Help decipher chronic adrenal, thyroid, hormone, gut issues?

I have been reading for some time and appreciate the time that people take to respond to questions on Curezone so I am hopeful some of you might have a perspective on my long running and layered issues (hormonal, thyroid, adrenal, other)!

I apologise in advance for the long and complicated history! I am a 28 year old Australian female, ex-athlete, globetrotter and spent too many years "burning the candle at both ends" ...I have been unwell for going on 5 years now (possibly longer at a sub-clinical level).

The chronic and most inconvenient symptoms I currently have are: - severe cold intolerance

-thinned hair
- inconsistent digestion (not too bad, but a little up and down)
- constant upper back and neck pain / tightness + poor recovery from exercise
- fatigue
- disrupted and non-restorative sleep (get to sleep fine, wake during night to use bathroom)
- impatience / lowered tolerance (i think partly because i'm in pain constantly)
- sensitivity to noise (even motorbikes) and chemical smells
- low blood pressure (88 / 60 as tested yesterday)
- thirst and hunger
- no menstrual cycle since January 2012 (8 months)
- painful intercourse

I am still functional, however I have always been someone who would push through almost anything (possibly to my detriment) so i pretty much soldier on. Below is an abbreviated health timeline with my major history, if anyone is kind enough to read further.

Pre-symptoms:

- Glandular fever Year 12 in 2001 at 17 years old. Lasted approx 3 months. Too much Sugar in diet. Too much partying and late nights.
- 2002 – 2006 dual tennis and cross country running scholarship to University in the U.S. Frequent long distance travelling with no recovery time, approximately 30 hours of sport per week (6-7 days per week) with no off season or summer holidays combined with 22 – 25 class contact hours per week. No menstrual cycle for two years and hair thinned. Also underperformed in cross country even though training more than ever before (possible because of). Otherwise “felt” healthy and never got any common colds, viruses etc. In hindsight I suggest this is where I was laying the foundations for the majority of my current health concerns, running my adrenal glands into the ground and creating massive hormonal imbalances. I was likely malnourished at the cellular level. I ate a lot, however I don’t believe I had the right breakdown of macro and micro nutrients for my activity level (too high in sugar, too low in good fat and possible vitamin / mineral deficiencies).
- 2006 – 2008 still working out 5 – 6 times per week, working full time in busy corporate job and frequent long distance adventure travel with no recovery time. Too much Sugar in diet and alcohol binge nights with friends once a week / fortnight.

Symptomatic:
- July 2008 neurological symptoms commenced following whirlwind trip to Japan (possible catalyst that brought underlying health imbalances to surface?). Full body MRI and other neurological tests came back fine. Various blood tests with questionable liver, inflammation etc readings at time but nothing concrete. Diagnosis was foreign viral infection that attacked my nervous system. Seemed to work its way out (in terms of the neurological component) after approx 3 months. Left with wide spread pain and tension, cold intolerance, dry skin and chronic fatigue.
- December 2008 spotting in between periods. Ultrasound discovered uterine polyp. Removed late December 2008. No further spotting.
- September 2009 - 2010 4 urinary tract infections in 1 year. No history of them prior to, and none since (however since that time have been left with odd urethra sensation of not being able to clear all urine).
December 2009 - abnormal thyroid screening test result (high TSH) resulted in full thyroid profile and diagnosis of underactive (hypo) thyroid with autoimmune component (high antibodies) + high reverse T3 (approx 600). Treated with T4, then T4 / T3, then straight T3. No improvement in symptoms. Did my own extensive research and overhauled diet (cut gluten, alcohol and Sugar at this stage) and lifestyle (cut out intense exercise).
May 2010 onward - started treating adrenals (naturally) in conjunction with thyroid (stopped meds, treated with supplements). Some improvement in symptoms from 30% function to maybe 70%. Have not been able to improve that last 30% and have had some dips.

Current shedule:

Work – 6 days week running own business (looking to sell to focus on recovery), morning and evening sessions (tiring) + back end management during middle part of day

Exercise – 2x short weight sessions never to failure. Leisurely cycling 2x week to and from work (approx 30 – 40 mins broken up into two parts). Light walking

Nutrition – anti inflammatory / autoimmune focus. Plentiful, unprocessed, predominantly organic diet of meat / fish, some nuts / seeds (soaked and dehydrated), lots of vegetables (majority lightly cooked to aid digestion), berries, coconut (milk, oil, flakes), organic eggs. No sugar, alcohol, soy, grains or legumes

Supplements – naturopathic herbal tonic to help circulation with some thyroid and adrenal supporting herbs, BioLogic Bladder Tone, BioChem Fat Metaboliser (to help balance fatty acids which are out of whack), krill oil (for fatty acid balance), Thorne Research Choline, Thorne Research L-Carnitine, Vit D3, maca powder and bee pollen (for hormonal and general immune health)

Treatment History:

General - Naturopathic herbs and vitamins for thyroid, immune and adrenal support (past and present). Naturopathic treatment for gut imbalance + candida (2009)

Hormones - Bio-identical hormones – progesterone cream (3 months 2010), pregnenelone tablets (3 months 2010), Progesterone tablets + estrogen cream + testosterone cream (2 months late 2011 / early 2012) – currently postponed as attempting to treat hormones naturally by overhauling fatty acid metabolism. Question about restarting these as hormones seem to be getting worse judging by lack of periods and painful intercourse?

Thyroid - initially treated with T4 (thyroxine), then T4+T3, then just T3 (tertroxin). No change in symptoms with T4 or combined T4 / T3. Slight improvement with cold intolerance when on straight T3, however no other improvement and reached max dose (started to have hyper symptoms) without resolution of other hypo symptoms. Also tried Metagenics Thyrobalance herbal support with limited success

Adrenals - Dr James Wilson adrenal protocol – adrenal glandular, adrenal multi vitamin, adrenal stress (B vits etc), magnesium, B5

Recovery - weekly massage, monthly osteopathy, infrared sauna

My latest blood test results (yesterday) that might warrant some attention are:

Biochem:

Bicarbonate: 32 mmol / L (22 - 31) Urea: 9.7 mmol / L (2.3 - 7.6) eGFR (mL/min): 51 per 1.73sqm (>60) Creatinine: 111 umol / L (40 - 80) AST 33 U/L (0-30)

These are new developments and were in range last tested approx 1 year ago. Possibly my protein intake has increased since then and I do have small portions for breakfast, lunch, dinner (often leftover dinner for breakfast, salmon and stir fry veg for lunch, then different meat / veg for dinner with nuts, veges, coconut based products, "mini meals", bone broth for snacks). However, i do not believe my protein intake is excessive to warrant these elevated kidney results, and I shouldn't be dehydrated as I drink plenty of water and herbal tea.

Hormones:

E2: 147 pmol / L (anywhere from 70 - 1300 depending on stage of cycle which I haven't had since January) PROG: < 0.5 nmol / L (1 - 130 depending on stage of cycle) Sensitive Testosterone: 0.7 nmol / L (0.6 - 1.7) Calculated Free Testosterone: 8 pmol / L (8 - 32)

*waiting on latest saliva hormone profile including cortisol, DHEA. Last test were low across the board (cortisol, DHEA, estrogen, progesterone, testosterone - borderline normal).

Thyroid:

Free T3: 3.3 pmol / L (3.5 - 6.5) Reverse T3: 588 (my integrative doc wants it under 150). Elevated thyroid antibodies also. T4 currently "in range"

I've spent so much money so far on investigating and treating and I would really like to get some traction! I remain ever hopeful that I can correct this and understand it was many years in the making and is such a layered mess that it will take years to correct. It is extremely frustrating however when I throw everything i can possibly think of and each time get little to no results!

I really appreciate any thoughts you might have. Tweet