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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by glenn on October 4, 2002, at 5:57:30
Perhaps we should start an anti cortisol club:}
On a more serious note you might all find the book
The Cortisol Connection interesting, it dooes have some interesting stuff in , but in some areas
we seem to know more- im not kidding!
The isbn is0-89793-391-5
author shawn talbottps my apologies to denise and pfinstegg for forgetting tianeptine, even a french psychiatrist once told me it was not very effective but the evidence seems to suggest it is, perhaps primarily for us hypercortisolaemics
glenn
Posted by Phil on October 4, 2002, at 6:21:04
In reply to To phil bob pfinstegg and denise, posted by glenn on October 4, 2002, at 5:57:30
Posted by pfinstegg on October 4, 2002, at 11:34:27
In reply to To phil bob pfinstegg and denise, posted by glenn on October 4, 2002, at 5:57:30
Thanks Glenn...tianeptine is an unusual AD in that you don't know you're taking it- it seems just like taking a vitamin. I chose it because I was really worried about my high cortisol levels, and what they might bring in the future in terms of physical ill-health. I was surprised that it actually worked as an AD, after all I had read about it here.
It is now the subject of intense research interest at Rockefeller University and the Max Planck Institute in Germany because of its ability, in tree shrews and rats, to protect the hippocampus from the stress effects of cortisol, allowing it to regain its normal size and begin growing dendrites again. They are studying whether this will also result in a resetting of the normal HPA axis.
I still have really high circulating cortisol, which my endocrinologist is working on, but I am no longer worried about depression, or a sense that my brain is being damaged. I feel that my memory, ability to respond to interpersonal situations effectively, and quickness to recover equilibrium after an emotional stress are all improving.
I hope you'll keep in touch with any new information which you find. I have found Psychobabble to be invaluable, and keep checking in to see what people are finding out. It's already helped me enormously in making the best possible medical decisions for myself, and I really do want people to know how much I appreciate their input.
Pfinstegg
Posted by denise528 on October 5, 2002, at 10:42:43
In reply to To phil bob pfinstegg and denise, posted by glenn on October 4, 2002, at 5:57:30
Hi,
I don't actually know if I have high cortisol levels, my Doctor said that if I did have then I would have certain symptoms which I don't have. I also had a hormone check on the NHS and that came up normal. Do you have to have extreme symptoms to know whether or not your cortisol level is high. How can you find out?
Denise
Posted by pfinstegg on October 5, 2002, at 11:10:35
In reply to Re: To Glenn and pfinstegg, posted by denise528 on October 5, 2002, at 10:42:43
Hi...I initially had the same problem with both my medical doctor and endocrinologist. They were expecting me to look "Cushingoid" (red-faced, high blood pressure, thin, easily bruised skin, thin arms and legs and a thick body), but I looked just the same as I always had- normal. At first, they didn't want to do the tests, but I pressured them into it, by showing them articles from the web- and from psychobabble. They were very abnormal, as I have described previously.
I think it is hard for doctors to be pushed into diagnosing something for which they don't have a good treatment. But, on this thread alone, people are describing the options that are beginning to open up.
To know for yourself, you need, as a minimum, an 8 Am cortisol level, a dexamethasone suppression test (taking 1 mg. of dexamethasone the night before at 11 PM, and then taking another cortisol level the following morning at 8) Normal cortisol level are up to 22 ng/ml, and a normal suppression test should be 5 ng. or lower. If these are not normal, you follow up with a 24-hour urinary cortisol.
If you can get this done, be sure to let us know.
Pfinstegg
Posted by denise528 on October 7, 2002, at 6:08:09
In reply to cortisol levels- how people look with them, posted by pfinstegg on October 5, 2002, at 11:10:35
Thanks pfinstegg (that's a difficult one to remember),
I will try and get a test although it's going to be difficult getting one. Last time I mentioned having a test to my psychiatrist his response was "why do you need one of those, we already know you're depressed). I've also asked my doctor for a T4 and T3 test but she said they wouldn't do one unless your TSH was abnormal. Mine was 2. I know they think I'm clutching at straws, I just really wish they could find something wrong with me.
I'll let you know if I do have the test though. Thanks for your advice.
Denise
Posted by Phil on October 7, 2002, at 6:33:10
In reply to Re: cortisol levels- how people look with them, posted by denise528 on October 7, 2002, at 6:08:09
Tell them you want to know because you're the patient.
Your shrink actually asked why you wanted the test, we already know you're depressed?
Some of these guys come up with some real zingers.
Tell him you want a sleep test next! Why do you want a sleep test, we know you're depressed.
If you could find some physical or physiological reason, you wouldn't have to see your doctor anymore.
I had my testosterone checked because if it's low, you get the exact symtoms of depression. Mine was a little above normal. Fine, I'll go to an endocrinologist next for my thyroid tests.
Psychiatrist's need people skills. Some give you the right meds but say things that make no sense.
Posted by pfinstegg on October 7, 2002, at 15:17:25
In reply to Re: To Glenn and pfinstegg, posted by denise528 on October 5, 2002, at 10:42:43
Hi Denise... your TSH of 2.0 is certainly within the normal range; however some experts think it should be brought down to 0.5 or even slightly lower if you have a treatment-resistant unipolar depression. Ideally, they will give you a combination of synthroid and cytomel in slowly increasing doses until the TSH reaches the optimal level. If you are dealing with the NHS, or a doctor who doesn't want to give too many tests, you can just ask for a TSH every six weeks while you begin taking low doses of the synthroid and cytomel, which you increase gradually until you get to a TSH of 0.5. The doses you will be taking are extremely low; you can always discontinue if you get any side effects such as increased nervousness. I am taking both of these now and have not had any difficulty so far ; the gradual increase helps. It's not the whole answer to the problem, but just one of the parts. I happen to be abnormal thyroid-wise, cortisol-wise and estrogen wise- and all these hormones apparently play a big role in my particular depression, although they probably don't for many others. Somewhere in the psychobabble archives(about 2 weeks ago, I think), I cited an article from the New England Journal of Medicine describing the use of synthroid and cytomel in this way, which my endocrinologist gave me: you could print it out and give it to your doc- continue his education a little!
pfinstegg
Posted by Denise528 on October 8, 2002, at 12:33:11
In reply to Denise 528- TSH levels, posted by pfinstegg on October 7, 2002, at 15:17:25
Hiya,
I've managed to find a place that does a T3 & T4 test so I'm going to have this checked out. Thanks for the advice.
Denise
Posted by pfinstegg on October 8, 2002, at 16:00:14
In reply to Re: To pfinstegg, posted by Denise528 on October 8, 2002, at 12:33:11
Hi Denise...just to put in my two cents worth, I think you would be better to skip the T3 and T4 tests, which are bound to be normal, and instead ask your doc to begin giving you very low doses of synthroid and cytomel. It's the TSH getting to around 0.5 which is one of the helpful adjuncts for depression. He can increase those two drugs very slowly and test your TSH every 6 weeks or so until he gets to the target reading of 0.5.
pfinstegg
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