My health: strategy for my low cortisol

written a week ago:

CORTISOL LEVELS WERE MEASURED REALLY LOW
I had a good think about that ridiculously low cortisol level that was measured the other day: 0,3 in the morning where a value between 25 and 60 is normal.

This tells me that on that particular morning my adrenals were not functioning at a sufficient level. However, I did manage to get out of bed, drive myself to the hospital, walk through the cold and get myself to the right department and seen to. So some cortisol was clearly still there, I was not in danger of adrenal shock. I don’t think I functioned on adrenaline or willpower alone, I certainly wasn’t pushing things or in a fighting mood.

However, there were a few problems that morning indicating insufficient cortisol. I did drive at 85% of my usual alertness (but as I am a perfectionist who usually operates at 115% and also have my motor bike license -which makes you a better spotter in traffic- I feel I was not a danger on the road). I was bothered by the cold very much, a known body stressor. I had trouble operating the machine where you present your hospital ID (hello brain fog) and my hands trembled when I spoke to the nurse (a sign my body was nervous and lacked the hormones to battle that).

So I’m not sure how to interpret the level totally correct.

The measured level however indicates my adrenals have now shut down completely. There’s a good case to be made for that theory:

WORKING THEORY
My adrenals have shut down (almost) completely, since end of August.

Looking back I’d say this happened at the end of August. And stress was the cause, not the low supplementation of hydrocortisone.
My stressors were:

  1. the death of my grandmother in the Spring
  2. supplementing Zinc and inducing Copper dumps during the Summer
  3. a non-relaxed holiday to Ireland at the end of August. Bad sleep and digestion shut down.
  4. a blow to the kidneys in mid September: too much weird food + dehydration
  5. ongoing kidney- and liver pain ever since, nausea (organ malnutrition as a result)
  6. worries about a trip to Morocco we were to take last week

nr 3, the holiday to Ireland was just too much. Afterwards I couldn’t get my digestion working well enough, I couldn’t refind my tranquility. In short: recuperation took too long and was too costly. Then nr.4 happened and my belly hasn’t been functioning properly for months now. Pains and pangs, uncomfortable feeling and nausea all the time. Looking back these are symptoms of too low cortisol levels, especially now that the ultrasound and the bloodwork do not show other causes. No cortisol means no stomach acid, no bile, no motility.

Lack of cortisol also explains why on occasion I’d fall into a deep, peaceful sleep whenever I took my regular dose of  hydrocortisone. Normally this hormone would activate a body. But with shut down adrenals it would just quell a screeching lack, thus providing peace. Peace enough to sleep. I was so surprised as it was the same sleepiness you get with progesterone overdosing. You cannot fight it, you just want to sleeeeep. But with progesterone you awake groggy. With this cortisol sleep I awoke fine. Rested (just unwilling to leave the bed).

Like I said, I think stressors caused the shut down, not the cortisol I’ve been supplementing regularly for over a year now. As I supplement only 12,5 mg of hydrocortisone per day I don’t think the hormone therapy caused the shut down. The amount quoted in literature is at least 20 mg. I’ve been supplementing this lower amount since August 2012 and from that date on I was notably getting healthier and more active by the month. It is why I started to drive my car. It is why I felt confident enough to detox with the Zinc and the genome results.

A normal dose for someone with shut down adrenals is 20 mg or more. Or the other way around: doctors report people’s adrenals shutting down when doses of 20 mg or more are administered.

Shut down adrenals do explain why I needed absurd high amounts of progesterone the last two months. My body was scrambling for any and all progesterone to convert into cortisol. Indicating some level of function in the adrenals, btw.

THINGS THAT DON’T FIT NEATLY IN THIS THEORY:

  1. When that low level was measured I still functioned at an acceptable level
  2. at night I still often wake up with a cortisol peak, 8 hours after my last hydrocortisone dose which has been totally gone from my system by then.
  3. Four weeks ago I got a cold. The first one since I fell ill in 2008. A cold indicates that my immune system was too weak to keep it at bay. Usually immune systems get suppressed by cortisol which is why stressed people (with healthy adrenals) get every virus during flu season. How could I get a cold when my immune system is running wild and unchecked for years now?
  4. I am sensitive to low doses of anything. It may well be that 12,5 mg is enough for my adrenals to shut down.

We can think of reasons that make these things fit the theory anyway.

  1. I got to the hospital fine? I must be able to function at lower levels than other people. I sure do so with other hormones and medications. Or adrenaline makes the system go without causing its usual jumpy state.
  2. I wake up? My adrenals work sometimes, especially at night when blood sugar drops or I get too cold or dust allergy kicks in or insulin surge from the previous day catches up with me.
  3. I get a cold? My number was up, this was probably a particular persistent virus. I finally met a peron carrying a virus, haven’t met one for years which is the real reason I haven’t had a cold or the flu/ Or an alternative: the trip to Morocco had me so stressed out that I did make more cortisol and with that suppressed my immune system enough to contract the cold. I sure was worrying about it and determined to get it done. Got my fighting modus on. The funny thing was that once I conceded that I was not to go on the trip I took to bed and fell asleep, I developed a high fever and broke the cold in the next 18 hours. After that I had to lay a week in bed to recover. And another two weeks to recover properly. I am now back in the cabin and just today and yesterday I’ve felt alive again. Active. But this can also come from not being in the city. I am more charged in the city. And in need of more cortisol there.

 

CONCLUSIONS

At the moment my adrenals are not functioning. Supplementation is needed. More than 12,5 mg. At least enough to get my intestines working again properly. Aim for 17,5 mg. Digestion is a measuring stick. Getting hungry indicates I took too much.

Higher supplementation will shut down the adrenals for sure. Or keep them shut down. This brings risk, life threatening risks. I am aware of this.

Shut down adrenals an sich is not a problem. There’s a school of thought in medicine that thinks that a short amount of time will give the adrenals a chance to heal.

This will be my working theory. It can be amended when results contradict.

 

STRATEGY

Have shut down adrenals for the next few months. Aid them with enough hydrocortisone to keep my body out of stress and to have digestion functioning again.

Enjoy the peace. Rest up. Relax. Enjoy life. Don’t worry, don’t fret. Take plenty progesterone.

Be aware of the life threatening dangers. Inform loved ones. Always carry hydrocortisone on your body.

In February/March slowly wean off of the hydrocortisone. See if the adrenals kick in again.

If they do so: YAY!

If they don’t: visit the Adrenal Specialists in Radboud to become an official Addison’s patient and explore with them if it’s the adrenals or one of the brain glands that’s kapot.

 

ANOTHER PUZZLING BLOOD RESULT

Homocysteine was below 6. This is lower than you would expect under my working theory that my DNA mutations cause too high homocysteine. Has my supplemention of mB12 and Florinic Acid corrected my levels in only 3 months? Or is this a heterozygote mutation and did the incorrect gene never express?

things to think about next.

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