Hormones and Hypotension Intensive Care

Published: May 24, 2022

Vitality101 Newsletter


Hello Reader,

Hormonal imbalance and hypotension (low blood pressure) can lead to a host of unpleasant symptoms. In part 14 of "Fatigue & Fibromyalgia Are Optional," I describe some of those symptoms, explain what they might imply of your health, and offer some steps you can take to help you get well.

BFF Summary

  1. In those with irritability when hungry, especially if their illness began with a viral infection (adrenal fatigue), I usually recommend the supplement Adrenaplex plus, in some severe cases, I add the bioidentical prescription hormone hydrocortisone (Cortef). At doses of 25 milligrams or more daily (equivalent to 5 milligrams of prednisone), this hormone can suppress your adrenals and have significant toxicity. But at doses of 20 milligrams a day or less, overall the research suggests it is fairly safe. People know within a month if these are going to help.
  2. Acne, severe weight gain, darkening of facial hair, and irregular periods? Consider PCOS (polycystic ovary syndrome) in women. I do this by looking at test results for a fasting insulin (high if it is over 10), or a high or high normal DHEA-sulfate or testosterone. The medication metformin, a low-carbohydrate diet (e.g., ketogenic diet) and birth control pills can all be very helpful.
  3. (continued...)

Long COVID Symptoms Linked to Effects on Vagus Nerve

Nervous System

In a small study of 22 people with long hauler post-COVID, 27% of participants showed evidence of inflammation of the vagal nerve. This nerve tends to counterbalance adrenaline and supports digestion in our body's dance of autonomic function. It shows one more mechanism, in addition to limbic and hypothalamic dysfunction, contributing to the sense of adrenaline overdrive and POTS that many people with CFS and fibromyalgia have. The decreased movement of the diaphragm muscle that separates the lungs from the abdomen may also be one factor contributing to the sense of breathlessness that many people have.

Meanwhile, another study showed that famotidine (Pepcid) stimulates vagal function to block cytokine storm. This is just one more reason why Pepcid during COVID can be so lifesaving. It may also help with the vagal nerve dysfunction and chronic viral infections seen in CFS and fibromyalgia.

Featured This Week

Q&A of the Week

Question: I was treated years ago for CFS and was prescribed Armour Thyroid, which helped. Now my total T3 levels are high, middle range free T4, and low TSH. My doctor says my TSH level must be increased, but my original doctor said to ignore TSH and focus on getting optimal T4 and T3. How can I talk with my doctor about this?

Answer: Unfortunately, most physicians are not familiar with proper thyroid test interpretation in fibromyalgia, or when T3 thyroid hormone is being used. Research has shown that TSH is not reliable in CFS/FMS, because of the hypothalamic pituitary dysfunction, and the normal range does not apply. In fact, many people with fibromyalgia find they need their TSH level to be low to get the optimal amount of thyroid hormone. So in fibromyalgia I recommend thyroid hormone based on clinical symptoms, making sure that the free T4 is not elevated. However, if on the desiccated thyroid, it is okay for the free T4 to be low.

When T3 is taken by mouth, the normal range for T3 is meaningless. If taking T3 by mouth, the blood T3 levels should be elevated for several hours after taking the dose. But many doctors are not familiar with using this hormone. To keep it simpler for the physicians (so they don't panic when seeing an inappropriately high T3), it is reasonable to not take your T3 or desiccated thyroid medication for the day until after your blood has been drawn.

You are not likely to be able to train your doctor in this.

For more information on thyroid treatment and testing, I recommend my book From Fatigued to Fantastic.

If you have a question for Dr. T, you can submit it to him at Ask Dr. T.

Bad News for the Burglar

One night a burglar broke into a house. While sneaking around he heard a voice say, "Jesus is watching you." He looked around and saw nothing. He continued creeping and again heard, "Jesus is watching you." In a dark corner, he saw a cage with a parrot inside.

The burglar asked the parrot, "Was it you who said Jesus is watching me?"

"Yes," the parrot replied.

Relieved, the burglar asked, "What’s your name?"

"Clarence," answered the parrot.

"That's a dumb name for a parrot,” said the burglar. “What idiot named you Clarence?"

The parrot replied, "The same idiot that named that big rottweiler over there Jesus."

Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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