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Archive for January, 2012

Symptoms of Fatigue. Numbness & Tingling. Muscle Aches. Sweating. Chills. Heart Palpitations. Nausea. Low Blood Pressure. Diarrhea. Excessive Hunger and/or Thirst. All at once?

Diagnoses of Anxiety, Fibromyalgia, Celiacs or MS?!

Thanks to a comment from a reader, I have started investigating adrenal insufficiency.Finally, a diagnosis that makes sense given the fact that I had a year with 5 major life-changing and stressful events preceding my symptoms. (

For my symptoms, check out “Numbness & Tingling on the Right side“).
For my latest theory on what’s happening, check out “Numbness, Tingling & Cold Spots = Stress + Vasoconstriction

Update: interesting relationship between thyroid and adrenaline: Note: http://tiredthyroid.com/feeling-hyper-when-hypo.html Thyroid and adrenaline (epinephrine) have an inverse relationship. [1- 4]

I finally got my doctor to agree (after I did all the research and pieced together a diagnosis), that the likely cause of all of my strange symptoms was “from stress wreaking havoc on my adrenal glands”.  The medical community had already ruled out MS, Lupus, Rheumatoid Arthritis, Celiacs, Ankylosing Spondylitis and more! Plus, there is a correlation between thyroid and adrenal dysfunction! It probably wouldn’t have been so bad if it had ben diagnosed right away. Instead, thinking I had one of those other diseases made me even more stressed. For six months I thought I was dying, and “impending sense of doom” is actually a symptom of adrenal fatigue.

When my cortisol and aldosterone were spiking, I had period numbness, tingling and “silent migraines” throughout my body. I think this may have been from norepinephrine – as they usually happened after something mildly stressful. This is a powerful natural vasoconstrictor. A vasoconstrictor causes the veins in the body to become more narrow. This increases the workload on the heart to pump your blood through your body. It also results in the high blood pressure often seen in people going through stressful situations. While NE can cause hypertension, local vasoconstriction, and tissue hypoxia in any patient, those with hyperthyroidism or who are also taking certain medications are particularly at risk. The drug can produce profound hypertension, local vasoconstriction, and tissue hypoxia. NE-induced hypertension typically presents as headache, photophobia, stabbing chest pain, pallor, intense sweating, and/or vomiting. Typical nervous system responses are anxiety and fear, headache and increased sensitivity to light sources.

Other infrequent side effects may include muscle pain or weakness, numbness or coldness in the arms or legs, trouble breathing or heart rate irregularities.

After several months (3ish) of numbness and tingling, adrenal fatigue set in, which is when my symptoms changed and my doctor thought I was a hypochondriac.  I was tired all the time, super dry hair and mouth, really achy hips and arms, heart palpitations (often at rest or in bed), dizzy spells, nausea, and oh, did I mention super, super tired! I also went through a period of snoring and would wake up feelingl like I was suffocating – never snored before or since. If I got out of the house, I could usually push myself through a day, however, when I stopped moving it was like I was hit by a truck and the whole next day I would be completely useless – seriously, couldn’t get off a couch.

By the end of June (6 months of symptoms), I had:

  • elevated inflammation markers (ESR = 34; CRP = 5)
  • Vitamin B12 deficiency (I wasn’t deficient at the onset (b12 = 270) but after 6 months of symptoms it was 115)
  • Magnesium deficient
  • Anemic
  • Low Ferritin (as low as 10)
  • Hypocalcemic
  • TSH was normal (I’m on PTU for my Graves Disease, although it was higher than normal for me – as high as 3.0 preceding my symptoms)
  • NOTE: these might have been exacerbated by my pregnancy, which happened shortly after the onset of the symptoms. A happy miracle!)

The longest lasting troublesome symptom has been that both my upper arms feel sore all the time, (tight, swollen and achy sensation with mild swelling). Haven’t been able to figure this out except that aldosterone can mess with your electrolytes, which can cause muscle spasms, etc… if calcium, magnesium, potassium and sodium are out of balance. (February 2012, and I still have sore arms, although they aren’t as bad, and it comes and goes now. Waiting to find an equilibrium! Read my latest blog on my vasoconstriction theory here: Numbness & Tingling, Cold spots on skin = stress & vasoconstriction )

Stop the Thyroid Madness explains:

Your adrenals, two small glands that sit on top of your kidneys. The outer cortex of your Adrenals produces the hormones cortisol, aldosterone, testosterone, DHEA, DHEAS, androstenedione and estrogens. And both cortisol (a glucocorticoid) and aldosterone (a mineralcorticoid) are vital and important players in your health and well-being.

When your adrenals become fatigued, they don’t make enough cortisol. And though low cortisol does not always equal low aldosterone, there may be a significant body of thyroid patients who with their low cortisol have low aldosterone!

WHAT IS ALDOSTERONE? Aldosterone is the principal of a group of mineralocorticoids. It helps regulate levels of sodium and potassium in your body–i.e. it helps you retain needed salt, which in turn helps control your blood pressure, the distribution of fluids in the body, and the balance of electrolytes in your blood.

WHAT HAPPENS IF ALDOSTERONE GETS TOO HIGH OR LOW?

When aldosterone gets too high, your blood pressure also gets too high and your potassium levels become too low. You can have muscle cramps, muscle weakness, and numbness or tingling in your extremities.

But when it gets too low, which can be common in some patients with cortisol deficiency, your kidneys will excrete too much salt, and it leads to low blood pressure; low blood volume; a high pulse and/or palpitations, dizziness and or lightheadedness when you stand; fatigue; and a craving for salt. Other symptoms of low aldosterone can also include frequent urination, sweating, a slightly higher body temperature, and a feeling of thirst, besides the craving of salt. Potassium can fall, as well, resulting in muscle cramps and aches.

This is the best article I’ve read on the adrenals: http://www.drlam.com/articles/adrenalexhaustion.asp?page=1

Here’s an explanation for some of my symptoms (in relation to cortisol levels).

Numbness & Tingling: Theory 1

  • Numbness and tingling is caused by a shift in the nerve electrolyte balance. ie water, K, Na, Ca, Mg, etc. Nerves are basically ion pipes that propagate an electric charge.
  • When aldosterone gets too high, your blood pressure also gets too high and your potassium levels become too low. You can have muscle cramps, muscle weakness, and numbness or tingling in your extremities.

Theory 2:

  • Cortisol increases blood pressure by increasing the sensitivity of the vasculature to epinephrine and norepinephrine = vasoconstriction = numbness:
  • Cortisol’s enhancement of epinephrine’s vasoconstrictive effect = reduced blood flow to muscles

Vaso-constriction. Cortisol contracts mid-size arteries.

 Diarrhea
  • Cortisol acts as a diuretic hormone, controlling one-half of intestinal dieresis,
  • Cortisol stimulates gastric-acid secretion.Cortisol’s only direct effect on the hydrogen ion excretion of the kidneys is to stimulate the excretion of ammonium ions by deactivating the renal glutaminase enzyme.

 Insomnia
/ Energy

  • Cortisol increases blood pressure by increasing the sensitivity of the vasculature to epinephrine and norepinephrine.
  • Cortisol production follows a curve from highest levels around 8am, dropping throughout the day until the lowest levels are reached about 11pm. In early stages of adrenal fatigue the body compensates with high night time cortisol. In this case the person finds it difficult to relax from the stress of the day and has trouble going to sleep. High night-time cortisol results in reduced REM sleep which is neither restful nor restorative. This can lead to depression and reduced energy levels the next day. In later stages of adrenal fatigue, the body may produce adrenaline (“fight or flight” hormone) in an attempt to compensate for low cortisol. This too will result in insomnia.
  • Stimulates hepatic detoxification by inducing tryptophan oxygenase (reducing serotonin levels in the brain), glutamine synthase (reducing glutamate and ammonia levels in the brain), cytochrome P-450 hemoprotein (mobilizing arachidonic acid), and metallothionein (reducing heavy metals in the body)[
 Weight / Hunger  Normalizing blood sugar level. Cortisol increases the blood sugar level in the body, thus providing the energy needed for the body to physically escape threat of injury in order to survive. Cortisol works in tandem with insulin from the pancreas to provide adequate glucose to the cells for energy. More energy is required when the body is under stress, from any source, and cortisol is the hormone that makes this happen.As adrenal fatigue progresses, blood glucose levels will tend to fall too low. The body responds to hypoglycemia by causing the person to crave anything that will rapidly raise blood sugar levels, such as a soda, candy bar, a cup of coffee or even cigarettes. Often adrenal fatigue leads to the abuse of alcohol, marijuana, and hard drugs because of the need to “fix” recurrent hypoglycemia. Unfortunately, the rapid rise in blood glucose provided by the “fix” only serves to start the whole cycle over.

I’m hungry, I need sugar NOW!
The adrenal glands, which rest on top of your kidneys play a vital role in controlling blood sugar. If the adrenals are exhausted from stress and sugar is the only food that’s fueling your system, you’re going to see a lot of irritability when hunger arises. The solution, besides eating balanced meals: Getting enough Vitamin C, licorice (Opt for the root, which helps slow down cortisol production), Vitamin B5 and adrenal gland supplements.
 Blood pressure, fluid retention, vitamin deficiencies   Stress increases the release of aldosterone, causing sodium retention (leading to water retention and high blood pressure) and the loss of potassium and magnesium in the early stages of Adrenal Fatigue.

  • Swelling & Veins: in the absence of cortisol, widespread vasodilation occurs.

Magnesium is involved in over 300 enzymatic reactions in the body. When the body lacks magnesium, it will suffer from a variety of pathological conditions such as cardiac arrhythmias.

 Elevated ESR or CRP (inflammation)  Cortisol has anti-inflammatory properties, reducing histamine secretion and stabilizing lysosomal membranes. Stabilization of lysosomal membranes prevents their rupture, preventing damage to healthy tissues. Absence of cortisol = increase inflammation
 Dehydration Your adrenals, two small glands that sit on top of your kidneys, secrete aldosterone, a hormone that regulates water levels and the concentration of minerals, like sodium, in your body, helping you stay hydrated. When your body is stressed, more aldosterone and sodium circulate in your system. Once the stress is over, aldosterone levels fall and sodium must leave your bloodstream. The sodium passes through your kidneys and exits your body as urine, taking water with it. If you experience high stress levels on a regular basis, you will weaken your adrenals and dehydrate your body. And even if you drink a lot of water, you may not be getting the hydration you need!
Muscle cramps When aldosterone gets too high, your blood pressure also gets too high and your potassium levels become too low. You can have muscle cramps, muscle weakness, and numbness or tingling in your extremities.
Heart Palpitations
Night Sweats
Fatigue,
Light-headedness
When aldosterone gets too low, your kidneys will excrete too much salt, and it leads to low blood pressure; low blood volume; a high pulse and/or palpitations, dizziness and or lightheadedness when you stand; fatigue; and a craving for salt. Symptoms of low aldosterone can also include frequent urination, sweating, a slightly higher body temperature, and a feeling of thirst, besides the craving of salt. Potassium can fall, as well.
Nausea Abnormally low amounts of cortisol in the body disrupts metabolism, resulting in low blood sugar levels and reduced glycogen in the liver, which is used for providing quick energy. Much like the effects of diabetes, low levels of cortisol can initially cause brain-fog and lethargy, and progress to gastrointestinal symptoms, such as nausea, vomiting and diarrhea. Loss of appetite, weight loss and an inability to tolerate colder temperatures are also common symptoms.
Acne/Dry Skin/Dry Hair
Cortisol increases the production of sebum, a natural oil that lubricates your skin. When too much is produced, however, it can lead to blockages that cause acne. Too little cortisol = reduced sebum = dry skin.Also, low aldosterone can cause excess sweating/urination = dehydration!
Swelling/ Edema As the body tries to keep the ratio of electrolytes and fluid balanced, fluid may pour into the tissues and cause swelling. Most doctors will only see the symptom and not the cause and prescribe a diuretic which further compounds the dehydration and electrolyte imbalance and making the patient worse.
Hemorrhoids / Big Veins Hemorrhoids are basically varicose veins of the rectum and are caused by blood pooling in the abdomen and pelvis. When a person presents with hemorrhoids, it is usually do to adrenal fatigue, but can be caused by liver congestion. Once again, listening to the heart can help determine the cause. If the loud second sound is over the pulmonic valve, it is indicative of adrenal problems, while a loud 2nd sound over the tricuspid valve is indicative of liver congestion.Varicose veins of the lower extremities result from the same pooling of blood in the abdomen and pelvis that causes hemorrhoids.
Excessive Thirst, Frequent Urination, & Salt Cravings The adrenal glands produce many more hormones than just glucocorticoids. One very important hormone is aldosterone, a mineralocorticoid. Aldosterone regulates fluid and electrolytes (sodium, chloride, potassium and magnesium) in the blood, between and in the cells of the body. As adrenal fatigue progresses, the production of aldosterone lessens. This causes “salt-wasting”. As the salt is excreted by the kidneys, water follows leading to electrolyte imbalance and dehydration. Those with adrenal fatigue should always add salt (preferably sea salt with its trace minerals) to their water. Soft drinks and electrolyte drinks like Gatorade are high in potassium and low in sodium, the opposite of what someone with low cortisol needs. Commercial electrolyte drinks are designed for those who produce high cortisol when exercising, not for someone who produces little or no extra cortisol during exercise. You need to add ¼ to 1 teaspoon of salt to a glass of water or eat something salty to maintain fluid/electrolyte balance.A person with low aldosterone may also urinate 15 to 20 times a day and drink excessive quantities of water. Unless salt is added to the water, the fluid/electrolyte balance in the body is further disrupted.
Sensitivity to Light / Dependence on Sunglasses Are you one of those people who can’t stand to be out in the bright, midday sun without your shades? Oversensitivity of the eyes to bright sunlight is a sign of adrenal problems from a chronic sodium-potassium imbalance which prevents the pupils from properly constricting in response to bright light.The good news is that being out in the midday sun with no sunglasses is a way to strengthen the adrenals. When I do errands, I try to leave my sunglasses in the car and walk to and from the stores so that my eyes get a good dose of unobstructed sunlight.I’ve noticed that my eyes have become significantly less sensitive to sunlight over the years as my diet has improved with the general banishment of refined sugars and carbohydrates in my home. While I still wear sunnies for safety reasons to reduce the glare while driving, I frequently find myself forgetting to put them on at all on very sunny days.
Photo Sensitivity Dependence on SunglassesAre you one of those people who can’t stand to be out in the bright, midday sun without your shades? Oversensitivity of the eyes to bright sunlight is a sign of adrenal problems from a chronic sodium-potassium imbalance which prevents the pupils from properly constricting in response to bright light.The good news is that being out in the midday sun with no sunglasses is a way to strengthen the adrenals. When I do errands, I try to leave my sunglasses in the car and walk to and from the stores so that my eyes get a good dose of unobstructed sunlight.I’ve noticed that my eyes have become significantly less sensitive to sunlight over the years as my diet has improved with the general banishment of refined sugars and carbohydrates in my home. While I still wear sunnies for safety reasons to reduce the glare while driving, I frequently find myself forgetting to put them on at all on very sunny days.
Really dry hands / Lines in your fingers and hands Turn your hand over and examine the skin of the fingertips. Do you see nice, plump fingertips or is the skin covered with vertical lines? If they are nice and plump, that is a good sign for your adrenals. Lots of vertical lines in your fingertips indicate adrenal stress.My own fingertips used to be quite lined years ago, but getting off refined sugar plumped them out nicely within a few months.
Balding Lower Legs Do you have bald patcheson your lower arms and legs or sparser hair in those areas than you used to (particularly men)? This could be a sign of adrenal fatigue.Boys entering puberty with sparser beards and leg/arm hair than their peers are frequently those with low adrenal function and an overall lower drive to achieve.
Unexplained Hip or Knee Pain Muscle weakness is a frequent sign of adrenal insufficiency. Unexplained back or knee pain with no accompanying structural defect may indicate weakness of the muscles supporting the pelvis and/or knees.In the case of lower back pain, chronic adrenal stress leads to weakness in the muscles which support the pelvis causing the pelvis to subluxate in a posterior direction. In other words, the lower back pain has nothing to do with the lower back and everything to do with muscular instability in the pelvis

I guess my next step is to reduce stress and maybe try Milk Thistle. Please let me know if you’ve had success with this!

For some additional insight, check out this thread on the topic: Symptoms of Adrenal Insufficiency.

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If you’re reading this blog for the first time, read “Numbness and Tingling on the Right Side” first and work your way up.

Quick synopsis: In January 2011 I started getting weird symptoms which started with numbness in right thigh and right cheek. I also had a slew of other symptoms: tingling, silent-migraine-like episodes, tingling, especially in the thighs, tight, spastic muscles.  Tested negative for Rheumatoid arthritis, lupus, celiac, MS (my MRI just came back clean).

I have high ESR, CRP and was deficient in B12, calcium, ferritin, magnesium and had bad anemia, which peaked in July 2011.

I’ve seen a rheumatologist, neurologist, endocrinologist and as of today, a gastroenterologist!  The rheumy insists it’s fibromyalgia (FM), but since treating my vitamin deficiencies, I don’t have trouble sleeping, and I’ve never had wide-spread pain or ANY tender points. Also, inflammation is not a symptom of FM.

I’ve been taking ibuprofen for 1.5 weeks and it helps with the constant aching in my upper arms. I have occasional spastic muscles (jaw, traps (shoulder), calf muscle and mid/lower back). My hips often are achy. I don’t think this sounds like FM, but maybe I’m wrong? Also, I have mild swelling all over my body. Slight pressure seems to cut off my circulation – like when sitting, or putting my feet up, tight elastics on shirts, etc…  Swelling isn’t terrible but I look puffy and bloated – just glad it’s winter time!

Next step: having upper and lower gastrointestinal tract (GI) scopes/colonoscopy.

On a positive note, my daughter was born this past November. Perfectly happy and healthy and is a pure joy through all of this. Still feel quite blessed that I don’t appear to be dying and have a beautiful little girl to show for all my trouble.

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