Now Low Cortisol? Already Hypothyroid And Low Hormones. What To Do?

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CaliforniaKat

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I thought you might like to read this from the email depository.

Thank you SO MUCH @Blossom
This is exactly what I needed to read. And will be researching on the forum all weekend before I try anything. I really felt great on T3 only for years, until Grossman was no longer available from Mexico (or anywhere else). Plenty of health stuff has crept up in the few years I have been on NDT, and have never felt as good. It would seem, initially; that pregnenolone and progesterone and T3 might be what I am looking for.
 
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CaliforniaKat

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So, I know I have seen it here, and now I have to find it. There is a really awesome flow chart that someone posted that shows the hormone cascade and which things convert to what with sex hormones and cortisol, etc.
 

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Thank you SO MUCH @Blossom
This is exactly what I needed to read. And will be researching on the forum all weekend before I try anything. I really felt great on T3 only for years, until Grossman was no longer available from Mexico (or anywhere else). Plenty of health stuff has crept up in the few years I have been on NDT, and have never felt as good. It would seem, initially; that pregnenolone and progesterone and T3 might be what I am looking for.
That sounds like a great plan. Please keep us updated.
 
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CaliforniaKat

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I have hypothyroidism and cannot take t3, when I take it I fell more fatigued, more hypo.

Also I can’t increase my T4 dose. Maybe my problem is low cortisol. Should prednisone 5 mg a day helps it? For how much time should I take it?
+1 what what already said. Do a cortisol test first.
 

Ella

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So what do I use to raise cortisol back to 'normal'?

What time of the day/night are you taking your thyroid hormone? Evening cortisol doesn't look too bad.

Liquorice has a long history Licorice abuse: time to send a warning message

Liquorice is contraindicative with high blood pressure and low potassium.

I used it when I aggressively targeted cortisol reduction.
Pregnenolone gave me a fat face. My fault in not being conservative with dosage.

My blood pressure is normally on the low side, so I watch if it gets too high. I don't over do liquorice because I am not sure due to it being estrogenic.

Thyroid hormone helps to excrete cortisol, so maybe look at tweaking thyroid supplementation.
 

DrJ

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Sugar is a really great blocker of cortisol. You might try sipping orange juice throughout the day to provide a slow steady supply of sugar with the accompanying minerals and vitamin c. It could be your liver is not storing enough glycogen so supplying a steady stream of sugar could help.
 

yoshiesque

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Ok I have adrenal fatigue/chronic fatigue - whatever you want to call it.

I did the whole cortisol saliva test and it came back low - it doesnt mean anything.

Have you got a 24 hour urinary cortisol? because thats a way better marker that cortisol is still being produced in large amounts. My 24 hour urinary cortisol came out very high, which contradicts my saliva cortisol levels. I cant remember why but there is legitimate reasoning for this.

In short it doesnt mean you have low cortisol. And you need to play with diet, supplements and thyroid. In my experience, T3 is way better than T4 but only in very small doses.

Also, salt, sugar, coffee in that order do wonders for my temperature. way better than thyroid.
 

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I agree with @yoshiesque, I prefer urine like DUTCH as it gives better overall picture. You may be producing lots of cortisol, but more important to know how well you are able to convert it and excrete it, The same applies to sex hormones. It matters how well liver is able to metabolise hormones and excrete via stool and urine. The efficiency of the liver as @DrJ says is crucial here. Are you eating sufficient good quality protein like lamb, beef, shellfish?
 
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CaliforniaKat

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I think it depends on the dosage.

I have a similar hormone profile as you, except I have "optimal" (according to lab work) thyroid levels. T3 at top of range but all other hormones still low. I was trying to see if optimizing my thyroid would improve my other hormones. Unfortunately no. So I tried experimenting with pregnenolone and it helped some. But since adding progesterone, it has increased progesterone levels as well as estrogen and cortisol. This was with taking 12-15mg (4-5 drops Simply Progesterone). I take the bulk of it at night. Sometimes I take 3 mg (1 drop) mid morning. I'm still experimenting to find the best dose, but wanted to share my experience.

Peat says progesterone knocks estrogen out of tissues and into blood, which explains the rise in estrogen. Not sure how to explain the rise in cortisol. In another place on the forum, haidut says that pregnenolone will normalize cortisol (make it lower if high, make it higher if low). Maybe progesterone has a similar function? But again, it probably depends on the dose. Too much might be suppressive to cortisol. That's why I've been experimenting very cautiously. I started with just one drop for a few days.
@sweetpeat thank you, this helped a lot. When you say similar hormone professional are you talking low cortisol too?
How much pregnenolone did you start with and where are you on terms of dosage now? How much/what kind of thyroid are you using?
 
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CaliforniaKat

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@Ella @yoshiesque @DrJ
Thank you for your responses.
The DUTCH tests are all expensive, and the money I have allocated will either pay for a private doc appt or the test, not both.

I take my NDT in the morning with my breakfast. I know it is better split up but with work I don't always to remember to take it.

Dietwise I am tracking in cronometer. I eat at least 2500 cals, at least 120 mg protein. CFP ratios are about 40/40/20 for now. CO at every meal. Breakfast is 1% milk, Daisy cottage cheese, half and half, coffee (mostly decaf), gelatin and fruit for breakfast. Lunch is fruit, often dates, sometimes cheese, beef, sometimes fish, or shrimp, sometimes orange juice. Dinner is usually beef or shrimp, fruit, milk, sometimes a small serving of potatoes or rice. Liver is icky to me and pate isn't much better. I am taking dessicated liver supplement at the moment. Often I stew fruit with a little sugar, and add a little gelatin once it cools. Apples and peaches are in season in CA right now so even organics are cheap(er). I'll have half a Red Bull here and there. I supplement what cronometer says I'm consistently short in. 5000 D3 alternate days, k2 (small dose, 90 mcg), C, thiamine, methylfolate, biotin, magnesium, low dose KI (225 mcg) daily. I take a baby aspirin daily, had a small stroke in January.

I'll be honest, there is some fear in playing with all this by myself. I am reading a ton. I'm totally frustrated with the medical community in general.

My other bloodwork is here:
Female/Iron/Thyroid Bloodwork. Help Please?
 
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Orion

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Low potassium intake, could be an issue. Progesterone keeps potassium from depleting, taking thyroid depletes potassium, high aldosterone depletes potassium.

Progesterone rises, to support extra potassium absorption, causing cortisol to fall. Progesterone won't be converting to cortisol or allopregnenolone.

Getting RDA of potassium 4500mg and some more from KCl, also higher doses of B2(riboflavin) will be helpful. B1 and B2 deficiencies are becoming more prevalent, and getting replete in B2 can take weeks at high dose.

MgCl and NaCl intakes could be researched as well.
 

sweetpeat

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@sweetpeat thank you, this helped a lot. When you say similar hormone professional are you talking low cortisol too?
How much pregnenolone did you start with and where are you on terms of dosage now? How much/what kind of thyroid are you using?
Yes, I'm hypo for all hormones (the ones I've tested anyway): thyroid, progesterone, pregnenolone, estradiol, testosterone, cortisol, DHEA. I've spent the last 2 years working on mainly thyroid, trying to optimize in the hopes the other hormones would raise too.

For thyroid supplementation, I've tried lots of different protocols: NDT, t3 only, Peat inspired ratios of t4:t3. Nothing seemed to help my brain fog and fatigue until I tried larger doses of t4 with small amounts of t3 - currently 160mcg t4 and 5mcg t3. But that's just me. I think each person has to find their own best dosage. For me, my natural t4 levels were below range and for now I need the extra t4. I say "for now" because it sometimes feels like finding the proper dosage is like hitting a moving target lol.

For pregnenolone, I generally take smallish doses of 10-30mg/day. I tried larger doses of 100-200mg but they make me feel "off". I suppose it's helping in some way, but I can't always feel the effects. It seems to do nothing significant for any of my other hormones, at least according to lab work.
 

Ella

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I take my NDT in the morning with my breakfast. I know it is better split up but with work I don't always to remember to take it.

From Ray Peat Wiki
Since the desiccated thyroid is made available by being digested, it's best to divide the day's dose, with some at each meal and at bedtime, so that the amount of active hormone entering the blood isn't too high at any time.

It's important to remember that it's cumulative, and the effect of any daily dose increases with time, and is affected by many things, so it's important to keep a chart [of temperature and pulse], watching for changes during a period of about two weeks.

This may be the reason for the increasing RT3.


An eighth of a tablet of either [Cynoplus/Cynomel] is a good starting dose. The difference is that T3 has a short half-life, and so can be repeated more often, while watching the pulse rate, so it's possible to get a quicker response.

Sensitivities and requirements vary widely. I've known people who temporarily needed 500 mg of Armour even in the summer, but usually the summer requirement is a fourth of the winter requirement. For some people, 15 mg of Armour was enough, and for some 1 mcg of Cytomel was an effective dose.



T3 should be supplemented at physiological dosages

[WINTER RECOVERY] The end of winter is the worst time, because of the cumulative stress injury. Small amounts of T3, just 2 to 4 mcg at a time, along with good nutrition, including plenty of calcium (e.g., two quarts of milk), helps to recover from winter.

T3 has a short half-life in the body, and by adding small amounts of it you could feel quickly whether it was having the right effects. I don't know how reliable the Erfa is in composition. Mood is a good indicator, and the temperature of the toes and fingers usually changes quickly with thyroid changes.

The liver has to convert T4 to T3 for it to be effective. It needs glucose and selenium to make the conversion. Adequate protein, at least 80 grams per day, is necessary. Sea food, once a week will provide selenium, two quarts of milk and a quart of orange juice would provide many of the other essential nutrients. Taking T4 at bedtime sometimes is helpful. Most people feel best on a ratio of T4:T3 of 4:1 or less. Checking the relaxation rate of the Achilles reflex is a quick way to check the effect of the thyroid on your nerves and muscles; the relaxation should be instantaneous, loose and floppy.


Breakfast is 1% milk, Daisy cottage cheese, half and half, coffee (mostly decaf), gelatin and fruit for breakfast.

Perhaps add a little seafood for breakfast. I know expensive, if you cut out some of the supplements which are also expensive and questionable and invest the money in more mineral and nutrient dense foods, your money is wisely spent. Shellfish, not only has selenium, iodine but good ratio of zinc and copper and chromium plus more.

Don't understand why you need to supplement KI, if you are having milk, dairy and shellfish. Methylfolate is another questionable supplement. Leafy greens, and fruits are high in folate. OJ is a good source of folate.

I take a baby aspirin daily, had a small stroke in January.

Sorry to hear about the stroke, you are perfectly justified in being frightened at going it alone and best to be under the supervision of a physician you can work with when experimenting. This I know is a huge challenge for many. They are out there but then again, cost an arm and a leg in getting the level of care that you need. Best to educate yourself, like you are and yes it is TERRIBLY frustrating and confusing. Thank God we have Peat to remind us on those health protective substances, otherwise we would all be at the mercy of the medical industrial system.

I don't know how old you and yes your hormones results suggest postmenopausal range. I have seen this even in young females in their 20's, again those carb restricting, over training in the gym, scared of fruit, sugar and milk. To me it means that resources are shifted to maintaining muscles and coping with high stress hormones with little available to maintain a cycle. Have you read Katarina Dalton's work?

Progesterone to estrogen ratio should be more like 200:1 and can go as high as 800:1.
Progesterone supplementation in your situation would be wise, principally due to its brain and heart protective mechanism.

If you are entering menopause, the progesterone will help for an easier transition. As the ovaries begin shutting down, adrenals need to take over. If you are dealing with much stress, then without the protection of progesterone, we can expect less ability to adapt to the stresses of life. I know this personally and wish I knew about progesterone when entering menopause and the significance of estrogen dominance on thyroid suppression.
 

Ella

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Ray Peat Email Exchanges - Ray Peat Forum Wiki
More on strokes from Peat Wiki. The deleterious effects of constipation, keeping the gut sterile and gut motility optimised is hugely underestimated by medical drs. Just resolving this one problem could prevent a multitude of disease conditions. I have seen benefits of progesterone with temporal arteritis and pericarditis. TA can cause blindness.

I have been involved in a big fight with a GP that failed to diagnose the condition in an 84 yro woman. He tried to tell me she was estrogen deficient and that estrogen would resolved the uti. I recommended she take progesterone due to being heart and brain protective. Pericarditis on 2nd echocardigram disappeared and specialist for TA stated that it could not be TA as she would still be experiencing bad headaches and it takes 12 - 18 months to resolve. Could progesterone have mitigated the severity of the condition?? She has been suffering since the start of June. It is now nearly 4 months and her symptoms are mild (still debilitating) but not as severe as the start. The trigger was an UTI infection + severe constipation which has been an ongoing saga.

The GP was convinced that it was a tumor somewhere in the body. He ordered every scan except one of the head. I argued that her high inflammatory markers were a directed result of the e.coli. infection. When I explained that e.coli was a gram-negative bacteria that contain lipopolysaccharides in its outer membrane and LPS translocation from bowel to bladder to heart to brain and high inflammatory marker could account for all her symptoms, he completely lost it. He told me NO, NO, NO, I was wrong and he didn't know what school I obtained my education from but I was wrong. Hehehee!!
All scan failed to reveal tumours, pericarditis disappeared and inflammtory symptoms subsided. When he reviewed the scans, he told this poor sick 84 yro, he could no longer see her as a patient and to find another dr. He told her, he was placed on too much pressure, he was only a GP and there is very little available to help those with arthritic and autoimmune conditions. He told her he could not live up to the expectation I had placed on him. I was grateful for his honesty. He had nothing in his toolbox to fix the problem, fair enough, but worst, he was unwilling to supervise this poor sick lady.

I have had previous experience in using progesterone for brain trauma and have been once more convinced by its brain and heart protective ability. The following is what Peat has to say in his advice to someone else.

Constipation might have been responsible for the stroke. Progesterone is already being used medically, 'experimentally,' for brain protection and repair, pregnenolone has some of the similar effects, probably not as powerfully, but it's safe in any quantity. Carbon dioxide increase can often restore circulaton to areas that have a vascular spasm; a little baking soda in water sometimes helps that. Sugar sometimes helps with constipation. They should be doing something for the constipation; inflammation is often involved, and aspirin and cascara (emodin) are helpful if the main blockage can be overcome with enemas. Inflamed tissues are hyperosmotic, so enemas with the standard 0.9% saline cause tissue swelling; double or triple osmolar saline is usually helpful.

[STROKE BRAIN RECOVERY] Both progesterone and pregnenolone are o.k. at the same time. They protect the brain. Vitamin K (1 or 2) is probably better to use before aspirin, since it helps to prevent both more clotting and also bleeding. A day after the vitamin K the aspirin would be safer, and it helps to protect brain cells. Niacinamide, vitamin B1 and biotin are other brain protective things, even is small amounts. Hospitals often treat strokes with too much oxygen, to reduce brain pressure, but that reduces circulation to the brain; 5% carbon dioxide with oxygen helps to reduce brain swelling while maintaining circulation.


 

fradon

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Hi,
So I got my most recent 24 hr saliva cortisol and dhea back. Cortisol was high and dhea was low 8 months ago, now dhea is still low (but better) and adrenal function is low. I posted my result here.

I posted my bloodwork in the bloodwork section, and I'm not sure how to link it here.

What do I do now? I'm exhausted all the time and I don't know whether the low cortisol is because thyroid isn't optimal yet (tsh says yes, but T3 and T4 still in bottom of range and temps have dropped again) or due to something else. I'm so lost and frustrated, and I know I have already asked a ton of newbie questions.

Waking temp is consistently 97.0
Afternoon temps are 98.2, but both waking and afternoon temps were good 4 weeks ago.

I know if I go back to NMD he will add adrenal support in the form of dessicated adrenal cortex, but Peat idea is that it isn't necessary? I'm confused (again) I feel like every step forward is followed by two steps back...

this is my current supplement for adrenals

twice a day in the morning and after work
15-25 mg of zinc
b complex 50 sundown naturals...the only brand that works for me...vitamin shoppe sucked
250 mg vitamin C or a chewable broken in half
magnesium citrate 100 mg
half a can of turnip greens for the vitamin A, copper, potassium, and calcium

avoid supplemented IRON... no iron enriched flour products...some is just metal filings like in cereal.
 
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CaliforniaKat

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@fradon Do you suffer from low adrenals? I thought zinc was a chelator of iron? My ferritin is only 15, total iron 67, iron saturation 21%. Low ferritin and low thyroid function tend to go together, but periods have been heavy for years too. I don't eat grains often at all anyway, maybe a few times per month. I don't eat starches more than a couple times a week right now.

For all, I met with the NMD today. He did recommend progesterone, and possibly pregnenolone in small doses. He did not want to up my thyroid meds (yet), but is open to that in the future. He did change me back from Acella to Armour, just in case the low energy and lower temps were related to the change. He wasn't super concerned with the salivary cortisol result at this time but told me to call if I felt worse once back on Armour.
My TSH is 0.03, put T4 is 0.9 (range 0.8-1.8) and T3 is 2.9 (range 2.3-4.2). He also wasn't against switching over to separate doses of t4 and t3 instead of NDT. Someone earlier said it is like hitting multiple moving targets..and that is exactly how I feel-kinda overwhelmed and not wanting to make myself worse. <----(there is some anxiety about that actually)

Can someone please share how much thyroid they were/are taking before they started to feel good? I know it is all individual, but I still see hypo bloodwork and would like to raise thyroid again and see if it makes a difference. T4 and T3 are still low end of range for both tests.
 

fradon

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@fradon Do you suffer from low adrenals? I thought zinc was a chelator of iron? My ferritin is only 15, total iron 67, iron saturation 21%. Low ferritin and low thyroid function tend to go together, but periods have been heavy for years too. I don't eat grains often at all anyway, maybe a few times per month. I don't eat starches more than a couple times a week right now.

For all, I met with the NMD today. He did recommend progesterone, and possibly pregnenolone in small doses. He did not want to up my thyroid meds (yet), but is open to that in the future. He did change me back from Acella to Armour, just in case the low energy and lower temps were related to the change. He wasn't super concerned with the salivary cortisol result at this time but told me to call if I felt worse once back on Armour.
My TSH is 0.03, put T4 is 0.9 (range 0.8-1.8) and T3 is 2.9 (range 2.3-4.2). He also wasn't against switching over to separate doses of t4 and t3 instead of NDT. Someone earlier said it is like hitting multiple moving targets..and that is exactly how I feel-kinda overwhelmed and not wanting to make myself worse. <----(there is some anxiety about that actually)

Can someone please share how much thyroid they were/are taking before they started to feel good? I know it is all individual, but I still see hypo bloodwork and would like to raise thyroid again and see if it makes a difference. T4 and T3 are still low end of range for both tests.

yeah i have suffer from adrenal issues also elevated calcium and elevated iron. just because your iron is low does not mean you don't have a lot of toxic iron build up in your body. iron makes you gain weight leading to hypothyroid.

remember peat said that low iron increases insulin sensitivity but it also increases LEPTIN which increases fat burning and increases metabolism...all that could speed up thyroid.

i realized my iron was elevated because i have something called the bronze fist as elevated iron creates arthiritis conditions.

http://haemochromatosis.org.uk/wp-content/uploads/2015/03/Hands.svg


the video i saw the other day talked about how iron can build up in the thryoid, the pituatary, the pancreas and that can cuase all sorts of issues with energy, thyroid, because those glands don't function properly. that could be why you are not making your hormones...not just you but hormones seem to be the problem issues everyone is facing these days. guys are on TRT and women are on birth control and all that creates hormonal isssues.

you may have high or low iron but it all depends if is bound to copper propperly and when you have adrenals issues chances are you have copper issues too.

the zinc will chelate bad copper and iron also it helps with male hormones. you can take small amounts of zinc like 10 mg I cut my 50 tablet in to 4 pieces as the body can only absorb so much at a time.

how is your vitmain A intake. you need A to help make DHEA.

MAG
ZINC
B VITMAINS
VITAM C are all the first vitamins and minerals that get dumped in times of stress. All these also antagoize copper to some degree. so supplementing this will help your body calm and help the body rebuild those hormones. also you need MELOTONIN as most of the hormones get rebuilt when you sleep.

if your DHEA is low then is your estrogen low too...and that could be low bound avaialble copper as copper increaes estrogen.

one more thing THRYOID needs tyrosine which requires adequate stomach acid could your issues be related to low stomach acid.
 
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Ella

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@fradon excellent points on iron and copper. Much has been learnt in the past decade on the intimate relationship between iron and copper, however there is still much learn. Anemia persists regardless of iron fortification. Anemia can't be resolved by just throwing iron at it. Copper is necessary to treat anemia as copper is required to sequester iron from spent RBCs and recycles it to form new ones.

Progesterone supplementation may result in increased copper excretion as copper and estrogen travel together. This good in the context of estrogen dominance and bio-unavailable copper. Oysters and shellfish are good sources of copper other than having to consume liver.
 

Lucas

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Fradon, what was your ferritin? Mine is 300 and I had hypothyroidism and knee joint pain.

yeah i have suffer from adrenal issues also elevated calcium and elevated iron. just because your iron is low does not mean you don't have a lot of toxic iron build up in your body. iron makes you gain weight leading to hypothyroid.

remember peat said that low iron increases insulin sensitivity but it also increases LEPTIN which increases fat burning and increases metabolism...all that could speed up thyroid.

i realized my iron was elevated because i have something called the bronze fist as elevated iron creates arthiritis conditions.

http://haemochromatosis.org.uk/wp-content/uploads/2015/03/Hands.svg


the video i saw the other day talked about how iron can build up in the thryoid, the pituatary, the pancreas and that can cuase all sorts of issues with energy, thyroid, because those glands don't function properly. that could be why you are not making your hormones...not just you but hormones seem to be the problem issues everyone is facing these days. guys are on TRT and women are on birth control and all that creates hormonal isssues.

you may have high or low iron but it all depends if is bound to copper propperly and when you have adrenals issues chances are you have copper issues too.

the zinc will chelate bad copper and iron also it helps with male hormones. you can take small amounts of zinc like 10 mg I cut my 50 tablet in to 4 pieces as the body can only absorb so much at a time.

how is your vitmain A intake. you need A to help make DHEA.

MAG
ZINC
B VITMAINS
VITAM C are all the first vitamins and minerals that get dumped in times of stress. All these also antagoize copper to some degree. so supplementing this will help your body calm and help the body rebuild those hormones. also you need MELOTONIN as most of the hormones get rebuilt when you sleep.

if your DHEA is low then is your estrogen low too...and that could be low bound avaialble copper as copper increaes estrogen.

one more thing THRYOID needs tyrosine which requires adequate stomach acid could your issues be related to low stomach acid.
 
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CaliforniaKat

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Fradon, what was your ferritin? Mine is 300 and I had hypothyroidism and knee joint pain.

@Lucas when you said had, does that mean you are no longer hypo? Joint pain is often associated with low thyroid function and/or high reverse T3. What was your ferritin when you were hypo? 300 is high, but I have heard/read several folks even on this forum that felt horrible with ferritin as low as mine.
 

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