Metabolic Scoreboard: Symptom Matrix
Signs and Symptoms: Adrenal Fatigue vs. Low Thyroid function
KEY: - generally absent
+ possibly present
++ often present
+++Always or almost always present
From: http://www.drrind.com/scorecardmatrix.asp 5/14/2008
+ possibly present
++ often present
+++Always or almost always present
From: http://www.drrind.com/scorecardmatrix.asp 5/14/2008
My Suggestion: print this out and highlight the description that most matches you. That will give you a good indication as to where you fit in this determining process. Teresa
| adrenals_vs_low_thyroid_chart_1.pdf |
TYPICAL FINDINGS on BLOOD TESTS
| adrenals_vs_low_thyroid_chart_2.pdf |
Footnotes:
1. In working with thyroid and adrenal dysfunction, I have come to realize that most patients with low body temperatures have a mixture of low thyroid and low adrenal symptoms (also called Wilson’s Syndrome).
2. Facial Pallor: A pale color, especially around the mouth. Easiest to see in light skinned individuals. In olive skinned individuals it is much harder to see. In individuals of African decent, there is a tendency to have dark pigmentation around the mouth, symmetrically on areas of the face or sides of the neck and usually over the forehead. Since wrinkles stay in the pale area, puckering the lips artificially creates wrinkles for a moment and their location identifies the pale zone. This technique is particularly helpful in dark skinned individuals. It is also easier to see in women than men (because of the beard hair which interfere with color identification and thicken the skin to make it more resistant to wrinkles).
3. Intuition is an interesting quality of early life adrenal fatigue. The later in life the development of adrenal fatigue, the less likely one is to spontaneously develop intuitive ability. People that develop adrenal fatigue early in life are often described as empaths and will tell their friends (but not their doctor) about their ability to pick up feelings. They often suffer because of their high sensitivity and are always looking for new ways to `ground' themselves. This problem often clears by simply supporting the adrenals and getting them to function well again. Poor adrenal function is not essential for intuitive development. Strengthening the adrenals does not weaken the intuition once it is there. Individuals that develop adrenal fatigue later in life (because of high stress, virus etc.) tend not to claim this intuitive ability. Spiritual orientation is more common in those with early adrenal fatigue, It is less common in those with later onset of adrenal fatigue and those with strong, healthy adrenals. There seems to be a personality difference (archetype) between those with strong adrenals and those with weak adrenals.
4. Mitral valve problems seem to affect women with adrenal fatigue more often than others. Body proportions tend to be smaller at the top, heavier at the bottom where the weight gain, if any, tends to take place. The tendency to valve problems may be related to connective tissue quality since it sometimes Improves with connective tissue support. Hawthorn Berry seems to help. Individuals with plain hypothyroidism don't appear to have a higher incidence of valvular problems compared to the rest of the population.
5. These individuals tend to digest meat poorly because of low gastric acidity. They often think they have high acidity because of occasional heartburn or heartburn when taking digestive enzymes containing digestive acid. The problem is usually not a problem of gastritis or gastric reflux caused not by excess acid but rather, it is a problem of inadequate acid production, but less adequate gastric protection not making enough gastric protective secretions. This could be helped by chewing or sucking on a specific type of licorice candy called DGL or by taking some Slippery Elm or trying both. Suck or chew on it about 1/2 hr before the meal. It produces Increased secretion of gastric (stomach) mucous protective layer. This helps to prevent irritation by the acids in the stomach.
6. In adrenal fatigue, the total cholesterol tends to run low to low-normal while the HDL tends to run high-normal to high. In hypothyroidism, the opposite tends to occur with a high-normal to high cholesterol and normal-low HDL.
1. In working with thyroid and adrenal dysfunction, I have come to realize that most patients with low body temperatures have a mixture of low thyroid and low adrenal symptoms (also called Wilson’s Syndrome).
2. Facial Pallor: A pale color, especially around the mouth. Easiest to see in light skinned individuals. In olive skinned individuals it is much harder to see. In individuals of African decent, there is a tendency to have dark pigmentation around the mouth, symmetrically on areas of the face or sides of the neck and usually over the forehead. Since wrinkles stay in the pale area, puckering the lips artificially creates wrinkles for a moment and their location identifies the pale zone. This technique is particularly helpful in dark skinned individuals. It is also easier to see in women than men (because of the beard hair which interfere with color identification and thicken the skin to make it more resistant to wrinkles).
3. Intuition is an interesting quality of early life adrenal fatigue. The later in life the development of adrenal fatigue, the less likely one is to spontaneously develop intuitive ability. People that develop adrenal fatigue early in life are often described as empaths and will tell their friends (but not their doctor) about their ability to pick up feelings. They often suffer because of their high sensitivity and are always looking for new ways to `ground' themselves. This problem often clears by simply supporting the adrenals and getting them to function well again. Poor adrenal function is not essential for intuitive development. Strengthening the adrenals does not weaken the intuition once it is there. Individuals that develop adrenal fatigue later in life (because of high stress, virus etc.) tend not to claim this intuitive ability. Spiritual orientation is more common in those with early adrenal fatigue, It is less common in those with later onset of adrenal fatigue and those with strong, healthy adrenals. There seems to be a personality difference (archetype) between those with strong adrenals and those with weak adrenals.
4. Mitral valve problems seem to affect women with adrenal fatigue more often than others. Body proportions tend to be smaller at the top, heavier at the bottom where the weight gain, if any, tends to take place. The tendency to valve problems may be related to connective tissue quality since it sometimes Improves with connective tissue support. Hawthorn Berry seems to help. Individuals with plain hypothyroidism don't appear to have a higher incidence of valvular problems compared to the rest of the population.
5. These individuals tend to digest meat poorly because of low gastric acidity. They often think they have high acidity because of occasional heartburn or heartburn when taking digestive enzymes containing digestive acid. The problem is usually not a problem of gastritis or gastric reflux caused not by excess acid but rather, it is a problem of inadequate acid production, but less adequate gastric protection not making enough gastric protective secretions. This could be helped by chewing or sucking on a specific type of licorice candy called DGL or by taking some Slippery Elm or trying both. Suck or chew on it about 1/2 hr before the meal. It produces Increased secretion of gastric (stomach) mucous protective layer. This helps to prevent irritation by the acids in the stomach.
6. In adrenal fatigue, the total cholesterol tends to run low to low-normal while the HDL tends to run high-normal to high. In hypothyroidism, the opposite tends to occur with a high-normal to high cholesterol and normal-low HDL.
WBC (White Blood Cells are the front line soldiers against infection) and platelets (they work to initiate a clotting response in areas of vascular injury) low relative to optimal. Typically, the WBC is under 5 and the platelets are under 200. It is also important to look at relative values. For example, if one has adrenal fatigue (we expect WBC to be <5) but if the WBC is >6, we can say that in a relative sense, the WBC is elevated (it is higher than we expect). We therefore suspect that something is elevating the WBC (white blood cell count) and that this is either a low thyroid function or an infection (sinus, a cold, bowel, bladder etc.) or both. A point of interest: I think it is interesting that with adrenal fatigue, we tend to see high end fibrinogen (increases clotting) and low end platelets (these also help clotting). Thus the higher fibrinogen (chemical) and lower platelet (cellular) balance each other out. Similarly, with immunity the antibodies tend to be high (overactive component) while the white blood cells tend to be low. Again, the (high) chemical component and (low) cellular component tend to balance each other out.
8. The MCV (mean corpuscular volume) is a measure of the size of the red blood cells. Their size tends to increase as vitamin B12 deficiency increases. Individuals with poor digestion / absorption tend to run low on vit. B12, so they tend to have larger blood cells, i.e., MCV tends to be at the high end of normal or high. This is more common in adrenal fatigue since these individuals tend to eat less meat, tend to digest it poorly if they do eat it and generally absorb poorly.
9. RDW measures the distribution or variability of the size of young red blood cells. Individuals with stable health tend to have little variability in cell size. An unstable or poor state of health generally shows up as higher variability in cell size.
10. Whenever a patient comes in with depression, I look for a suboptimal thyroid function. This is not the same as saying ‘outside of the normal range'. Optimal is a zone within the `normal' range which I've identified as the range at which I find my healthiest patients. If the thyroid function is near or at optimal and depression persists, I then look for other supports such as supporting neurotransmitter levels with the following:
o For Serotonin (the ‘calmer') support: Tryptophan or 5-Hydroxytryptophan (i.e., 5-HTP) if the patient is not on SSRI antidepressants (SSRI's can adversely interact with Tryptophan or 5-HTP by promoting excessively high serotonin levels). The way I dose it ls usually by starting low doses AM, mid day if needed, and evening for sleep support. I find this especially useful for obsessive compulsive disorder (OCD) if the patient is not taking prescription medications of the SSRI type. A typical dosage regimen (after gradual increase to check for any adverse responses) might look like this: AM 50 mg-100 mg 5-HTP; Noon 50 mg-100 mg 5-HTP; Bedtime or a little before, 200-300 mg
o For Dopamine and Norepinephrine (the ‘stimulants') support: Tyrosine is usually the one it em most needed. A typical dose might be 1-2 capsules (500 mg size) in AM and 1 capsule at mid-day.
11. I find that most cases of anxiety are due to adrenal causes. The typical condition is not severe enough to be picked up with standard test which are designed only to pick up the most severe adrenal fatigue. As the individual is heading in that direction, the standard blood tests will not pick up this transition but the symptoms become quite noticeable with anxiety, cold hands or cold intolerance, poor and/or un-refreshing sleep heading the list of probable symptoms.
12. Obsessive compulsive tendency may look like a repetitive act such as washing hands too many times or going back several times to double or triple check to see the door is locked or oven turned off. As the adrenals improve and insecurity diminishes, this tendency also diminishes or clears.
13. Low C02 is often associated with poor pancreatic production of bicarbonate. This as typically part of the poor digestion seen with adrenal fatigue. What probably happens is: adrenal fatigue -> low gastric production of hydrochloric acid (HCI) -> gastric contents when expelled from the stomach into the duodenum are not acidic enough to trigger an alkaline (bicarbonate) release from the pancreas used to neutralize the acid.
Dr. Bruce Rind
National Integrated Health Associates
5225 Wisconsin Avenue, Suite 401, Washington DC 20015
phone (202) 237-7000 fax (202) 23710017
8. The MCV (mean corpuscular volume) is a measure of the size of the red blood cells. Their size tends to increase as vitamin B12 deficiency increases. Individuals with poor digestion / absorption tend to run low on vit. B12, so they tend to have larger blood cells, i.e., MCV tends to be at the high end of normal or high. This is more common in adrenal fatigue since these individuals tend to eat less meat, tend to digest it poorly if they do eat it and generally absorb poorly.
9. RDW measures the distribution or variability of the size of young red blood cells. Individuals with stable health tend to have little variability in cell size. An unstable or poor state of health generally shows up as higher variability in cell size.
10. Whenever a patient comes in with depression, I look for a suboptimal thyroid function. This is not the same as saying ‘outside of the normal range'. Optimal is a zone within the `normal' range which I've identified as the range at which I find my healthiest patients. If the thyroid function is near or at optimal and depression persists, I then look for other supports such as supporting neurotransmitter levels with the following:
o For Serotonin (the ‘calmer') support: Tryptophan or 5-Hydroxytryptophan (i.e., 5-HTP) if the patient is not on SSRI antidepressants (SSRI's can adversely interact with Tryptophan or 5-HTP by promoting excessively high serotonin levels). The way I dose it ls usually by starting low doses AM, mid day if needed, and evening for sleep support. I find this especially useful for obsessive compulsive disorder (OCD) if the patient is not taking prescription medications of the SSRI type. A typical dosage regimen (after gradual increase to check for any adverse responses) might look like this: AM 50 mg-100 mg 5-HTP; Noon 50 mg-100 mg 5-HTP; Bedtime or a little before, 200-300 mg
o For Dopamine and Norepinephrine (the ‘stimulants') support: Tyrosine is usually the one it em most needed. A typical dose might be 1-2 capsules (500 mg size) in AM and 1 capsule at mid-day.
11. I find that most cases of anxiety are due to adrenal causes. The typical condition is not severe enough to be picked up with standard test which are designed only to pick up the most severe adrenal fatigue. As the individual is heading in that direction, the standard blood tests will not pick up this transition but the symptoms become quite noticeable with anxiety, cold hands or cold intolerance, poor and/or un-refreshing sleep heading the list of probable symptoms.
12. Obsessive compulsive tendency may look like a repetitive act such as washing hands too many times or going back several times to double or triple check to see the door is locked or oven turned off. As the adrenals improve and insecurity diminishes, this tendency also diminishes or clears.
13. Low C02 is often associated with poor pancreatic production of bicarbonate. This as typically part of the poor digestion seen with adrenal fatigue. What probably happens is: adrenal fatigue -> low gastric production of hydrochloric acid (HCI) -> gastric contents when expelled from the stomach into the duodenum are not acidic enough to trigger an alkaline (bicarbonate) release from the pancreas used to neutralize the acid.
Dr. Bruce Rind
National Integrated Health Associates
5225 Wisconsin Avenue, Suite 401, Washington DC 20015
phone (202) 237-7000 fax (202) 23710017
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