HC and Medrol

[Lethal Lee]

Hi Deb,

Feeling a bit better myself & now trying to catch up with posts.
Sorry I've been AWOL!!!!

BP HR & BP meds
Im having problems with my B/P-HR going high.

My B/P-HR this AM
8:06 126/89 88
9:01 126/100 128 1/2 cig
9:17 145/102 115 1/2 cig
9:29 141/98 105
9:41 131/88 95
9:50 132/93 87
10AM 129/88 86
11AM Sitting 136/87 71 Standing 123/87 88 Temp 98.1

Took 10HC, 1/2 tsp salt, B-Complex, 99mg Potassium, 1000 B12 and 600 Calcium at 8:30 AM.

Majority of your BPs look fine to me!!!!! The highest are only a bit high & didnt last long. Could easily have been from low blood sugar increasing Adrenaline. When did you eat prior to 9.17 & 9 .29 am readings?

Why do you need a BP med? Have you had a 24 hour BP monitor? Beta Blockers stop T4 to T3 conversion so taking Metroprolol would be a very bad idea IMHO. Only work around is to take T3 only. You are still very HypoT as per these results. Most BP meds mess with electrolytes either directly & indirectly so I would NOT take the BP med if it was me. IN fact my BP & HR was MUCH MUCH higher than any of your readings. I had BP 24 hour monitoring 3 times. Cardiologist said DESPITE BP spiking high I did not need a BP med. Florinef & Balancing Potassium & Sodium stopped the spiking & reduced my HR.

31st Jan'09 *on 1 grain Westroid
TSH........................2.44 (0.35-5.5)
Free T3................... 2.8 (2.3-4.2) *low 26% in range
Free T4................... 1.0 (0.61-1.76) *low 34% in range

14th Feb'09
TSH..................... 1.321 (0.450-4.500)
T3 Free...................... 3 (2.3-4.2) *37% in range
T4 Free................. 0.91 (0.61-1.76) *27% in range

FT3 has improved a bit but both FT4 & FT3 still far from optimal

Florinef Sodium & Potassium
Not sure how to go about starting the Florinef without knowing where my sodium and potassium levels at.I'm supposed to start 1 Tab Florinef. Do I start 1/4 tab florinef in the morning?I'm having diarreah thru all of this.

Sea Salt - now up to 1/2-1/2-1/2-1/4 = total 1 3/4
Potassium - tried increasing to 99-99-99-99.

That lasted 2 days and then I had to back down as my left arm, shoulder and chest ached.
27th Oct’08
Florinef 1 Tab 99 days
Sea Salt daily 2 1/4 tsp
Potassium 99mg 4 x daily 400mg
Sodium......................136 (135-145) *almost bottom of range
Potassium.......... .......4.2 (3.5-5.2) *suboptimal
29th Jan’09
Sodium......................134 (136-145) *deficient
Potassium..................3.9 (3.3-5.1) *very low in range
31st Jan’09
Sodium.....................139 (136-145) *very low in range
Potassium................ 3.8 (3.3-5.1) *very low in range
2nd Feb’09
Sodium.....................134 (136-145) *deficient
Potassium................ 3.9 (3.3-5.1) *very low in range
14th Feb'09
Sodium.....................136 (135-145) *almost bottom of range
Potassium................ 4.4 (3.5-5.2) *pretty good level

Obviously the Sodium is still way too low. The Potassium is not bad though I think you were on 3x99mg Potassium at the time? If so I am surprised that it is so good with the low supps you are on. Was the recent test done in am before any meds & supps? Looking back on results above Potassium has been really low usually.

Anyway I would start the Florinef at 1/4 tab. You know the drill. Increase 1/4 tab at a time every 5-7 days or so. Watch your vitals (BP , HR Temps). Watch out for any low Sodium/low Potassium symptoms. May be able to reduce Sea Salt supping once get up on the florinef.

1 tab Florinef is average dose though some need less & some need more. Some need to split the dose some do OK with am only dosing.

I would get up to 1 tab (either 1 tab am or 1/2 am & 1/2 pm) stop there for a wekk or two & retest electrolytes at that time.

Vit D & Calcium
27th Oct’08
Vit D............... 31.9 (32.0-100.0) *bottom of range
Calcium.............9.5 (8.8-10.2) *mid range excellent result

14th Feb'09
Vit D ...............63.3 (32.0-100.0) *46% in range
Calcium............ 8.7 (8.5-10.6) *9% in range far too low

Great improvement on previous Vit D result. You have been supping Vit D 4000 daily for last 3 months I think? I would keep supping Vit D for a couple more months then maybe drop to 2000 IU daily.

Not so good re the lowered Calcium. I know you are taking Calcium supps 1200mg daily & have for some time? I dont think they are helping as far as I can see?

I suggest you consider adding 10,000 IU Vit A daily (usually very cheap) to help optimise Vit D & Calcium levels? I take softgells 5000 IU 1 in am & 1 in evening.

DHEA
June `08
Estradiol……………22 (19-528) *very low
Progesterone………. ....0.3 *very low
Follicular 0.2-1.4/ Luteal 3.3-25.6/ Mid-Luteal 4.4-28.0
Testosterone……….. ....32 (14-76) *very low
Testosterone Free... 0.50 (0.10-0.85) *very low
Free Test %............ 1.57 (0.50-2.80)
DHEA- S…………............47 (32-240) *very low
14th Feb'09
DHEA 523 (110-554) *is this DHEA or DHEAS?

This looks like DHEA? Unfortunately cant tell if DHEAS is good from the DHEA levels. You may have trouble with converting (done by Liver). Doesnt tell you whether Testosterone is good either.

CBC Test
29th Jan'09
HCT..........................43.1 (36-46%)
14th Feb'09
HCT..........................45.2 (34.0-44.0) *slightly elevated

All other CBC results now in range except Hematocrit (HCT).
So WBC, Neutrophils, Monocytes no longer elevated. So looks good likely infection has passed.

HCT is increased in:

-Dehydration as might occur with prolonged or severe diarrhea.
-Emphysema, severe asthma, and other forms of long-standing respiratory distress.
-Macrocytosis (deficiency of B6, B12, folic acid, or hypothyroid)
-Adrenal cortex overactivity.
-Polycythemia vera.
-High altitude adaptation
-Splenic hypofunction
-Testosterone supplementation

Likely your slightly elevated result is due to some dehydration from low Sodium & the recent diarrhea

Carbon Dioxide
31st Jan’09
C02.......................... 23 (23-29) *bottom of range
14th Feb'09
CO2...........................21 (20-32) *almost bottom of range

Not much change there still bottom of range. At least its not deficient as has been in the past.

When bicarbonate levels are higher or lower than normal, it suggests that your body is having trouble maintaining its acid-base balance or that you have upset your electrolyte balance, perhaps by losing or retaining fluid. Both of these imbalances may be due to a wide range of dysfunctions.

So likely the electrolytes are still the issue here as well.

Ferritin
27th Oct’08
Ferritin................81 (10-291)
14th Feb'09
Ferritin.....?

Has Ferritin result come through as yet?

[dseezs]

Hi Ya Lee,
I'm glad you're feelin better. I was getting worried about you. Hope it isn't or wasn't serious and everyone in the family is alright.
On to questions. I ate at 8:15-8:30 like always cause that's when I do my meds.
I've been really paying attention to the adrenaline lately! Seems to be happening a lot. I've been thinking since yesterday that I've been smoking a lot more lately. The need for more HC? Never had the adrenaline like this before on higher HC! A thought? Wonder!! My B/P goes up having a ciggie EVERY time!
That B/P med scares the crap out of me. I haven't taken any. When I asked the nurse what effects I should look for when taking it she couldn't answer me and changed the subject. So I'm NOT taking it. I did wear a heart monitior for 24 hrs. but never have seen or heard any results.
I'm wondering if the improvement of the FT3 is from the addition of salt and tryin to balance electrolytes better. Is that possible? I haven't changed the amt. of Thyroid I take. I can tell that I've been depressed as all get out the last week or so again.
At the time of last Sod. and Potass. I was using 99mg Potass. 3x and 1/2-1/4-1/4-1/4 salt. The potassium suprised me. I didn't think it would be that high. Potass. supps worked well! As of today I'm still at the same amt. of Potass.,but I've increased my salt alot. Now 1/2-1/2-1/2-1/4+1/8 last night.
Another thing to throw a wrench into things, getting my period. Thinking about things now it seem we pretty much went thru this same scenario last Dec with my period. Just a thought.
Anyhoo, I started 1/4 tab Florinef today. What a kick in the butt! Definitely felt that kick in! I got dizzy big time just turning my head.
I'm going in to see Dr tomorrow AM to go over my test results. I'm planning to be nice to her stupid nurse, but when she finds out Im not doing things the way she(the nurse) told me too I expect her to be pretty snippey with me. Esp. not taking the B/P med. I plan to ask to get Sod and Potass. checked just to have some idea since now starting the Florinef. I expect to add Potass. with the added Florinef. My B/P actually went up a bit today with the Florinef but I don't expect it to last.
To clarify if I've got this right. I should keep up with the Florinef until my B/P rises at least 10 points on standing? And reduce my salt if my B/P gets too high? Top or bottom? Is this the right way to go about it?
That's another thing adrenaline gets better with the addition of salt. It doesn't last but that's what has been happening. My achey hurting right kidney area and ribcage seem to also have gotten better. Not much problem with that lately.
I increased my Calcium VitD and Magnesium. Calcium 1200 to1800, Vit D 4000 to 5000 and Magnesium 500 to 750. You think I should stop that and take Vit A? Is that fat or water soluable?
This is DHEA, that's the test she wanted. She said she wanted it included as part of her baseline as where to start treatment. I don't know.
Still have diarrhea. Seems the salt goes right thru me. I realized yesterday that the only time I'm drinking is when I take salt. 5 or 6 glasses a day of water. And that's the only times I eat much too. No appetite! I've been trying to do better today.
My Ferriten result is 83 (10-291). I'm not understanding why it hasn't dropped with the periods I have but will take this and count my blessings that I don't have to supp it anymore.
I got and email from Econo that the LabCo I use will no longer accept my lab samples thru the mail. I sent a letter begging them to help me out since I live so far away. Hopefully they will or I'll have to get things done the spensive way here.Then I won't get any results either. I'm praying it works out.
Glad to here you're doing better and hope it continues that way.
Hopefully Dr appt. goes alright and doesn't all blow up in my face too!
G'day or G'nite as the case may be
Thanks
Deb

[dseezs]

Lee
Can't sleep. Killer headache! Adrenaline rushes big time!
B/P not going up real high but high enough to bother me.145/90-80. I'm pretty sure it's the adrenaline doing it.
Can I go up on the HC while starting Florinef? I've got to figure out something to stop this! I'm miserable.
I think the headache (forehead, temples, back of head) is from crying so much today, but who knows. Won't go away. Had it since this afternoon.
My eyes tell me to sleep but the adrenaline says no way!
Whatcha think
Thanks
Deb

[dseezs]

I don't get it. I added 5 HC to my regular daily dose thinking I could get rid of this adrenaline. 30HC total daily for almost 2 days now.
This afternoon I can feel the adrenaline again. Started at 7:30 PM out of the shower B/P 125/77-79. Starting feeling the adrenaline hit me in the gut after having a cig and ever since then my B/P has been steadily climbing.
138/91-73 137/88-70 142/89-67 158/97-83. I sat on the bed watching TV. I got up to fold 1 small load of laundry and put it away. Sat and read some things on PC.
This adrenaline thing is driving me crazy. Its scary! I'm not doing anything but siting around and it hits me like a ton of bricks.
What do I do? ANYONE!!!!!!HELP ME OUT HERE! I CAN'T TAKE THIS ANYMORE!!!
Can this be cause my sodium is low or what? I'm totally lost here!
HELP!!!!
Deb

[Lethal Lee]

Hi Deb,

Getting this all sorted out is hell isnt it? Sure is a trial of patience that would frustrate a Saint!!!!

Its possible that 30 mg HC is not enough for you. However I think it far too early to say that as yet. You have increased only recently to that amount. Need to give it some more time.

As far as the Adrenaline it can be caused by so many things. First how are you eating? Regular frequent meals with good fats & protein to keep blood sugars regulated. Low blood sugar will raise Adrenaline.

This afternoon I can feel the adrenaline again. Started at 7:30 PM out of the shower B/P 125/77-79. Starting feeling the adrenaline hit me in the gut after having a cig and ever since then my B/P has been steadily climbing. 138/91-73 137/88-70 142/89-67 158/97-83.

The smoking is obviously affecting you. What can I say? If it causes Adrenaline & BP spikes you need to stop or at least cut down. Do you want to have to go on a BP med because you smoke? I know its hard. You are used to the extra Cortisol/Adrenaline it gives you. Maybe you could start weaning? Or if you feel craving for it take a small 2.5mg HC stress dose & see if that stops you having one?

Yes I do think your BP & HR is being affected by the Sodium/Potassium levels. As you say it looks as if the Salt is going through you. You cant take enough Sea Salt to bring up your levels so the only choice is the Florinef!!! Once on the florinef you should be able to just take 1-2 teas Sea Salt & be able to hang on to it without side effects.

By the way having a shower if often VERY stressful on the Adrenals. It has been brought up on RTH & Vals Forums from time to time. I used to shake & take 1-2 hours to recover from a shower even needing a stress dose!!!! I beleive its because our bodies are crap at regulating our temperature. Val advises to take showeres at close to body temp as possible & make sure the bathroom is heated to reduce the stress.

So I suggest that is time to start the Florinef. Leave the Potassium where it is for now. Just be vigilant for low Potassium symptoms. I would cut back on the Sea Salt to where it does NOT cause diarreah. No point taking the Salt if all you end up doing is making yourself further dehydrated & depleting electrolytes!!!

Now I know that you've struggled with Florinef before but I dont see what else there is to do but give it another try. Perhaps the answer is to go up reasonably fast?

Say start with 1/4 tab am & 1/4 tab pm with 99mg Potassium & 1/2 teasp Sea Salt in water with each dose. The timing of the pm dose I'll leave to you. I take mine at bedtime or possible late avo/early evening might suit you better. It just depends on when or if you have symptoms.

I increased my Calcium, Vit D and Magnesium. Calcium 1200 to 1800, Vit D 4000 to 5000 and Magnesium 500 to 750. You think I should stop that and take Vit A? Is that fat or water soluable?

I am wary of taking a lot of Calcium. I think contrary to what is propagated that most are in fact taking in TOO much Calcium already. Low Calcium is more likely a problem with absorption in the gut or VIt D deficiency/too low. Vit A I mean you should ADD to supplements. It helps with Vit D levels. It is fat soluble so dont dose too high with it. 5000 IU in am & 5000 IU in pm preferably in gel caps is fine & not likely to cause any problems. As far as Calcium goes I wouldnt increase it I think you are on enough probably too much already. I would stay on current dose or cut it back to ~1000mg & wait & see what Vit D & Vit A do for Serum Calcium levels. Increasing VIt D & Magnesium is fine as long as it doesnt increase diarreah!!!!!

Your period would exascerbate low Sodium of course as Progesterone is at its lowest then so lower Aldo then than at other times in cycle.

I sure hope you can keep on mailing in your blood samples. Its gonna make life a lot more difficult if you cant!!! Cross fingers for you there!!!!

The electrolytes sure do affect sleep even witjhout Adrenaline surges!!!! I'm still trying to get back to normal sleeping pattern after the heatwaves messed them up. I wasnt sleeping until 6-7 am but have now managed to bring it back to 3-4 am. Usually I get to sleep around midnight so am still working on that.

I sure hope that fixing your electrolytes will help with your sleep too. Last year it was optimising Progesterone that helped me. I guess it was also helping with Aldo/Sodium? Perhaps we should look at some for you at some point?

How did the Doc appointment go? Did you get your Ferritin result yet?

[dseezs]

Hi,
This is total hell. The Dr appt. seemed to go alright. Fri. Got an RX for Potassium.
Dr. said raise its OK to raise HC to 30 because of the adrenaline I'm having. Continue to raise the Florinef. Bump up Thyroid to 2 Grains.
So I go home thinking I'll be working on the HC acouple days, then work with the Florinef and wait a few days. See how things go. Leave the thyroid alone for the time being yet. Not too many things at once.
Didn't feel too bad that day. B/P's not too bad. Could still feel adrenaline but figured I'd wait it out and see what another day of 30HC would bring. Stil feeling OK til I really started to feel adrenaline about 7:30 PM . No smoking, just sitting and watching TV, folded some laundry,put it away. 8:33 PM 158/97-83. Sat down and was reading and posting on PC. 8:53 PM 162/94-71.
By 9:08 165/93-68 ate hard boiled egg, adrenaline hitting hard, laying down 9:13PM 154/95-64 9:17PM 163/93-64 knees start shaking feeling cold, teeth starting to chatter 9:26 PM 159/95-65 , 9:39 PM 167/98-84 really shaking all over and feeling very cold. Drank 1/2 tsp salt water. felt very cold and really shaking bad all over and couldn't stop. Couldn't feel the adrenaline atart and stop anymore. Went ot ER!!!
I was shaking so badly I could hardly walk also by then my head was shaking uncontrollably too. They put warm blankets on me becuase I said I was so cold. That felt really good. I told them I had just seen my Dr. the day before and that we talked about my adrenaline issues and going up to 30HC. He (the dope from last visit) didn't understand that. I told him I thought it was adrenaline causeing this and or electrolytes. Anyway to make a long story shot they gave me Ativan. The shaking stopped and I warmed up. After about 2 hrs of being there they sent me home with Ativan and RX for more. I flet like holy crap all day the next day and I don't think I'd have made it thru w/out the Ativan. I used Ativan this AM.
Part of this feeling crappy yesterday was because I dropped down to 25HC because of what the dope at the hosp. ER said. Why add more HC if you already have adrenaline? I couldn't explain 1- because I could hardly think srtaight and 2- he had just got done telling me once again that my electrolytes were fine. 137 and 3.9 what a guy!
I used 30 HC today. I needed the Ativan again this AM because of the lowered dose of HC yesterday I'm assuming. Not smoking much at all the last few days and the B/P still goes up. I've increased my salt 3/4-1/2-1/2-1/2 Potassium 99mg 4x. Thought of adding more tomorrow. I haven't touched the Florinef and am still at 1/4 tab.
I'm going in circles not knowing what to do. I totaly stumped by the adrenaline and didn't think I should really be messing with other things til that's sorted out. The Ativan bottle doesn't leave my side. B/P's still drop on standing as expected. Temp has been stable for the last3 days but that really isn'r saying much. 98.9-98.7-98.7
My B/P going high is what's got me bugged. It was 134/89-80 at 7:18 PM, I walked 8 steps to the PC sat and posted this walked the 8 steps back check B/P 153/96-89 and walked back to pc to finish posting. You tell me?
I have Dr. appt for tomorrow AM and we'll see what kind of plan if any she has, couse now I can't feel my butt with both hands and don't know if I really want to anymore.
Thanks for perusing this
Deb

[dseezs]

Hey
Doc has dropped me down to 25 HC from 30. I was having adrenaline issues then and now it's worse.
Does this mean I need more HC or Medrol? I can't take this much longer and my B/P is going up there pretty good just laying down.
What do I do?
Electrolytes still screwed up. Sitting at 1/4 tab Florinef and bumped Thyroid up 15 mg today.
Thanks
Deb

[Lethal Lee]

Hi Deb,

I think the drop in HC was a mistake. It hasnt helped the symptoms anyway. I would have thought leaving the HC dose alone & concentrating on Florinef & electrolytes would be the way to go. I would go back to 30mg HC. In fact with increasing Armour you may need a small stress dose for a day or two.

How long have you been on 1/4 tab Florinef now? Try adding in another 1/4 tab Florinef. Try adding it to late avo early evening as that is when you have had several episodes of high BP & HR. Only do as much of the Sea Salt supping that does not cause diarreah. No point taking more if you end up MORE dehydrated from diarreah.

I read that the Doc gave you rx for Potassium too? Have you filled the script as yet? Not sure that you need it YET but would be good to have on hand in case low Potassium symptoms appear & if the OTC tabs dont seem strong enough.

You are eating small regular meals with good fats, proteins & carbs to keep blood sugar levels regulated as much as possible. Low blood sugar will cause Adrenaline.

Still trying to moderate the number of ciggies & caffeine??

Are you still using the Ativan? All the Benzos have bad affects on the HPA & are extremely addictive but use it if you really have to especially if it helps you get to sleep. Just try to avoid having to use it more than once a day or for longer than a few weeks.

Last comment. If nothing else seems to help consider DOUBLING Hc for just one day. So instead of 30mg take 60mg HC (double each dose). This may be enough to knock the Adrenaline down & generally calm down the Adrenals.

Just go back to "normal" HC the next day. It is better to have a little too much rather than not ENOUGH. All this constant stress & episodes must be burning through whatever HC you are taking.

I sure hope things start to settle down some real soon!!!