Case Study Friday: Stressed? Can't Sleep? Always getting a cold?
High cortisol levels can deplete your body of vitamin D.
Low vitamin D plays a role in many different diseases, including hyperparathyroidism, T1DM, T2Dm, and PCOS.
Optimizing endocrine health by adding in Vitamin D supplementation may be another way to manage symptoms.
Symptoms can be alleviated, and disease can be improved by restoring low vitamin D levels to normal.
This case study was shared by Dr. Sima Aidun, a practicing naturopathic physician for endocrine care in Arizona.
Summary:
A business manager, mother, and wife, Mary (51) works more than 70 hours a week for over ten years. At the same time, tending to her family responsibilities. For years she was able to “do it all” efficiently. Yet, she started having difficulty functioning several months before seeking treatment. She became paralyzed by stressful situations. Irritable and started experiencing excessive emotions and anger outbursts, especially when it got closer to her period. The menstruation cycle became less frequent and not as heavy.
Mary had difficulty falling asleep not feeling refreshed. A decline in energy levels and stamina
She also started getting colds every two or three months.
Mary's primary care doctor offered her antidepressants and birth control medication to manage her symptoms.
Mary refused the treatment as she wanted to discover the underlying cause of the recent changes to her well-being. That led Mary to undergo a complete hormonal evaluation with a different doctor.
Initial Hormonal evaluation was as follows:
Hormonal levels were tested on day 21 of the menstrual cycle. Mary was deficient in progesterone, cortisol, and vitamin D. Her progesterone levels were at 0.5 ng/dl, while ideal levels of the hormone at this point of the cycle range between 1.7-2.7 ng/dl. Progesterone levels are affected by changes in ovulation, and a lack of progesterone is associated with mood changes and anxiety.
Cortisol levels fluctuate throughout the day, but Mary tested low for this hormone in multiple screenings. The AM cortisol level was 8.3 ng/dl, while optimal hormone levels range up to 22 ng/dl. Anything below 13 ng/dl is considered low.
Vitamin D levels were at 18 ng/ml, which is low. A normal range of vitamin D is between 30 ng/ml and 100 ng/ml. Vitamin D deficiency is associated with mood fluctuations, reduced bone health, and changes in hormone functionality.
Thyroid profiles of TSH, T4, T3, and anti-microsomal TPO antibodies were within a normal range. Lipid panel, iron levels, and testosterone levels were all optimal.
Estradiol levels returned at 131 pg/ml, which falls in the optimal range between 44 and 211 pg/ml. However, estrogen levels fluctuate naturally from hour to hour. Drastic fluctuations contribute to premenstrual depression and moodiness, symptoms experienced by Mary.
Treatment dosage was as follows:
Bioidentical hormone replacement therapy: Featuring estradiol and progesterone.
IV therapy for adrenal health: Injection of vitamin C and B5 B6, B- Complex, calcium, magnesium, and the antioxidant selenium. Treatment was given once a week for one month and then biweekly for three months.
Oral supplement use: Phosphatidylserine is taken nightly to maintain cortisol levels with Vitamin D supplements.
Post follow up, four months:
Mary’s blood work showed improvement in her adrenal health. Her cortisol levels improved from 8.3 ng/dl to 12.4 ng/dl, and her vitamin D levels improved from 18 ng/ml to 37.9 ng/ml. Her hormone health also experienced positive changes. Estradiol levels improved from 131 pg/ml, considered within the normal range, to 195 pg/ml. Her progesterone levels, which were low at the onset of treatment, increased from 0.5 ng/dl to 5.4 ng/dl.
After four months of treatment, Mary’s energy had returned to nearly normal. Her menstrual cycle remained irregular, which is typical for a woman entering perimenopause, but her perception was an overall improvement in her health. She felt that her health was back to normal.