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Re: Elevated Cortisol and NIH Hospital Visit tenifer

Posted by Elroy on December 28, 2005, at 11:28:57

In reply to Re: XXX Medication, posted by tenifer on November 21, 2005, at 12:43:40

> Elroy,
>
> You know us cops..we tracked down leads!
> I found that site after I read your earlier post.
> After seeing your references to XXX you know I had to do some sluething! :)
>
> Looks very promising don't it?
> I'm on top of it. Gonna do some reading when time permits.
>
> Thanks again brother!
>
> David
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Well have been back from NIH for a couple of weeks now. Needed that first week to rest up from all of that testing and then the second week (last week) was Christmas week, so a lot of activity going on then.

Anyway, their bottom line won't be available until they get the final week's worth of testing in and get the full analysis done, but they were able to come up with an "early guesstimate" that they felt pretty comfortable with. They are pretty confident that I while I do have a degree of hypercortisolism, that I do not have any form of "regular" Cushing's (in other words a Cushing's caused by a pituitary or adrenal gland tumor or an ACTH-secreting cancer). They believe it to be a form of Pseudo Cushing's driven by stress/anxiety problems that had existed over the late 90s and up thru around 2002. At some point the HPA Axis became dysfunctional - in the form of hyperactivity - and it was then "off to the races". Also they feel that the HPA hyperactivity and the resultant hypercortisolism are moderating - very, very gradually and very slowly moderating (as compared to where levels were six months ago and twelve months ago and especially eighteen months ago). Also the tests showed that the adrenal gland tumor present is simply an incidentaloma, it is a "fatty-tissue lesion that is not only completely benign, but also is biologically inactive" (i.e., not doing anything).

That's all "the good news"...

The bad news is that they really don't have an answer of how to deal with it. No suggested therapy or prescription, etc.

Now they felt that the recent regimen of Remeron "may" have done a lot to give the HPA Axis a needed break (R&R) and helped things along... but also agreed that if it was excessively sedating, that it wouldn't do as a long-term application. Additionally they felt that taking action to simply combat the cortisol wasn't addressing the root cause and that dealing with the anxiety / stress based problem was more the key to solving the problem. They felt that the moderating process had been helped along by things like anti anxiety meds (including possibly the Remeron which has not only the anti cortisol effects but also has anti anxiety effects), ongoing EMDR therapy, and - interestingly - even the TRT and other protocols designed to optimize hormone levels... Also, I am a "fast metabolizer" of cortisol in that I process it much more quickly from the bloodstream and into the urine than normal (part of that being from the extra liquids consummed and partly from a very efficient P45o enzyme system)

(So the question that the docs at my end had as to "which element is driving what" was pretty much answered in that there's not a cortisol problem primarily driving the anxiety and related symptoms, but more primarily the anxiety driving the cortisol problem as well as the related symptoms)

So not sure where to go from here. One of the "comments" raised dealt with issue of possibly being "under medicated" for anxiety issues. Part of that was my concern in getting too involved with anti anxiety meds if it turned out to be a primary cortisol problem. So am going to have to consider some different possibilities. Increase the current anti anxiety meds to a more therapeutic dosage? Try a different direction altogether (am giving some strong consideration to giving lower dose Dilantin an experimental try - in these types of situations if it works it seems to do so very quickly)? Push the EMDR therapy more aggressively? Obviously will continue with fine-tuning the TRT (and hopefully the addition of HcG to the protocol at some point will help things along further also).

In regards to the aspect of optimizing hormones, I had dismal levels of DHEA (139) back in December of 2004. I started supplementing with DHEA (25 mg daily) around April of 2004 and recently (about three weeks ago, just before NIH) had tests done again and was surprised to find out that my DHEA levels were only a 154. That seems like a very poor increase for eight months of supplementation! I am wondering now if I am using a poor brand of DHEA (I've been using "Nature's Bounty" exclusively), or if I need to increase the dosage level to 50 mg? Or is it that I also need to spread my intake out over the day as I am metabolizing the DHEA much more quicker than normal (i.e., take one 25 mg in morning and one in mid afternoon)?

Anyway, was a very "interesting" visit to say the least. Both extensive and intensive testing - especially the first week. There would be days where the testingwould start at 7 - 8 AM and go on non stop until 4 - 5 PM. In fact, on Tuesday, Wednesday, and Thursday of the 1st week I had three IVs going on all three days (and partly in use through the night) for various injections of test substances, blood draws, etc.

So.... some good news, but not the bottom line definitive answer that I was hoping for.

Elroy
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poster:Elroy thread:124535
URL: http://www.dr-bob.org/babble/20051221/msgs/592740.html