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Dr. David
Dr. David, Board Certified Physician
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Dear Dr, I am 47 yrs female who has been out for many years

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Dear Dr Thomas, I am 47 yrs female who has been burnt out for many years & couldn't find anyone to correctly diagnose me. Then I found a GP here in Australia who had good knowledge of Adrenal Fatigue, he put me on Dr ***** *****'s supplements. After more than a year I don't feel very much improvement. A friend has suggested that perhaps he should have started with detoxing my liver before putting me on supplements & drops. What are your learned recommendations that I can do or try to get better improvement to my health?  It is all making me quite depressed.  I also suffer from fibromyalgia and have some ankylosing spondolosis.

Hello, this is Dr. David. I have read your question and I'm ready to help.

can you tell me more about your symptoms you are having?

have you had blood testing to check your adrenal hormones? ACTH levels? AM cortisol testing?

have you had thyroid hormone testing?

how about liver enzyme testing?

are you having regular periods? any signs of menopause?
Customer: replied 3 years ago.

Can I also please add that the daily 'brain fog' is almost as hard to cope with as the constant lethargy.

I see

have you had blood testing to check for thyroid hormone levels?

are your periods becoming irregular? or have stopped? this would be a sign of menopause which comes from drops of your estrogen levels and can also cause brain fog and lethargy.
Customer: replied 3 years ago.

My apologies as it seems my first reply to you did not come through, so I will go back and answer your original questions if ok?

Symptoms-constant lethargy, brain fog, constant 'mental chatter' even while asleep, extreme back pain and joint aches.

Testing-many times I had my thyroid checked by other GP's but came back normal. Only when new GP did saliva testing (at different times during the day) was it picked up that my adrenal glands were quite low but not Addison's disease fortunately. Blood tests for liver always came back normal. Liver enzyme testing I can't remember having that done. Please advise what ACTH levels mean so I can try & remember if I've had them tested.

Periods were always heavy & for more than 7 days so I had a "Marina" inserted by recommendation so periods are now light and irregular. That was done 7 years ago. No signs of menopause or peri-menopause as yet!

In answer to your second lot of questions:-

Estrogen levels I think were ok but Testosterone slightly low.

Customer: replied 3 years ago.

Also I had been on cortisone medication and creams throughout the years previous as I suffered badly with sinus & chest infections and allergies.

ACTH is Adrenocorticotropic hormone and is the hormone your pituitary gland makes to stimulate the adrenal glands to function and make steroid hormone. a proper workup of your adrenal glands has to include more than just salivary cortisol levels. you need to see an endocrinology hormone doctor and get blood testing to include AM cortisol levels and also blood testing for ACTH to see if the problem of low steroid hormones in your body is due to your adrenal glands not working correctly or your pituitary gland not telling your adrenal glands to make more cortisol hormone for your body.

if you have had a history of heavy periods, you need to get your iron and ferritin levels checked. you could have low iron levels caused by loss of lots of period blood which can cause fatigue and brain fog as well. B12 and folate levels should be checked as well.

make sure your thyroid stimulation hormone testing or TSH levels are between 0.3 and 3.0. levels above 3.0 could mean you are hypothyroid

long term steroid therapy can actually decrease your immune system strength and cause you to have more infections. so you have to be very careful about how long you take cortisol and what your true adrenal functions are.


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