Posted by bearinthewoods on March 11, 2013, at 13:39:40
I have severe treatment resistant depression (did not respond to ECT, tried all medications in each class and about everything else). Last year in the summer I had a cortisol level test. My level at the time was 33, and the upper limit quoted to me was 19.5. This level was so unusually high they tested me with the dexamethasone suppression test to see if I had Cushing's. I passed the test, or had the standard result of the cortisol being suppressed the morning after taking the dexamethasone.
I was surprised to learn that, especially if you don't have Cushing's (I don't even think I qualify for "psuedo-Cushing's" since I passed the DST) there aren't a lot of medication routes available. Maybe if I whined, but a lot seem very intense. I was also surprised that despite having over 3x the normal levels of cortisol (and low DHEA to boot) it was kind of treated like a non issue by doctors. They more or less told me to just "relax", stuff like yoga, meditation, etc.
I tried a course of Relora at the recommended dose, 750mg (magnolia bark and berberine, shown in a study to reduce cortisol and raise DHEA) as well as 300mg or so of phosphatidylserine daily. I continued this course for probably 4 or 5 months. I was hoping to see a reduction in cortisol, but my level was down to 32 from 33, which I'm guessing is not even statistically significant given fluctuations in the body, time of day, etc.
I am starting to think that I have gotten into a vicious cycle with the cortisol and it is contributing to my non-response to medication. I'm also very concerned that doctors are still treating it like a non issue (they only cared up until I passed the DST). I am running out of ideas on how to treat this and the vicious cycle is I'm very depressed and stressed, don't respond to medication, so cortisol stays high and continues to make me unwell.
I like the sound of Metyrapone, as I am recovering from PTSD as well, but I can barely find any information about it being prescribed in the US. Does anyone know what I could say to my doctor to convince them to go a more traditional route with medications used to treat Cushing's, or is it just too risky/damaging? The only thing I am doing in the meantime is trialing more psych meds (that don't really work) and taking a higher dose of bulk phosphatidylserine.