Two weeks later and I visit the new guy-who is very new indeed. Later I found out he had only been a real practicing dr for one week when he saw me. The office was very different from the last endos office. Her place was a bit like a meat market with twenty or thirty peoiple waiting at any given moment. You would sit in a little box when they took you back for about thirty minutes and then get a three to five minute visit with Dr. Satan. This office was a small room with some couches. Two or maybe three people would be waiting. The office was filled to the brim with Texas decorations. Somebody here loves Texas! The doc was totally different. He was young and cheerful and didn't seem to be in too much of a hurry. I think i didn't shut up for fifteen minutes straight. I never got a chance to say anything to satan women as she made it clear she didn't have time to talk. This poor guy got his ears talked off. I showed him all my previous test results and told him I wouldn't take the synthroid till the other problem, whatever it was, was resolved. He ran a bunch of tests for cortisol and ACTH as the symptoms appeared to him to be adrenal related even though the ACTH stim test looked fine.
The next week we had another visit. The tests came back fine and he was at a loss. He wanted to try an even lower dose of synthroid-12.5 ug. At this point I was a bit disgusted with the idea as the past couple of weeks had been very tramatic. But it was a very low dose and he was a really nice guy so I figured I'd try it. The first day I saw the excessive urination, headache and nauses come back in small amounts. On the third day I dropped the amount to 6 ug or so given that chewing a tablet in fourths isn't real practical. The symptoms were still there and I was getting a bit weaker. It looked like now I would just slowly get worse and worse. No optimism here. I got a bit herbal on my poor doc and tried to take some licorice rooat as it is the herbal solution for weak adrenals. Licorice prevents the enzymatic conversion of cortisone to cortisol in the kidneys. This allows a large excess of cortisone to be present in the kidneys and bind to the aldosterone receptor, replacing a lack of aldosterone. Usually this enzymatic conversion is what gives aldosterone its specificty as cortisone can bind just as tightly as aldosterone. Licorice "poisening" results if you eat tons of licorice root and mimics hyperaldosteronism (conn's disease).
It worked! I actually felt better. I took several licorice pills and drank some licorice tea. Of course the problem with herbals and the like is that the way they work is so unregualted and you have no idea when they stop working. On the second day I went back to the ER as I guess all the licorice was metabolized and I went from fine to severe tremors in ten minutes. Of course the ER doc said I should TAKE MORE SYNTHROID... Of course I should. Poor guy.
I went back to the endo the next week and told him what happened. He said we could try taking no synthroid at all but I had seen the change taking the synthroid, at least at first. I did feel better. I wanted to feel better. I was tired of living in a shell with wierd symtpoms all the time and feeling like a hyperchondriac. So he was going to try a dose of prednisone with the synthroid. I asked him to consider a very low dose of hydorcortisone instead and he said sure. Then I said that since my symptoms were aldosterone related, perhaps we could just try florinef for a bit first as it won't suppress the HPA axis at all. He said sure why not and sent me home to take 100 ug of florinef and 25 ug of levoxyl. I think he was so baffled.
A week later I was back and doing really well. I felt much better and the florinef was keeping me stable with no apparent side effects. In theory if I was making aldosterone in reasonable quantities I would see edema and raised blood pressure but overall I saw nothing. My endo was so excited. He told me to keep taking the synthroid for five weeks and then we would do more tests and possibly raise the dosage. My poor endo...
