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TOPIC: Doctor In Distress--Seeks Advice From Patients

Doctor In Distress--Seeks Advice From Patients 9 years 4 months ago #1

I am a 39-year-old male Naturopathic Doctor living in Seattle, WA, USA. For the eight-years since graduating I have mostly been teaching (genetics, A&P, microbiology, biochemistry, nutrition, pathology, and pharmacology). In practice, I focused on physical medicine (sports injuries, motor vehicle accidents, etc.) and using diet/nutriceuticals to prevent and reverse illness. I have worked for cutting edge genetic-testing laboratories, microbiology labs, and am now the Research Fellow for an alternative health research foundation in California. Suffice it to say that I strongly prefer my medicine to be evidence-based.

I am not into energy-medicine, homeopathy, muscle testing, or any of the typical woo-woo practices that can plague the naturopathic profession. I have even avoided using most herbal medicines--unless the evidence was solid and overwhelmingly positive. Hormone therapies were always interesting, but the thought of using them seemed too artificial and heavy handed—-until recently anyway.

Recently, I had a VERY stressful year: I survived a serious and highly-toxic house fire 14 months ago, I had to fire (and may end up suing) a criminally-incompetent rebuild contractor, I chose to work on my house myself on a badly sprained ankle for two months nine months ago, and then I fractured my face in three places while playing ultimate frisbee (with residual nerve damage) seven months ago. Career, home, personal belongings and relationships all went topsy-turvy too. Even in the backdrop of my previously very tense/intense life, the last 14 months have been very rough.

I've always been tough to life's twists, but now some important things in me are feeling quite different.

Since the fire, I have had many signs of connective tissue failure: I am a hairy guy, and a few months after the fire, I saw that most of the hair on my legs was breaking off. Then I noticed that my gums were bleeding every day. Then I cracked a tooth for the first time, followed by spraining one ankle badly, then the other one even worse. Seven months ago I fractured my face in three places playing a field sport that I have enjoyed playing for 20 years. In my teens and twenties, I used to teach karate and kick boxing, so I am not used to getting injured easily, healing slowly, or feeling weak. I seem to have all three now.

Although I had previously broken bones without significant swelling, my ankles were severely swollen for months, and my face has been very slow to heal and still hurts now. I am thinking that my cortisol levels may have hit bottom and my inflammatory responses are way up.

Since the fire, I have noticed that for the first time in my life, I am feeling cold most of the time and find that I am dressing up with winter hats and coats inside at temperatures that previously would have had me in a T-shirt. I am thinking that my T3 is not what it used to be, but I am not sure exactly why (hypothalamic-pituitary/thyroid/or peripheral conversion).

About four months ago I noticed that my sex drive dropped away—seemingly almost overnight. So I’m thinking that DHEA, androgens, or testosterone took a major dive too.

I’ve always been a night owl, but recently I have been easily staying up till 2-5AM in the morning and sleeping in till 11, or 12. I was previously used to waking up feeling tight, sore, tired, and fuzzy, and it’s even worse now. I am drinking two strong cups of coffee to just feel normal, but have to be very careful not to drink too much lest I fall into a serious anxiety state (something I have been managing for years with 100 mg 5HTP 1-2x/day) I’m guessing that this is another sign that my Cortisol is down as well.

I am now also generally feeling tired and irritable and depressed. I am also visibly putting on weight--especially in my face and stomach. Any more than two beers can be pretty darn hard to recover from the next day--when I can feel a lot of anxiety and depression. I am a home brewer and used to love a well-earner, all natural beer.

Currently, I am bringing my FULL being (what’s left of him anyway :S) to the task of grasping my state on the spectrum of Adrenal Exhaustion and figuring out how to respond most appropriately. My background in academic biochemistry, endocrinology, and physiology is quite strong, but I have almost no practical experience treating the kind of patient that I have apparently become. On the bright side, I can already see myself re-opening my practice with new-found sensitivity to my adrenal-fatigue, metabolic syndrome, FM/CFS, and chemically sensitive patients. :)

OK, back to Doctor Heal Thyself...

QUESTIONS:
Is a salivary cortisol/DHEA test worth the $150-200?
If so, is 4x/day on cortisol and 1x/day on DHEA enough?
(Locally in Kent WA, Diagnos-Tech Lab adds: insulin x2, secretory IgA, 17-OH progesterone, and gluten antibodies all for $149)
Given my very wacky sleep schedule of late: staying up till 2-5AM, waking at 10-11AM, when should I take my saliva samples.

OR, given the clarity of my symptom set, should I go straight to clinical trials of therapy?

DHEA (25mg QD) comes to mind right away.
Does this seem advisable?
If so, what time of day does one best take DHEA?
How serious is the liver damage potential?
Should I get liver enzymes run before starting?

There are a host of herbs that have reported adrenal supportive properties: Rhodiola, Ashwaganda, Panax Ginsing, Eleuthero, Lichorice, Maca, Bupleurum, Magnolia, Epimedium, L-Theonine...
Which one(s) have the best effect for someone in the exhaustion stage?
Which one(s) are best avoided in the adrenal exhaustion stage?
(Am I in the exhaustion stage??)

I was also thinking of selenium (to support 5’deiodinase conversion of T4->T3).
Vitamin-C 2000-4000 mg/day.
B5 (or pantethine itself), and B6 foods and supplements.

What else should this \"doctor in distress\" be doing to heal himself? I open my case to public exploration, and I thank you for your time and consideration.
<br /><br />Post edited by: trmorrisnd, at: 2010/01/19 08:30
May you be well!

Dr. Timothy R. (T.R.) Morris
Naturopathic Medical Doctor
trmorrisnd.com/
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Re:Doctor In Distress--Seeks Advice From Patients 9 years 4 months ago #2

  • Maff
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Hi Timothy,

Welcome to the site. It's good to have someone with your academic background with us!

I have answered your questions as best I can on my personal problems re: DHEA toxicity and liver problems in the other thread you replied to but I can add more.

I believe in murine studies it has taken an equivalent dose of 1000mg/day to produce liver toxicity in healthy animals so the risk at commonly used supplemental doses of 10-100mg would seem quite safe unless there is quite significant exisiting liver pathology - as in my case.

I personally feel the ASI test is worth the money as symptoms are a good indicator of the presence of adrenal fatigue/exhaustion but not the specifics i.e. cortisol and DHEA levels throughout the day.

Having said that a treatment trial with DHEA and low dose hydrocortisone (or licorice) or adrenal glandular would be one way to go.

For a bit of clarification I point you to my own ASI results from summer 2008. My sleep-wake cycle is similar to yours and the reasons for this are clearly reflected in my results. I have low cortisol in the morning and it climbs at night - as you are undoubtedly aware - this is essentially the reverse of normal. My DHEA levels are unusual as they seem to follow those for cortisol throughout the day but to an exagerated degree - going above reference range at times. This seems odd since apart from the liver problems, DHEA helped me feel better in every way as if it is exactly what I was missing!

My Adrenal Stress Index (ASI) Results

No need to worry about when to take the saliva samples for the ASI as you take samples at set times throughout the day to give a picture of diurnal variations. I have done 12 hour versions but I believe you can also do 24 hour ones now - although waking during sleep would obviously skew the results from a normal 24 hour period.

I would start with DHEA 25mg/day in the morning and increase at 25mg per day per week if you get no results up to 100mg/day/

T3 was also a help to me when combined with DHEA and licorice for adrenal support. Trying to increase thyroid hormone activity is not a good idea with exhausted adrenals as you will end feeling overstimulated and exhausted. Along with the stages you mentioned as possible blocks in the thyroid pathway I would suggest that receptor resistance due to such things as oxidative damage or reduced expression could be another possibility? I would suggest a trial of T3 readily since it is none toxic at physiological doses - e.g. starting at 25mcg/day.

I have tried the majority of the herbs you mention and found all to be over-stimulating. The only one I would suggest based on your description of your symptoms is licorice taken in the morning as this should raise your morning cortisol levels and may shift your sleep-wake cycle back to normal - as well as giving you back a sense of vitality.

I'm afraid my time is limited at the moment as I am busy writing my bachelor's degree thesis and other work so I can't supply citations for all of this.

I refer you to Dr. Lam whom I consider to be one of the leading experts in adrenal and thyroid-related issues.

His website is www.drlam.com

I hope you find some of this of help and once again it's good to have you on the site.<br /><br />Post edited by: Maff, at: 2010/01/19 23:43
If you are going through hell, keep going - Winston Churchill
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Re:Doctor In Distress--Seeks Advice From Patients 9 years 4 months ago #3

Hi Timothy,

I wrote you a long reply last night and then \"lost\" it when I tried to post it. :unsure: I just want to encourage you tonight that you can get better. I've got a goal to come back tomorrow and write you. I have no way of knowing if my story will help you, but maybe something that has been helping me with help you too.

\"See\" you later,
tomorrow...
greatful*:)
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Re:Doctor In Distress--Seeks Advice From Patients 9 years 4 months ago #4

Hi T.R.

I'm back, and have been thinking about you, hoping you are feeling better. I'm not a doctor and I still have a couple of troubling issues to figure out, but if my story can help you, I'd like to think I haven't gone through it for nothing. Maybe something here will help you.

My life was changed dramatically when I moved into a house with dry rot and mold. I didn't know it until after I was terribly exposed, so by the time I got out and stayed out of that house, I was damaged from the inside out. When I read your story, I wondered what chemicals you got exposed to in that fire. No matter what the environmental elements were, it sounds like something compromised your immune system and probably poisoned you.

Here is a simple list written the way I received the instructions.
    To start, eat only organic fresh foods.
    Eat on a four day rotation diet, keeping a journal to discover if any allergens, sensitivites.
    Eat 80% raw vegetables and 20% cooked
    Eat an anti-fungal diet. It will help balance ph. See www.barbhealth.com and www.hacres.com and www.ravediet.com and www.knowthecause.com
    Drink green smoothies and barley green drinks.
    Juice fresh carrots, celery, beets, etc. Drink fresh.
    Drink distilled and/or purified water. Stay away from flouride and chloride. In fact, stay away from all chemicals. Give your body a break!
    Take lots of minerals and vitamins, starting with the RDA and then take some things in mega doses. Each person is an individual so doses vary, however I found magnesium, potassium, zinc, selenium and CoQ10 to be good for my heart.
    On the subject of selenium, this scientist healed himself from MCS with megadoses of it. www.nutricology.com/Interview-with-Found...ne,-Ph.D.-sp-25.html
    Also, I take Vita C, D, and B12 in megadoses. Take a good multivitam with no iron and get flax seed or omega 3, 6 and 9. Coconut oil is good too.
    Absolutely no processed foods.
    No MSG, aspartame, or any of its relatives.
    No alcohol or smoking.
    Absolutely no chemicals in foods.
    Use sea salt and dulse daily. No table salt.
    Don't overdo exercise. Take short, gentle walks until your body can detox sufficiently.
    Before starting a serious detox program,

    Check your heavy metals level. Do you have mercury amalgams in your teeth? If so, you must have them removed. I believe that once the body's \"toxic load\" is overloaded, then every toxin found must be eliminated at its source. Most mercury enters the body via the amalgams so that source must be removed. www.iaomt.org/
    toxicteeth.org

    Next, do you have root canals? I do and I found things that I never dreamed of. Dr. Weston Price did some research, and for 50 years it was ignored. If you have root canals, you need to read this.www.healingdaily.com/exercise/root-canals.htm

In my own case, I was diagnosed with CFS, adrenal exhaustion, hypothyroidism, gluten intolerant, MCS, and food allergies. Everything listed above helped me survive and even improve, but once the mercury was out, I started seeing and feeling significant positive changes. The only symptom that still gives me significant cause for concern is this palpitating heart, and even that improved after the mercury was removed. I am hoping that after detox and root canal extraction, my heart will calm down. If you have any thoughts based on your questions and Maff's answers, that you think might help me, I sure would appreciate hearing back from you. Thank you.

Take care out there. I will be hoping for your best health ever!

greatful*<br /><br />Post edited by: gr8tful4life, at: 2010/01/21 05:21
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Re:Doctor In Distress--Seeks Advice From Patients 9 years 4 months ago #5

Hi,

Is this a good place to have the ASI test done? I copied and pasted a couple of their tests so you could see, but the website is below: (Thanks for guiding me.)

www.guidance.org/store/Available_to_All.html


ASI KIT & Consultation - Foreign Delivery
A-1006
$60.00
The Adrenal Stress Index kit is from DiagnosTechs Laboratory in Seattle. Please note: Once you have collected the saliva samples you must send them with $99.00 to the laboratory for processing (instructions included). The $99.00 fee is the laboratory’s charge for the actual test itself. The $60.00 charge, plus S&H, includes a complete review of the test results with Dr. Neville in a twenty minute personal phone consultation. In this consultation you can expect to learn of the exact nature and degree of your adrenal dysfunction and about how we can assist you improving your condition.
Order View Cart





ASI Kit & Consultation
A-1005
$60.00
The Adrenal Stress Index kit is from DiagnosTechs Laboratory in Seattle. Please note: Once you have collected the saliva samples you must send them with $99.00 to the laboratory for processing (instructions included). The $99.00 fee is the laboratory’s charge for the actual test itself. The $60.00 charge plus S&H, includes a complete review of the test results with Dr. Neville in a twenty minute personal phone consultation. In this consultation you can expect to learn of the exact nature and degree of your adrenal dysfunction and about how we can assist you improving your condition. *Please note that only the initial 20 minutes of this consultation is included in this fee. Any time over 20 minutes will be billed at our standard fee of $2.00 per minute.


Thanks so much,
greatful*
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Re:Doctor In Distress--Seeks Advice From Patients 9 years 4 months ago #6

I actually just mailed in my samples for my first ASI test through Diagnos-techs. I think you need to have a doctor's prescription--at least from Washington State and directly through the lab. I'll make another post about what my experience is like when I get my results and take their technical support for a test ride.

If you need a prescription, I can write one for you and also be hired to help with interpretation. Where do you live?
May you be well!

Dr. Timothy R. (T.R.) Morris
Naturopathic Medical Doctor
trmorrisnd.com/
The administrator has disabled public write access.

 

 

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