Posted by Elroy on September 23, 2005, at 13:36:04
In reply to Re: Remeron and Cortisol, posted by Tenifer on September 22, 2005, at 22:24:36
Dave,
Should have mentioned that I noted your serum cortisol levels and that they clearly show a trend towards cortisol levels elevating - which can be a definite sign of HPA Axis becoming dysfunctional.
Unfortunately the serum testing or cortisol just gives a "snapshot" of what your cortisol levels are at the precise moment, and cortisol secretion has a "rollercoaster" like "ups and downs" of secretion during the day... so an hour after your last listed cortisol test, you may have had a serum reading of 35 or 50. The 24-hr urinary test is better in that it shows a daily total and whether there's a total elevation or not.
Also, have your doctor run Late Night Salivary Cortisol Tests on the same nights that you do the 24-hr UFC. Cortisol is what wakes us up in the mornings (as it rises) and puts us to sleep at night (as it falls), so your night time levels should be really low (you do the test between 11 PM and Midnight). Prior to Remeron my levels rans in the low 30s to mid 40s (range is "less than 100" - people who have full-blown regular Cushing's will be up close to 100 or often WAY over 100). Afetr going on the Remeron, I am getting levels like 7, 11, 13, 17 (the highest I've had on Remeron), etc.
If your late night levels are higher (into 30s, 40s, and above), then you will know why you are having problems with the sleep...
If this is all foreign to your doctor, check with psych doc and see if they are familiar with the concepts of elevated cortisol, dysfunctional HPA Axis and psychological disorders.
If they're not familiar with that concept (too many immediately assume you have a serotonin deficiency and try to push an SSRI which often is the worse thing that you can take for anxiety - and especially even more so with elevated cortisol situations as many SSRIs - as you found out - actually INCREASE cortisol levels!), find yourself an Endo... You are looking for a Adrenal - Pituitary specialist... the vast majority seem to be diabetes specialists so watch who you get hooked up with... and have the testing done through the Endo (tell them that you suspect a Pseudo Cushing's situation based on HPA dysfunction via severe anxiety).
Elroy
poster:Elroy
thread:124535
URL: http://www.dr-bob.org/babble/20050921/msgs/558531.html