (this) “represents a marginal cortisol output with reduced DHEA levels reflecting a limited adrenal response…this suboptimal response is any response not consistent with a normal diurnal cortisol production pattern.  This condition is usually the outcome of chronic and protracted stress exposure.” 

Uh, yeah!

A surprising result from this test was that I was found to be positive for Gliadin Ab, or Gluten Intolerance.  Borderline range for this lab was 13-15 U/ml.

A positive result is anything greater than 15/mil. 

My result was 32 U/mil which was described to me as moderate to severe gluten intolerance. 

I was surprised to learn this, although it made a lot of sense as to why I felt better when I consistently eliminate gluten. 

I think that this has been the slowest realization to sink in because I am faced with challenges every day.  I find myself repeating “I am gluten intolerant. When I eat gluten, my intestines are inflamed and my body doesn’t absorb nutrients I need.” 

I have read a lot about gluten over the last 2 years, where it hides and how to cook most “normal” things without it, so I’m not completely at a loss.  My greatest challenges are being prepared and holding the boundary when others I am with don’t have this issue.  At least now I have a medically diagnosed reason to be gluten-free.

I guess it feels more “official” and helps me feel justified when I explain it to people.

Adrenal Treatment:

I already updated my treatment page a few days ago, but let me explain in detail. Our plan to strengthen the adrenals involves taking Hydrocort at specific times throughout the day. I am working up to 7.5 mg (5 mg am, 2.5 mg at noon).

My NP has not prescribed DHEA support at this time as she wanted to see how I respond to the Hydrocort.  She also prescribed a supplement called Ashwaganda, an adrenal adaptogen that I also take in the am and at noon.

I started this medication just over a week ago and I am still building up to the full dosage.  I still feel extremely tired, but I can say I have noticed a lot of improvement in my anxiety, especially in the morning.  I definitely still feel anxious, but it’s more subdued than a week ago.  I am hoping that my energy improves over the next few weeks too. 

I’ll leave it at that for now. 

I still want to talk about what I have to teach myself about adrenal fatigue, fertility and how to effectively treat myself but I will save that for another post. 

I also have some very important information about thyroidchange.org, but I want to give it my full attention so I’m saving that for my next post coming soon.

Here I talk about cheese and spitting. Try to contain your excitement.

I saw my NP about a week and a half ago and I have a couple of updates:

I was pleased to learn that my diet and the Morinda Supreme capsules have helped my body start to heal internally, and I am trying my best to keep up with the food changes.  I don’t quite know what to call my diet.  Probably the “Can’t Eat That” diet sums it up best. This is difficult to do some days when I am just exhausted have nothing handy in the refrigerator to throw together and I know it would be so easy to call the pizza guy. 

Some days I stumble. My vices:  Red vines.  Margaritas.  Cheese.

 Oh, I miss cheese.

Especially when I am tired, or amped up with anxiety or knocked out by the summer heat on my drive home in my cranky car with the lukewarm AC.  And I slip knowing that I will very quickly start to feel even worse. 

I like to think it would be so much easier if I didn’t have an office to go to 40 hours a week, which is true, but it really boils down to being intentional with my time and planning ahead for days like that.  It may sound like an excuse, but maybe one of you reading will understand when I say that it’s hard to muster up extra energy to pre-cook freezer meals.  Of course, that’s if I remember in the first place.

I’m working on that.

This week I took a Saliva test to check for Adrenal Fatigue.  I actually have my wonderful husband to thank for advocating for me when he had an opportunity to speak with my NP.  He was able to share what he sees regarding my struggles and she listened to him! 

I love how he loves me.

I was already aware of this, but when I met with her in my appointment she explained that many of the symptoms of hypothyroidism and adrenal fatigue are the same and if there is adrenal fatigue there may also be underlying thyroid issues.  She said that a saliva test is the most accurate way to test hormone levels.  You can read more about why here.

She ordered a saliva test for me to complete and send to the lab.  It was very strange; I had to (literally) spit into 4 vials 4 times during the day: morning, noon, afternoon and midnight and then send it directly to the lab the next morning.  I am hoping these results won’t take as long as my blood tests.

 I have updated my Treatment page as well.  I have decreased my iodine and I am taking Vitamin C and Zinc. 

I take a freakish amount of supplements.

An update, as promised.

Here I am.

I know it’s been a while. 

I’ll try to make up for it with a ridiculously long post.

The last couple of weeks have been interesting, confusing and busy. I have had a couple of appointments with my Osteopathic NP since my last post.  I would say I am officially on a journey, although I have no idea where I am going.  It’s frustrating but I do feel like I’m in good hands.

My long-awaited and very extensive blood work revealed “relatively good” T4 and T3 levels according to my NP.  I have slightly elevated cholesterol and low vitamin D and B’s.  She explained that she could put me on thyroid hormone, but with my levels being where they are she would be concerned that it would have the opposite effect and send me in to hyper symptoms.  I asked her why my temperatures were as low as they were and why I was experiencing a number of hypo symptoms.  She hasn’t been able to answer that so far. Instead, she had me start taking Lugol’s Iodine Solution and up my Vitamin B’s in addition to the other supplements and probiotics I already take daily. Her reasoning was that because my thyroid levels were “relatively good”, perhaps the iodine would help with the transfer of the T3 to my cells.

I take 6 drops of Lugols Iodine Solution in a glass of water each morning.  It looks something like this:

 I also  take Vitamin B Complex in the morning and again in the afternoon, around 2:00, to keep my energy somewhat level.  I wouldn’t say I’ve seen immediate results, but I have noticed that at the end of the day, I feel like work days are more productive. I have even had enough energy, on occasion, to work on different house and yard projects without paying for it for a few days after.  No day is ever the same but I do feel “brighter” some days, if that makes any sense. Having enough energy to do activities I enjoy is really encouraging, even if that involves pulling weeds in my yard!

I am also maintaining my no dairy, gluten, carbs and sugar “food lifestyle” and I definitely believe this has contributed to feeling physically better.  I haven’t experienced nearly has many energy crashes after meals, headaches and general blech-ness.  I don’t know how long we will stay this course, but I am trying to learn to trust her and what treatment she believes is best for me now.  I continue to experience many of the same symptoms: fatigue, heart flutters, foggy thinking, anxiety, shakiness, acne, no weight loss.

She also increased my progesterone to 90 mg (sorry, not 45) because my cycle started to shorten again (back to 23 days from 25 last month) and I’ve started noticing hot flashes/sweats at night.  Not as bad as before, but noticeable. She thinks the increase in progesterone will start to lengthen my cycle again.  Our goal is 28 days.

At my appointment last week I asked about my weight and how I am surprised that despite consistent diet changes after my first appointment in April I have continued to maintain my weight. This has and never will be about me wanting to lose weight except to be healthy, but seriously, all I eat are almonds, almond butter, vegetables, legumes, some fruit and lean organic meat and my weight hasn’t budged in almost 2 months. At all. She explained that my body is in a major transition and there is a lot of adjusting happening right now.  The best thing I can do is to be consistent and to let my body focus on healing (as I crunch on a cucumber).

I have updated my Treatment page to include all the supplements I take and the iodine.

I’m working on a really lengthy post about an appointment with a Fertility Specialist I had a little while ago.  I’m still trying to put my thoughts together. It’s a difficult one to write about because it requires me to really think about the reality of my situation and what I am willing and unwilling to do.  It is a potentially touchy topic for others facing infertility and I want it to be shared in an open, honest and sensitive way because I think it is vital to my story and this journey.
Robin

The “Worst Blogger” Award Goes to….

(boo, hiss, *throw rotten tomatoes*)

Oh, good grief.  It happened again, didn’t it?  Weeks Months have passed and I have neglected this little corner of the web. My only excuse is the truth.  I’m busy!  Work, husband, family, house, laundry, repeat. 

Allow me to share a few highlights of what I’ve been up to:

Wanderings:  Since the first week of February I have delved into the world of running and I love it.  I’m no marathoner (not sure I will ever be) and that’s okay because that’s not why I do it.  These days I average about 10 miles a week.  I would like that number to be higher, but a lingering left ankle injury in March keeps me from pushing myself too hard, so I’m taking my time and building strength at my own pace.  I enjoy the experience of running and the high that comes after a good run.  I track all of my miles this year and will add that to the miles I spend hiking.  As for hiking, I am gearing up for a backpacking trip later this month (August).

Projects: This is where most of my extra time has been spent since you heard from me last.  I have put together my plan to complete several home improvement projects around our house this year and I will enjoy sharing them when I am am finished.  I will post them here as I complete them.  Sewing, crafting and home decor projects coming soon! I do have a couple of pictures of a few things I am working on:

Food:  I have stumbled upon some really great recipes recently and have succesfully created some of my own.  I am maintaining gluten-free cooking at home. July marked one year since I began reducing (not quite eliminating) gluten from my diet. It also marks a year since I started using chemical free products (hygeine, cleaning). I’m not 100% by any means, but I have definitely changed my way of living and feel heathier for it!

Bookworm Chronicles: Not going to go there. Page 534. 3 Years and counting….