Wednesday, March 16, 2011

Low Adrenal Function Symptoms

ADRENAL BASICS

The adrenal glands produce many hormones which regulate the endocrine system (Pituitary Gland, Thyroid Glands, Parathyroid Glands, Thymus, Pancreas, Adrenal Glands, Gonads)
If the adrenal glands are not functioning well,
all of the endocrine system will function only on a low level which may result in related problems such as low thyroid, PMS, or diabetes.
The adrenal medulla (inner part) of the adrenal glands produces adrenaline a quick acting hormone which enables the body to cope stress especially in emergency situations: the body constantly produces and stores adrenaline
The adrenal cortex (the outer part of the adrenal gland) regulates mineral metabolism (sodium, potassium, chloride), water balance, metabolism (utilization and distribution of carbohydrates, protein, and fat), allergic and immune reactions (such as hypersensitivity, allergies, and autoimmune diseases) and the production of male and female hormones; these hormones are not stored in the body
These three primary hormones are produced in the adrenal cortex:
Cortisol which regulates blood pressure, blood sugar and muscle strength;
Aldosterone which regulates sodium and fluid balance
DHEA (precursor hormone to estrogen, progesterone, and testosterone) which influences stamina and libido
Low Adrenal Function

Usually symptoms of low adrenal function occur slowly
and gradually worsen
Symptoms become evident when body under heavy stress

Normal- high cortisol peak in morning tapering off to low at about 3am
Cortisol should peak in the morning to get you going, declining slowly and steadily throughout the day to sustain energy, then dropping off in the evening to allow you to drift off to sleep. This optimal pattern signifies healthy adrenal function.

When the adrenal glands are not functioning optimally, you can have a condition that is known as adrenal fatigue, or adrenal exhaustion. Adrenal fatigue often develops after periods of intense or lengthy physical or emotional stress, when overstimulation if the glands leave them unable to meet your body's needs.

S1 - early symptoms of low adrenal
S2 - mid symptoms
S3 - later stages called Addison’s disease (adrenal glands cease to function) Some other names for the syndrome include non-Addison's hypoadrenia, sub-clinical hypoadrenia, hypoadrenalism, and neurasthenia.

Early stages of adrenal dysfunction
Cortisol levels are too high during the day and continue rising into the evening. (can be in this stage for years)
increased sensitivity to odor- predominantly on noxious odors such as petroleum fumes; tolerance of perfumes
dark circles under eyes
susceptibility to bruising
allergies & intolerances increase

Middle stages of adrenal exhaustion
cortisol output may rise and fall unevenly throughout the day as the body struggles for balance, but levels are abnormal and typically much too high at night.

Advanced stage of adrenal insufficiency
adrenals are exhausted from overwork, and cortisol never quite reach normal levels

Symptoms of Low Adrenal Function


BLOOD PRESSURE
S3 - low blood pressure and or pulse (or changes in blood pressure or pulse); 80/50 to 110/70 (normal 120/80)
S3 -heart muscles become weak (myocardial weakness), circulatory failure can occur); heart slows
S3 - decreased blood volume (hypovolemiia - elevated pulse, diminished blood pressure, skin pale or blue esp. lips and nail beds, dizzy, faint, nauseous, thirsty, can lead to shock)
poor circulation due to reduced cardiac (heart) output (caused by weak heart muscle and dehydration)
heart palpitations (fast hard beating) and chest pain
S2 to S3 - tachycardia (rapid beating of heart over 100 beats per min)
S1 - lightheaded or dizzy when stand quickly (orthostatic hypotension) or even when sitting; unsteady or stop movement but still standing
S2 - fainting (peripheral vascular collapse)
slowing of heart rhythm
S3 - small heart size
may have mitral valve murmur or prolapse
easily becomes tired, exhausted
shortness of breath
sudden fatigue and muscle weakness- low blood pressure causes the muscles to weaken from low blood supply
poor circulation
lethargic (sleepy, doppy, foggy) and weak
hemorrhoids (varicose veins of the rectum) and varicose veins of lower extremities caused by blood pooling i abdomen and pelvis

BLOOD SUGAR
S2 & S3 - shakiness
S3 - low blood sugar (hypoglycemia) ; may need frequent small meals to stabilize blood sugar
S1 - excessive craving for sweets, fats, and salty foods; black licorice
S3 - severe insulin sensitivity
insufficient carbohydrate formed from protein results in hypoglycemia (low blood sugar) and diminished liver glycogen
(sugar stored in liver for energy)
lowered blood cortisol makes it difficult for liver to convert glycogen into glucose
fats, proteins and carbohydrates (the body’s reserve energy pools) can not be easily converted into glucose
during stress insulin levels are increased because of the higher energy demand of cells
insulin opens the cell wall membranes to take in more glucose to provide more energy to the cells
without adequate cortisol to facilitate the conversion of glycogen, fats and proteins (energy reserves) to new glucose supplies, the increased demand is impossible to meet and low blood sugar results (increased insulin and decreased cortisol)
may lead to addictions as an attempt to bring up blood sugar

DIGESTION
S2 - nausea & stomach problems; bloated stomach; gas, gas pains, cramping; indigestion
S3 - abdominal pain (may increase with exertion)
S2 & S3 - vomiting and diarrhea; gaging
S2 & S3 - irritable bowels or may move food too fast (hyperactive transit time) therefore malabsorption ; food exits stomach too fast causing poor enzymatic digestion
S1 - mild nausea, little appetite
S2 - inability to handle food high in potassium or carbohydrates unless combined with fats and protein
S2 - low levels of gastric hydrochloric acid
S3 - indigestion and poor absorption of nutrients - due to sluggish circulation in abdomen; poor carbohydrate, fat, and protein
metabolism therefore little energy
trouble digesting protein
S3 - malnourished due to inability to absorb micronutrients - often deficient in trace minerals necessary for electrolyte balance and tissue structure; anemia
S2 - tendency to constipation (slow digestion)
S3 - sores in intestines and stomach (gastrointestinal ulceration)
S1 - low metabolism ; gains weight easily even if don’t eat (also low thyroid)
S1 - women tend to put weight in lower half of body (pear shaped)
S2 - difficult to lose weight; may lose weight when they rest and recover
S3 - unexplained weight loss - decreased or loss of appetite
S3 - sudden weight loss; thin; can’t gain weight

EMOTIONAL
anxiety. nervous; tense; startle easily; worry, fearful; panic attacks
depression or apathy - caused from malnourishment
overriding fear - due to low energy and secondary copper toxicity
irritability
very serious; numb; may just stare and not blink
reduced tolerance for stress; difficult to cope
overwhelmed by daily tasks; difficulty functioning
decreased ability to handle stress
fluctuating mood
due to build of metals in body may have emotional problems: obsessive compulsive tendency; bipolar disorder, schizophrenia; emotional instability
nightmares

EYES and EARS
sunken around eyes
dark circles under eyes
fluid under the eye (result of low thyroid -hypothyroidism)
dry eyes
S1 & S2 - sensitivity to bright light
night blindness
long after image (ie. headlights)
S3 - dilated pupils, involuntary, abnormal eyelid movement
eye pain, blurry, hurts to focus
ringing in ears
chronic ear infections

FATIGUE
complains of fatigue or exhaustion (wired and tired); tense
awake exhausted - insomnia; sleep light; awake at 2-4 am; unrefreshing sleep
sleep best semi-reclining due to low blood pressure
need excessive amounts of sleep
tired in mornings - don’t really “wake up” til 10am
midday fatigue - sleepiness or clouded thinking from 2 to 4pm
burst of energy at 6pm
feel better after meals and in evening
sleepiness at 9 to 10pm
“second wind” at 11pm that last until 1am when finally go to sleep; insomnia
trouble getting to sleep and staying asleep (waking up middle of night)
generally low energy level in morning gradually rising, being highest late at night
S3 - slow, sluggish, lethargic movement
S3 - speech - slow and sluggish
S1 - chronic fatigue, low stamina and endurance (exertion producing profound fatigue)
S3 - response times slow down

IMMUNE SYSTEM
adequate cortisol balances and keeps the immune response from responding excessively: examples of excessive response - allergies and sensitivities
diminished resistance to infections; recurrent, severe illness;
esp, respiratory infections
frequent sore throats
ability to handle trauma and other stress is diminished
allergies - increased allergies (new ones); hay fever; more stuffy
unable to counter production of histamine and therefore tissues become inflamed; which causes pain throughout body
S3 - lower white blood cell levels; (leukopenia)
chemical sensitivities
wounds do not hear quickly or well
slow recovery from illness
chronic infections
Asthma, bronchitis or chronic cough
lymph glands swollen and tender (esp in neck)
atrophy of lymph system which lowers the body’s immune mechanisms
autoimmune problems
may be sensitive to medications and supplements etc.
and need small doses of medications

MENTAL
poor memory and memory retrieval; episodes of amnesia
decreased clarity of thought; easily confused; difficulty paying attention
hallucinations
headaches; migraines; constant headache
neuralgia (nerve pain) esp in neck and head


MUSCLES
S1 & S2 back pain
S2 abdomen tighten and cramp when move
S3 - extreme pain in the stomach, lower back and lower limbs (crisis)
flank pain - pain on side of body -between last rib and the hip
Pain with pressure on mid-back (over adrenal glands)
joint and muscle pain and aches caused by inflammation
muscle aches (esp in shoulders and back)
nerve pain - neuralgia esp. in neck
carpal tunnel
fibromyalgia
discomfort when standing; walking easier
lax ligaments (connective tissue); may be exceptionally flexible
may have flat feet, or be double jointed;
joint strains/sprains are common
Instability of joints leading to pain - low back pain, knee pain, feet and ankles, calves
uncontrollable restlessness; muscle cramping, spasms, jumpy legs; muscles cramp easily; esp shoulders
shaky
stiff- difficult to more
poor coordination
chest tight and pain
muscle weakness- related to insufficient carbohydrate and deficient neuromuscular function (muscles under voluntary control; ie incontinence (lack good bladder of bowel control); weakness may be sudden and severe (unable to lift feet and arms, blink, legs won’t hold weight)
numbness and tingling in hands and feet (low thyroid)
S2 - sensitivity to noise- startle easily

REPRODUCTIVE SYSTEM
S2 & S3 - PMS
skipping or stopping of menstrual cycle; can stop having periods
difficult menopause (due to adrenals inability to increase their production of estrogen to help compensate for the loss of estrogen from the ovaries); hot flashes
low libido
can lose pubic and underarm hair

RESPIRATORY SYSTEM
body is unable to respond to adrenaline because needs more cortisol - (normal response is for bronchi to become relaxed so air can reach lungs and mucus production is inhibited)
without enough cortisol there will be bronchoconstriction
(constriction of the airways in the lungs due to the tightening of surrounding smooth muscle, with consequent coughing, wheezing, and shortness of breath.) Bronchoconstriction can also be due to an accumulation of thick mucus. and swelling of mucous membranes which make it hard to breathe
Asthma, bronchitis or chronic cough
rapid respiratory rate (tachypnea)
S1 - frequent sighing

SKIN
skin rashes or lesions (injury, patches or damage) on the feet and hands; sores on the inside of the mouth
S2 - excessive pigmentation of skin and mucous membranes esp in creases (eyelids, inside knees and elbows) - darkening (blueish black around nipples, lips, mouth, rectum, scrotum, or vagina) or tanning beyond normal; may be pinkish or tan even where skin not exposed to light; increase in moles and freckles
S3 - Vitiligo (white spots or patches) uneven pigmentation
skin excessively dry (have little oil or sweating); scaly and thin
hair - straight; sparse on body, abundant on head; may be dull and dry
nails - thin, brittle
smooth finger-prints (flat/shiny); may have longitudinal wrinkles over finger pads (probable cause is low collagen level)
red palms or fingertips
pale or flushed color to skin
TEMPERATURE
S3 - subnormal body temperature -tends to have low body temperature around 97.8 or lower (can be high if have virus or infection)
fluctuating temperature - average of three daily readings changes from day to day (normal is to be consistent average temperature)
S1 & S2 - excessive sweating on the face and or hands
S3 - poor sweating
S2 - pallor and cold sweat; high fever, shaking chills
S2 - intolerance to cold (may have hypothyroidism) (have low blood pressure and poor circulation)
poor regulation of body temperature ; thermoregulation; (hot when warm; cold when cool)
S3 - temperature drops after exercise
cold hands and feet(clammy); may turn blue
heat intolerance - esp. with high humidity and low pressure

WATER AND MINERAL BALANCE
S2 - usually mildly dehydrated
S3 - dehydration - unable to concentrate urine which results in dehydration
S1 - dry mouth
S3 - kidney (renal failure) shutdown; (Anuria- inability to produce urine
S2 & S3- water retention and puffiness
S3 - swelling due to electrolytes unbalanced; esp of feet and legs, fingers
S3 - low electrolyte levels (hypochloremia); high potassium levels (hyperkalemia); crave salt to rebalance and avoid dehydration (must have more than normal salt in diet or will die)
S2 & S3 - excessive thirst and urination

ADRENAL CRISIS


Addison’s disease- at least 90% of adrenals destroyed
Occurs when adrenal glands are no longer capable of producing enough cortisol to deal with stress (accident, virus, pregnancy, heat, cold, burns, muscular fatigue, infections, nervous strain such as pressures, discord, change, shock, surgery, fear and worry, allergic reactions, menopause, lack of sleep, injury, chronic pain, hypoglycemia, noise, severe stress, starvation or dieting, over work, emotional stress, etc)
If low may appear well but with trauma, surgery, illness, infections, dehydration, emotional stresses etc. symptoms will appear
Life-threatening state
Caused by insufficient cortisol; treated with cortisol tablets or shots

*warning symptoms
*fever (if infection), chills, painfully cold (esp. feet); sweating
*mild nausea. loss of appetite
*dizziness; orthostatic hypotension (dizzy when stand up)
*headache
*joint aches
* low blood sugar (shakiness, wobbliness, irritability, faintness, hunger, brain fog)
* confusion
* mild diarrhea
* muscle cramps (esp. in back and neck)
* extreme weakness, loss of muscle strength, energy
* fatigue, drowsiness (asthenia); trouble staying awake
* skin turns pink or tan
* low fasting blood sugar
* feeling restless, confused, or fearful

If given adequate cortisol medication, rest, extra salt, frequent small well balanced nutritious meals, and relaxation, usually a person can avert a full crisis and possible death from shock.

Advanced symptoms (Addison’s Crisis or Adrenal Collapse)
body temperature low; VERY cold; feet and lower legs feel like in ice water; lips cold and blue; pale
severe nausea
vomiting and/or diarrhea
vertigo- severe dizziness
very low blood pressure (shock- peripheral vascular collapse)
severe pain in the abdomen, lower back, or legs
unable to move or even speak- slurred speech
loss of consciousness from acute hypoglycemia (low blood sugar)
renal shutdown (nitrogenous waste build up in blood stream)
severe dehydration ( unable maintain salt and potassium balance)
shock- circulatory collapse; death

Cancer and heart disease, and Parkinson’s and Alzheimer’s can be end-stage results of toxic accumulation and energy depletion (low adrenal function).



22 comments:

  1. I had been on synthroid for about 12 months. I was cold all the time, had dry flaky skin, and could not lose any weight even with a strict diet and exercise.I have been taking bovine thyroid for about 2 months now. My skin is not nearly as bad than usual.

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  2. I have been tested and my thyroid T4 production is a bit low but not low enough to need to take thyroid supplementation. I am cold with a temperature of 93 to 95 in the mornings and my skin can be dry. When I take my hydrocortisone, my temperature starts to rise. Also now that I am taking a higher dose of hydrocortisone, my skin is less dry and I am starting to slowly lose weight.

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  3. I am not taking hydrocortisone. I am on Fludrocortisone. I am very cold. I get dizzy when standing my pressure was very low the other day. I am now a caregiver for my husband and we have had a lot of stressful things happen in our lives too. I am truly tired. I am on synthyoid, but should I be on hydrocortisone too.

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  4. I can't function without hydrocortisone. Fludrocortisone helps with blood pressure, but the hydrocortisone enables me to deal with stress. Otherwise I am extremely ill. Hope you are feeling better.

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  5. Dear E. Russell,

    I am doing pretty well. Most doctors, including endocrinologists, don't have any idea what to say to us. This is a rare disease, though I think more people though are experiencing stress adrenal glands so maybe it isn't that rare.

    Reducing stress isn't easy. You sound like you have had a lot of stress during the last few years. Little things like eating organic food and filtered water can help and it also helps to have a positive attitude. You need to feel that there is something in your life that you can control. I try and look at all I can do instead of my limitations. That helps.

    Yes, low adrenal function makes you feel constantly exhausted. If you can squeeze in a nap or two during breaks, it will help. It takes a long time and lots of good care of yourself to allow your body to recover from stress. Some people take a small supplemental dose of hydrocortisone to help their adrenal gland heal. You could ask your doctor about that and what vitamins and minerals he recommends.

    Your body sounds like it isn't able to handle all the stress if has been put under, but anything you can do to cut stress will help you feel a little better.

    I find that moist heat helps with the pain so I can sleep better so I soak in a hot tub before bed.

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  6. es, I experience stiffness, swelling and pain especially in the hands. It increases the more tired I am. I have been told I have fibromyalgia but not arthritis. The cortisone in your body helps the body to control inflammation. When your cortisone levels become depleted, they you are more inflamed and experience pain. Also the adrenal glands produce hormones which regulate water balance in your body. If these hormones are also low, then you will have swelling and possible problems with blood pressure.

    The adrenal gland also help to manage your immune system. When these hormones are low, you will become more sensitive to everything around you.

    Exercise will help some with water balance; eating food with potassium and getting enough salt will also help (don't over do though, but your body may not be retaining salt if your adrenal glands are not working well.

    If you rest and cut all the stresses down that you can, it help your adrenal glands to recover. (see my blog for ideas)

    You might want to talk to your doctor. Sometimes a small dose of hydrocortisone (very mild and low dose), can help the adrenal gland to recover.

    Hope this helps.

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  8. Just found your blog today. Was diagnosed at our local hospital's women's center about five or six years ago. What a battle! The traditional medical field outlook on it all doesn't help! I look forward to reading more of your blog in the days to come. Enjoyed living in Park City and working in Salt Lake City for twenty years. Hope all is well there!

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    Replies
    1. Yes, we are having a beautiful fall.

      It has been about twelve years for me. After my daughter's wedding (I got very tired), I just couldn't get back up. When I got to the point of not being able to eat or sleep, we discovered that my adrenal glands had quite working and I had Addison's disease. Do you have Addison's or just low adrenal function?

      It is a challenge to learn how to manage medication to handle stress and to keep all stresses at a minimum. Personally, I think being a diabetic would be easier in some ways. I have learned a lot and am a better person because I have had to deal with this problem.
      Cheryl

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    2. Doctors can certainly help, but they really don't know much about what to do to help. It is a lot of experimenting to see what works. My doctor gives me the parameters like blood sugar needs to be between 70 and 145 and don't take more hydrocortisone than 60 mg and then I experiment and give him the data and we decide what to do.

      Yes, pushing yourself really doesn't pay!

      Delete
  9. I havent been officially diagnosed... but for the..past two wks I've been really ill with pretty much all the S3 symptoms from my whole body being ice cold to sever pain and swelling in my abdomen and leg and had to be hospitalized. They said i was extremely dehydrated and lacking potassium, they did a blood and urine analysis and said there was no red flags and sent me on my way... Its been almost a week and i still feel sick and have been researching my symptoms day and night. which brought me to your blog, and gave me hope. what test are done to diagnose this disease?

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    Replies
    1. I'm sorry that I didn't answer you sooner. I just discovered that the emails were going to another file.

      They do a fasting blood test. It shows the level of adrenal hormones that your body is producing. When I had the test, my body produced no detectable level of cortisone. Sometimes people just need some adrenal support for a while then they can slowly cut down on the medication (hydrocortisone) and no longer need it. You will need to discuss the tests and treatment with your doctor, but you can feel much better with medication.

      Delete
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    ReplyDelete
  11. What an interesting site. I was managing my disease well for years with few crises however each one left me with extreme muscle weakness, unstable slow gait and the latest in November 2012 left me with ataxia movements, stilted, slurred speech and poor short memory. More than a year later, I still can't walk properly, my legs ache constantly and I have tingling in my feet.
    My endocrinologist says this is not typical for the disease and is unable to help me.
    Has anyone experienced anything similar?
    Sharon

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    Replies
    1. Low adrenal function should not cause problems like that, but I do have some problems with walking. Low adrenal does affect your electrolyte levels which affect your nerves. It also affects you ligaments, making them very lax and stretchy. Not feeling well for so many years has also resulted in muscle weakness and poor circulation. I am working at doing stretches and muscle strengthening exercises. It is helping with the numbness in my toes, pain in my lower back and dragging of my right leg. You might want to discuss your problems with a nerve specialist. Could you have had a stroke? Hope you are better now.

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  12. This comment has been removed by a blog administrator.

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  13. was diagnosised with hypothyroidism last year but I always felt thyroid was not my issue. After reading this blog, I would have to say 110% I have adrenal fatigue as primary and maybe thyroid as secondary due to the adrenals not working properly. In my research I found that even using the thyroid meds that it may help for a small time and then you will have to keep increasing dosage if adrenals are not taking care of first. I would like to stop the thyroid and do so gradually, so I can take care of adrneals first. (first I am going to get adrenal function blood work done, to confirm) Any thoughts ?

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  14. That is a good idea to test your adrenal hormone production first. That will give you and your doctor some information to make a decision on what to do next. My doctor also had me keep a journal of what I was taking, eating, exercising, sleeping and how I was feeling, what made me feel worse and when I felt better. It was a big help in trying to determine the right course. You might want to discuss your test results with an endocrinologist. If your Thyroid glands are the problem you probably will have normal levels of other hormones. If the adrenal glands are the primary problem, then all hormones will probably be a little low. Your test results should really help you know what to do.

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  15. Why on earth are mainstream doctors so willfully ignorant? this makes them absolutely dangerous! 10 yrs confined to wheelchair,swollen feet, ankles, loss of balance, vertigo, violent muscle spasms,shortness of breath, misdiagnosed with MS as well as more exotic labels ruined my life.

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  16. Hi my name is Lauren and iam 26 years old. For 2 months now I have been going to my doctors and there telling me I have anxeity and depression. It all started with me waking up in the morning, weak, stiff, feeling drunk, blury vision and different body temps. Then other symptoms occurred. Breaking out in hives randomly, cold chills, balance off, hot and cold sweats, blury vision, dizzy, gaining weight, bad acne, slow speech, can't concentrate, senstive to light, smells and sounds. More anxeity, heart races, shortness of breath, uncontrollably muscle movements, senstive to cold and hot at random times. Too many symptoms for them to add up so both my Nerologist and pcp say it's anxeity. My period is off as we'll. normal blood work and MRI was normal. I have fluid in my brain as we'll and just had a spinal tap yesterday. Still have the same symptoms. I looked up what could cause my condition and I got Addison disease. I don't know what to do anymore cause my doctors told me it's all in my head. I written symptoms down and kept notes. They said it sounds like I do have a hormone imbalance but there not concerned. Just wanted to know your thoughts. Thank you

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  17. You bring back memories-- most are unpleasant! I know what it is like to feel awful day after day, but I also know that when you find out what is the matter, you can feel a lot better. (the only symptom I didn't have was hives, but I had lots of food allergies and chemical sensitivities) When I was in my early twenties, I went to many doctors to find out why I was so ill. I was told to go home and take tranquilizers. For thirty years I continued to get worse. I began to wonder if the doctors were right and I was just "nuts", but I felt a strong assurance that something was really physically the matter with me. I know the Lord helped me make it through all those years when so many people told me I was "just depressed". Finally, in my mid fifties, my adrenal glands came close to quitting. I couldn't sleep or eat. After a rough three days, my doctor suggested that I try some hydrocortisone. Almost immediately I began to feel better. This was the only thing that had ever helped me to feel better, so we tested to see my adrenal function. It was a simple blood test to see the level of adrenal hormones in my body. We found that I had no detectable level of cortisone!
    Finding out what hormones your adrenal gland is producing can easily be done. I wish I had had the test thirty years before and saved myself from all those years of misery. If the test shows that your adrenal glands are functioning well, then you will know to try other tests.
    My prayers are with you. Don't give up!

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  18. I came upon your blog today and was very excited to see that other people are living with Addison's Disease too. I was diagnosed at 19 and now I'm 47. I've been living with Addison's for a very long time and I find that it's more difficult for me to manage the disease now than ever before. When I was younger I could get away with not taking as much hydrocortisone and still have the energy to work, but today I find that my doctors are frustrated because my dosages keep fluctuating. Basically, if I had taken better care of myself when I was younger, I may not be having so many problems today. My doctor prescribed Florinef (salt) tablets 1mg a day but my sodium levels are still dropping and potassium is super high. He wants me to increase the florinef to 2 mg but i'm already swelling up, gaining weight (20lbs from a year ago), and I feel like I'm going to pop like a balloon. I'm also constantly thirsty and hungry, especially for the obvious...salty foods. I"m frustrated with my diet and exercise but yet find that i'm being pulled in another direction because of lack of energy and always hungry. I feel like the disease is dictating how I look and feel and I no longer have control. I will let you know how I'm doing in the near future. Thanks so much for this wonderful blog!!

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