Posted by Pfinstegg on November 14, 2002, at 16:42:21
In reply to my hormone test results, posted by turalizz on November 14, 2002, at 1:48:45
Hi..I have been getting my endocrine levels investigated also. There are three important things which I had done which I don't see mentioned here: the dexamethasone suppression test(DST), the 24-hour urinary cortisol, and the TSH (thyroid stimulating hormone), T3 and T4 levels. The most common physiological findings in either bipolar or monopolar depression are:
l. non-suppression of the DST
2. elevated 24-hour total urinary cortisol
3. abnormally low T3 (triiodothyroxine)Since all three are abnormal for me, I am trying out the following:
1. Supplements of all the vitamins, especially folic acid, B12, C and E and fish oils
2. supplementary T3- Cytomel
3. Alpha-linoic acid and phosphadatylserine- natural substances which we often don't get enough of and which are thought to help lower cortisol- 100 mg each
4. tianeptine 12.5 mg 3x/day- a European AD which has been shown in animals to protect the brain from excessive cortisol- it hasn't been tested for this effect in humans yet, although it has been used in Europe for 12 years and, although it's not a strong AD, it does have a good safety profile.
5. a trial of rTMS(rapid transcranial magnetic stimulation). This has about the same effectiveness as ECT, but has a better safety profile- there's no anesthesia or memory loss reported. According to one published study, half of the patients treated had a return of their cortisol profiles to normal. I'm going to start this is January, but am expecting I'll need additional treatment afterwards, even if it's successful.
6. For the future, there are now trials of mifepristone going on at NIH and Stanford-it is outstanding in rapidly returning cortisol levels to normal, and in alleviating both types of depression, and should be available within a few years- the FDA has fast-tracked it for that.
7. Beyond that, there are CRH- antagonists, Substance P antagonists and a number of treatments designed to alleviate depression through targeting the basic thing that goes wrong when you have it- HPA axis dysregulation. These are quite a few years off, though.
I am doing just the first four of these things at present. I do note some improvement on the supplements, Cytomel and tianeptine. After the rTMS is completed, my neuroendocrinologist is planning to redo the cortisol tests. As to afterwards. we don't yet know! I hope this will be at least a bit helpful to you.
Pfinstegg
poster:Pfinstegg
thread:127563
URL: http://www.dr-bob.org/babble/20021108/msgs/127665.html