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Summary 6: addison's, pituitary, thyroid, celiac.
My original question asked for suggestions for adrenal insufficiency/addison's along with celiac disease.  I have been on a strict gluten free diet for 2 years along with dairy free, soy free, yeast free, no sugar ot tomatoes and very little citrus (can have lemon and lime).  Still tired, have malabsorption of fats and some proteins, intracellular mineral levels are off with potassium high/sodium low and all others low but still not as far off as potassium and sodium, still no beneficial bacteria in gut even with an excellant probiotic daily for 2 years, intolerant to heat and cold, muscle spasms, many allergies.  Started weekly IV's of amino acids that are very low and vitamins/minerals that are low.  In a 24 hour urine for addrenal hormones every value was low.
My endocrinologist informed me that there are some crossover symptoms which are the same as celiac if the adrenal glands are weak and not functioning properly and gave me a diagnosis of addrenal insufficiency.  She did many more blood tests.  Last week she called me with the results.
Cortisol is low which confirms the addrenal insufficiency noted in the 24 hour urine.
Autoimmune Hashimoto's thyroiditis test was positive and T3 was off indicating the thyroid is not working properly and is low.  This will progress and get worse.  She started me on Synthyroid 50 each morning on an empty stomach with a full glass of water.  TSH has always been fine in the past and I was having it done twice a year.
ACTH was low indicating that the pituitary gland is not working properly as this hormone is supposed to stimulate the addrenal glands to make cortisol and it is not, as cortisol was low at the same time as ACTH was low.
B12, iron, magnesium, vitamin D  all okay now
Parathyroid gland is working properly
Prolactin is fine indicating the adenoma of the pituitary gland that was secreting prolactin in the 70's is still quiet-
I have this checked every year along with A Humphrey Visual Field computerized eye test to be sure eyes are not affected by an adenoma pressing on the optic nerve and affecting vision.
Treatment with above information at this time will be as follows:
Started Synthyroid 50 mcg and check levels again in 4 to 6 weeks.
MRI of the pituitary to be sure there is not a tumor of the pituitary-most tumors of the pituitary are benign and depending on size and location are either watched or removed.  Some pituitary glands press on the optic nerve and cause vision impairment or blindness so have to be removed promptly.  My MRI is scheduled at 8AM on August 15th.
Results should be in in 3 to 7 days.
After thyroid is at the right level confirmed by further blood tests she will add Cortisone and Florinef one at a time.
In the mean time she said to continue to drink salt water one teaspoom to each liter of water and more if needed on hot days when perspiring to keep blood pressure from going to low..  Also she asked me not to change anything else until things are where she wants them, stay out of the heat and try to minimize stress.
She said the reason I am still feeling the way I am after 2 years on a gluten free diet are because of the adrenal, thyroid, and pituitary problems.  She also said that treatment will be more complicated because of the celiac diagnosis.  Levels will need to be monitored more frequently and doses may have to be higher due to malabsorption.  She will be seeing me every 4 to 6 weeks initially.  
Robin in Massachusetts

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