# Adrenal fatigue (alongside thyroid dysfunction)



## Goodlife

Is there anyone here with experience of TTC and adrenal fatigue as an underlying health condition? I have Hashimoto's and seems likely I have adrenal fatigue too.  Waiting on test results.  It seems medical world do t have a clue about these issues let alone when TTC. Thanks,


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## Calluna

Hi Goodlife,

I've just sent off my samples for a salivary adrenal profile so I'll let you know!

I have a thyroid issue but I don't have high antibodies. My problem seems to be with conversion of T4 to T3 and it could be an adrenal issue or something else contributing to that. 

Who are you seeing privately? I've just seen Dr Chapman (he was on the thyroid UK list) and I really liked him. I felt for the first time like a medical professional was willing to look at the bigger picture.

When are you expecting your results? x


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## Goodlife

Hi Calluna, great to get your response! I hope to get my results next week...I went through a functional nutritionist to get them done by Genova so results come back to me via her. 

So glad there is someone else I can talk to about this who is TTC also.  

What's your story so far with thyroid? Did you hit rock bottom with NHS mistreatment too and resort to your own research and private practitioners also?

I have had the biggest nightmare with it all, that it was driving me crazy at the lack of knowledge by my gps whose knowledge was negligent. After they over medicated me (as they didn't bother to check I have Hashimoto's and sometimes will dump thyroid hormones making me hyper) but wouldn't accept that would be the problem and insisted I carry on the meds without reducing them to what I was asking and I nearly ended up hospitalised I decided enough was enough...they don't know what they're doing. I also pointed out the NICE guidance agate links to and I got told NICE guidance is unrealistic and they wouldn't test my TSH monthly whilst TTC or refer me to an endocrinologist as they won't accept me. My head was spinning with rage at being so ill with incompetent people 'looking after me' (ha!!) that I found a private blood testing kit via Thyroid UK and did a home test.  The result came back as Hashimotos. I was furious! Anyway after that diagnosis the gps did refer me to endocrinology and that appointment is 6th May.

In the meantime I'll have my cortisol results.  But then will need to battle to get hydrocortisone if it shows the lows I expect it will.  I don't think gps or endocrinologist maybe will know about HC.  

This whole situation is crazy that NHS don't know what they're doing with thyroids. One doctor adamantly said hypothyroidism doesn't cause infertility and smugly rolled out a list of other things that he knows does. Unbelievable.

So I think adrenals will definitely be affected and sex hormones too as they are all linked, except worryingly the gp doesn't know this!!

How far did you travel to see the private gp/consultant and did they link thyroid and adrenals (hoorah,) and arrange the saliva test?


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## berberprincess

Hi, I did the Genova adrenal stress tests (cortisol and DHEA) as I wanted to take DHEA when I found out my AMH was really low. My TPO antibodies were raised but not hugely and my thyroid was behaving normally. . Anyway my test results showed I had raised cortisol overnight so I was told to have late night snack. The nutritionist passed on a PDF of how to correct my low DHEA levels naturally. She really discouraged me from taking DHEA but I have to say I ignored her advice. I will say stress levels, food intake and balancing blood sugars are crutial as it all has huge impact on how the body functions. I downloaded a fabulous book called woman code by alisa vitti. It was massive lightbulb moment for me. There's tinnes on you tube by her without you buying her book. I wasn't sure on the cyclical eating but balancing blood sugars definitely made sense to me. I'm really not sure if my answer is helpful as my thyroid problems are really quite minor but just thought I'd say id been down the adrenal fatigue road you have. 

Take it easy , hope you get some good answers soon

BP ️XX


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## Goodlife

Thanks berberprincess, did you get someone to guide you with the DHEA? What I'm finding is the medical people don't have a clue and the functional people who know about it can't prescribe meds. I'm worried I'll need hydrocortisone but won't be able to get anyone to prescribe it.


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## berberprincess

My ivf consultant recommended the DHEA regardless . As it turned out, my levels were rock bottom but corrected quickly with the DHEA (75mg / day in divided doses). Because of my TPO antibodies she thought it wise I see professor quenby at coventry hospital for uterine NK cell testing (the abnormal immune responses tend to be linked I think). However, prof quenby didn't want me to waste an egg on her test ( the uterine biopsy can only be performed 7 DPO so abstinence from TTC is a must). She did lots of bloods tests to rule out other things such as clotting probs, coeliacs disease, low vit d levels which all came back clear. When I did get pregnant this time I had bit of a panic that I should be on steroids or blood thinners. The nurses at my clinic checked with several consultants and prof quenbys notes and they all advised against this as could cause more harm than good. So far so good with this pregnancy and hoping it continues this way. However, had I gone the donor egg route, they would've treated me with aspirin, prednisilone and clexane ( different clinic different doctors different opinions!!)) 

Sometimes it's hard to get any consensus of opinion and can send you in a bit of a spin on whose opinion to trust.

I hope this has been helpful/useful and not total waffle!!  

BP xx


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## Calluna

Hi Goodlife,

It's so frustrating isn't it, how little GPs seem to understand about the thyroid?! I've had lots of issues over the years that are likely to be linked to a thyroid problem and when I had my TSH tested it was over 3 but not high enough for my GP to think it was an issue. My GP said she couldn't take responsibility for treating it but if I got my fertility consultant to write to her and advise on the appropriate TSH levels for fertility then she would prescribe on the basis of his advice. 

I had no idea how much of a problem I actually had until I started thyroxine and felt AMAZING! You know when you're running and your legs get so tired they feel like they're made of lead? Well it was as if I'd lived my whole life like that and suddenly I felt light as a feather and had so much energy! 

Unfortunately it didn't last though so I increased the dose and felt better again but not for long. I keep upping the dose but haven't felt as well as I did initially. My T3 is usually at the very bottom of the range (3.1ish) but when I've felt better it coincides with when it's crept up to 4. Can't imagine how fantastic I would feel if I was treated properly and it actually made it towards the middle of the range or better!

I decided to test my reverse T3 and that's right at the top of the range so the ratio of T3 to rT3 is about half what it should be. So I decided to see a dr who would test for possible reasons why my body seems to want to make too much reverse T3 and not enough T3. Dr Chapman is in Hendon, which is about a 2 hour journey for me. I've done all the additional testing through him and he can prescribe T3 or whatever else we decide I need.

I'm feeling much more hopeful now that we can get to the bottom of it. I've completely given up on the advice of conventional doctors really so I've just been researching and solving my problems myself and I've managed to solve several issues that supposedly couldn't be cured. I dread to think how much money the NHS wastes sending women for IVF (not to mention all the heartache!) when some of them could probably conceive perfectly well if they just had proper thyroid treatment!

It sounds like you've really been through the mill! Good luck with your results next week. I hope they paint a clear picture of the problem and you can get the treatment you need. I wouldn't fancy your chances of getting it from a standard GP though! 

xx


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## Goodlife

Thanks for the replies berberprincess and Calluna, can I ask you both if the help you have got has been private?  I now think I understand, after waiting 5 months for our first fertility hospital appointment, that they don't even investigate or support immune issues anyway??  As I have autoimmune thyroiditis I think there will be associated issues like inflammation, overactive immune system but level 2 NHS won't even explore this or ever actually?  This is such a minefield to be constantly working out what I need and then where to get it.  Like the DHEA...and NK cells testing is that through a private professor or somehow through the NHS?

I feel like my time is running out to figure it all out.  Thanks lovelies.


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## berberprincess

Hi , yes you are right. What a mine field. It's so hard to know what to ignore and not worry on or spend those hard earned pennies on!!! For me it was slightly easier in that my daughter was conceived without any issues so I knew it was possible to carry another pregnancy again. However, I really feel for those who just don't know this and are in a bit of a spin over whether to go whole hog on immunes or to wait for something to go wrong before investigating. My heart goes out to you. 

Professor quenby is based at coventry hospital. She runs a recurrent miscarriage clinic privately and NHS I think.if you google her you'll find it. You can self refer even if you've not had miscarriages but will probably have to pay.  I saw her privately. It cost me £100 to discuss my concerns and she would've given discounted NK cell biopsy if we'd gone ahead. I know another lady, tin can cat saw her too. I seem to remember googling recurrent miscarriage clinics and there's one in London  St Mary's hospital. 

I've just remember I tried to get on the TABLET trial!!! I'm not sure if they're still recruiting but you might fit their criteria. I couldn't go on it as I planned the donor egg route so that ruled me out. Can't remember their medical criteria though. I'll try and find a link. 

I did see a lovely chap for traditional Chinese medicine too. He put all sorts of stuff in my mix for immune issues and also for stress!!! God knows what it was but it definitely helped with my stress levels!! Special mushrooms !! 

You might end up seeing a few people and but piecing it all together.

Let me know if you need any more info. Happy to help 😊️xx


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## berberprincess

http://www.birmingham.ac.uk/research/activity/mds/trials/bctu/trials/womens/tablet/index.aspx

Not sure you'd fit the criteria. I had TPO antibodies but normally functioning thyroid. It's worth an ask though maybe?? They were really helpful regardless. It was run by midwives specialising in recurrent miscarriages.

Xx

*This post contains an unconfirmed link/information and readers are reminded that
fertilityfriends.co.uk or its owners are not responsible for the content of external internet sites*


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## Calluna

Hi Goodlife,

My GP is actually really supportive but they're limited in what they can do. I managed to get all the 'level 1' tests done through my GP (some of the blood tests she had to request more than once because the blood clinic queried why I needed them). We paid to see Dr Gorgy at the Fertility and Gynaecology Academy in London privately for 'level 2' immune testing. If you don't know what I'm on about with 'level 1' and 'level 2', have a look at Agate's Immune FAQ (under Diagnosis - Immune issues) - that's a really helpful starting point. Also, if you haven't already read it, I'd suggest looking at Dr Beer's book 'Is your body baby friendly?'. I really liked Dr Gorgy (although his accent can be difficult to understand!) so we will now cycle there when we finally get around to starting again (we have to self-fund fertility treatment anyway because we don't meet NHS criteria). With a letter from Dr Gorgy, my GP was willing to prescribe thyroxine but, as that doesn't seem to be working terribly well, I then went privately to see Dr Chapman. 

I monitor my thyroid (TSH, FT4 and FT3) regularly through Dr Gorgy (it costs £85 a time). My GP will occasionally throw in a free TSH test but not the others. I spent about £1000 (plus consultations) on initial immune testing with Dr Gorgy - NK panel, cytokines, KIR receptors and MTHFR (as we're using donor sperm we didn't do the tests that look at compatibility between couples and, as I'd never been pregnant, I didn't do the LAD test because it would be low whether or not that was part of the problem). 

Initial testing with Dr Chapman cost about £650 (plus consultations). I've also paid for the infection testing in menstrual blood through the Greek clinic Serum and I paid privately to have my AMH tested. All of this has been money well spent, in that we have identified and solved or partially solved several issues, but it does all mount up.    

Can I ask how old you are and whether you've had you FSH/AMH tested and/or had an antral follicle count?  xx

Berberprincess - congratulations on your pregnancy - fingers crossed everything runs smoothly this time   xx


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## Goodlife

Thank you so much berberprincess and Calluna...this is all so helpful and yes berberprincess congratulations to you!!

So it looks like travelling around the country and nothing will be understood my local hospital?  How do you know where to go for what? I did asked to be referred to Addenbrookes reproductive endocrinologist but gp wouldn't refer. So I'm waiting for local hospital level 2 tests. So far in 6 months all I've had are the level 1 progesterone test and partner semen analysis.  Semen analysis shows "some" atypical sperm but doctor wouldn't do a follow up test after prescribing my partner with antibiotics and said she'd passed us on to level 2 services and washed her hands of us basically.  She wouldn't even give my partner a copy of the tests saying she'd sent them on and queried why he wants them.  I know from when they say "normal" for TSH tests they're way off, so always get exact levels and copies of results now.  Our fertility level 2 appointment has today been cancelled by letter I received and put back to 12th May....we agreed this all with gp in November so it's getting ridiculous now by my expectations of timeframes!

I'm 38, I'll be 39 in October.  I've just got my results today from my functional medicine nutritionist and I have adrenal fatigue.  Low cortisol all day. My TSH was 1.72 the last private test I did which was down from 10.94 in November. Hashimoto's TPO antibodies 320 and TG antibodies 220.  I'm seeing the local endocrinologist on May 6th. That was a battle to get that appointment and only because I privately diagnosed Hashimoto's myself.  I'm getting a lot of blood tests done prior to my endocrinologist appointment like cortisol, b12, ferritin, full blood count and coeliac. I'm waiting for a vit d test result too. I did query whether I should be seeing an immunologist for Hashimoto's instead of an endocrinologist, so time will tell whether it's a waste of time.

Any suggestions about what I should be saying at my first level 2 fertility appointment to get them thinking about these issues or get them to refer to people who can help?


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## Goodlife

Forgot to say I'm on levothyroxine.


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## deedee_spark

It sounds like we are all quite similar in symptoms and illness, maybe not in underlying cause.

I bought this book prior to being diagnosed with Hashi's: http://www.amazon.co.uk/Adrenal-Fatigue-Century-Stress-Syndrome/dp/1890572152/ref=sr_1_1?ie=UTF8&qid=1428853071&sr=8-1&keywords=adrenal+fatigue

It's pretty good but don't recall it being as expensive as it is listed now.

The key is stress management which is really difficult through infertility especially when you feel a time pressure. Without reducing stress, it's a no win situation.

I found difficulty sleeping again when I found out I was about to start treatment. My cortisol levels were rising at night and during the night.

I found getting my body clock working alleviated the symptoms.

So as someone mention, eat at the same time every day. Try to go to bed at the same time every day.

Also, try to get daylight first thing in the morning. This really helps.

I found tart cherry juice helped me sleep (Active cherry). It has natural melatonin and it made me sleepy at the right time and then at least I woke fresh. As a bonus melatonin helps egg quality during IVF. I am not sure about during a natural cycle though as I think LH is impacted but I will use it when I feel I am not sleeping?

This message may be a bit scrabbled as I had 9 eggs removed today.  Anyway, sleep and stress and diet really help recovery.

xx

*This post contains an unconfirmed link/information and readers are reminded that
fertilityfriends.co.uk or its owners are not responsible for the content of external internet sites*


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## Calluna

Hi Goodlife,

This site is where I've found the details of who to see for what. From reading the FAQ and posts on the immune thread, I decided to go to Dr G for immune testing (I chose him because he will treat while you're cycling with another clinic although I'm now going to cycle with him anyway). Deedee put me on to the Thyroid UK list when I was looking for someone to investigate the thyroid further. If you know where you're being referred you can see if they have a thread for people being treated there on the regional boards and ask others who have been there what their attitude is to immune issues/treatment etc. And if you read the immune FAQ it will give you an idea of the sort of tests and treatments that are available so you know what to ask about.

Sorry your appointment got delayed   You're a similar age to me then (I'll be 38 next month). My advice would be to ask for an AMH test (you might have to pay) so you have an idea of your egg reserve. Luckily my AMH was high enough that I decided it was worth taking some time out to try and solve all my issues (all the ones I've identified so far anyway!). It would give you an idea how long you might want to spend trying to get what you want out of the NHS or when you might want to pursue other routes. If you can find out the attitude of the people you're seeing before you see them then you'll have a good idea what they'll say. I think you'll struggle to find a conventional doc that is interested in the adrenal issue but a growing number of clinics offer immune treatments xx

Deedee - that's a good number of eggs - congrats! Hope they all fertilise and you get plenty of good quality embies to transfer and freeze xx


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## Goodlife

Thank you deedee_spark and Calluna, I feel very isolated dealing with these complex issues and am very grateful for the replies.  I'm starting to piece my research together and figure out what I need, so being pointed in the right direction for things really helps.

I live in quite rural East Anglia and don't know how many other people would be having these issues locally to me but I have asked on the regional board what to expect at our first hospital appointment.  I'm really like them to do a scan but am I dreaming  I think that can tell about egg reserve and any physical issues? And then they should schedule a tubes dye test?  I should be day 1 to 3 of my cycle at the first appointment so if they do tests to fit in with a cycle I'm hoping that's good timing if they just get on with things.  I know I'll be upset if we have to book another appointment to start getting anything investigate.  I'll feel better knowing what my egg reserve is.  What's the usual egg reserve test method?  

I'm seeing my nutritionist tomorrow about getting support for my adrenals. She's been great explaining to eat protein heavy to stabilise blood sugars and not wake up with high cortisol spikes due to low blood sugar during the night.  I had no clue how much nutrition affects hormones and therefore how much hormones can be supported by food and eating strategies. I meditate everyday too and do lots of nice things for myself.  I think as time has gone on i think less about getting pregnant as i used to expect to be pregnant every month and nowI fon't expect it so do t get so upset. 

It's so nice to have people to talk about these struggles with.

Thanks!!!!


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## berberprincess

Hi goodlife, thanks for the congrats. Still not real yet so Im just waiting for first trimester to finish before believing this COULD happen. 

It sounds like calluna and deedee have more experience than me at what to ask. I was lucky in that I was always pushed towards the right professionals by a friend who d already gone down the infertility path so had a list of good contacts!! 

It sounds like your GP doesn't like patients that are empowered. It's a blow that you're appt but has been delayed so sorry to hear that but as soon as you're in specialist care you're contact with GP tends to taper off so that's one less stress come May. 

Keep up the quest for answers but also spend time being kind to yourself. There's a very powerful mind body connection that can get neglected (mmm if only I could heed my own advice). 

BP ️xx


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## berberprincess

Lol, my reply car thru just after yours saying you meditate so ignore what I said about mind body connection, it sounds like you're on it!! Yes I was shocked at how much influence blood sugar balancing can regulate hormones. Dark choc still good for you as it has antioxidants!!! Perfect for happy eggs 

😋

Xx


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## Goodlife

Thanks berberprincess.


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## deedee_spark

Goodlife - There is no doctor listed for East Anglia or the surrounding areas in my Thyroid pact. Maybe contact ThyroidUk or use one of the ones I listed for London (bit of a trek though).

x


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## Goodlife

deedee_spark I ordered the book plus another one by Dr beers that was recommended about body being baby friendly.

I'll travel anywhere at this point...my gps don't like referring me , they think I'm making a fuss about nothing!! So if I'm paying do I still need referrals?

My endocrinology appointmen is 6th May maybe I should see how they treat me or not treat me particularly my adrenals.

I wonder if the reproductive endocrinologist at Addenbrookes would be helpful for all these issues?  Gp was against referring me there and wanted me to go locally.  I didn't argue too much at that time as that was huge progress from the last gp who refused to refer me and nearly hospitalised me by not recognising I had swung hyper and wouldn't reduce meds!!

So I think my plan is go to 1st endocrinology and fertility appointments then go elsewhere if needed...probably.  I would lieder fertility investigations at Addenbrookes too and I know it's supposed to be patient led but gps clearly don't see it like that.

What is the method they predict egg reserve?  I'm keen to have that ASAP.

Thanks again everyone.


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## Calluna

Hi Goodlife,

Your AMH, FSH and antral follicle count can all give you some idea of egg reserve. 

The FSH tells you how hard your body is having to work to stimulate your egg follicles to grow. Your antral follicle count gives you an idea of how many follicles are recruited in a particular month (and therefore an idea of how many might be available to grow if you took stimulating drugs). AMH is produced by smaller follicles at an earlier stage so gives you an idea how many potential eggs are waiting in the wings. 

FSH and AFC are probably more useful in telling you how you would respond to stimulation. AMH is probably more useful in giving you an idea how long you might have until menopause. 

Your GP should be happy to do a hormone profile on day 3 (1-4 will do) of your cycle to check FSH. Hopefully they'll scan you and look at antral follicles when you have your appointment (I don't know though - hopefully someone on regional thread will be able to tell you). You might have to ask at your appointment about getting AMH tested.

Completely agree on the importance of diet! I wish I could be as disciplined as you with the meditation! I really need to work on the stress side of things xx


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## Goodlife

Thanks Calluna, I'm overwhelmed by how kind and helpful you all are. My gp isn't interested in doing anything else fertility for us. Even wouldn't follow up on partner's atypical sperm and said he'd have to wait for a retest at hospital. What was the point in gp doing it ...to tick a box,grrr. It's the day 3 test I really want - it's rubbish that my gp surgery is so rubbish. I'm moving surgery as soon as it won't confuse the fertility process!


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## Calluna

Hi Goodlife,

Yes I've found the ladies on this site incredibly helpful. And it's good to know you're not alone in what you're going through, even if it's heartbreaking to know how many people are suffering with these struggles. 

It really does sound like you need a new GP! It's shocking that they haven't even done basic tests like a day 3 and day 21 hormone profile. Surely they should make sure you have those kinds of results to discuss at your appointment. Hopefully when you finally have you're appointment they'll be more helpful!

So will you see someone privately now to get the adrenal treatment? I didn't need a referral for Dr Chapman - I just made an appointment. He's very booked up though! I was lucky to get in earlier than they originally said because I asked them to let me know if there were any cancellations, otherwise it would have been a couple of months to wait to see him. If you can get to London there are quite a few others on the Thyroid UK list who could probably help you without a referral.

xx


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## Goodlife

Hi again Calluna, things seem to be coming together on the private side of things-a nutritionist that I found appears to be a very clever lady and practices from a functional medicine approach (which I had read is great for thyroid and adrenals and I didn't know there was such a nutrition approach as well, so it's an amazingly good coincidence her approach is what I would ideally have wanted and could have travelled miles yet she's local!). She advocates James Wilson's approach to adrenal fatigue and coincidentally (again!!) I had just ordered his book as recommended by deedee_spark...see how it's coming together...bit of research, bit of good timing and fortune!!  On her recommendation I've ordered James Wilson's own brand of product to support adrenals plus a product to support thyroid alongside my levothyroxine.  They are called food supplements and are "hormone washed" so they don't give supplemental hormones but nourish my own adrenals and thyroid.
I take 50mcg daily levothyroxine and my last TSH reading was 1.72 which I'd like to stabilise at or slightly lower only.  I'm going to see what NHS endocrinologist is like on May 6th but they haven't even ordered T3 to be tested for my pre-clinic blood tests just T4 so I don't think they will be able to satisfy my care expectations.  From what I've researched I would like to be on T3 Liothyronine too but if they don't test T3 levels I can't imagine they prescribe it and stick with the rigid levothyroxine only protocol. Looks like I'll definitely be continuing with my private blood tests as NHS at all levels don't run a full thyroid panel it seems! I did the finger prick test myself last time but will go to a phlebotomist next time as I found it traumatic taking my own blood, lol.  What benefits do you feel the private thyroid doctor gave you? I bet it was another world but does he have different treatment protocols like T3 do you know?  Did he have an understanding of a full thyroid panel?  That's what I'm after.
I now also have a fantastic book arrived in addition to James Wilson's 'Adrenal Fatigue 21st Century Stress Syndrome' and that is Alan Beer's 'Is your body baby friendly' about what to do when your immune system says "no" to pregnancy, so that I can learn how Hashimoto's or other immune responses I may have can be helped to have a successful pregnancy.  I cut out gluten when I got the Hashimoto's diagnosis and my hives skin itching and body aches went and when I had to reintroduce it for the coeliac endocrinology pre-clinic test a few days ago I had full on allergic angioedema reaction to my eyes after 3 days of it so I stopped it and just got the blood test as not poisoning myself for 2 weeks or getting hospitalised with a more severe angioedema that could affects my airways as has happened a few years ago due to an unknown trigger. Needless to say my immune system is clearly over active and I want to find out if that's causing issues TTC as well, so that's something else that I'll want expert input with.  I need to start making lists or references of people's recommendations so I don't lose the names and locations of specialists in threads for when / if I need them. Thanks as always.


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## Calluna

Hi Goodlife,

Yes Dr Chapman does a whole range of tests including 24 hour urine test for T4, T3 and iodine, plus the adrenal saliva test and blood tests relating to B12, folate etc. I already had a full set of recent blood results for TSH, FT4, FT3 and reverse T3 when I went to see him. He treats with T3 when needed.

I've also cut out gluten and some other things - my diet is mostly paleo with a few modifications.

Sounds like you're making good progress with it all. Let me know how you get on with the adrenal/thyroid support. 

xx


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## Goodlife

Thanks Calluna.


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