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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Jerrympls on July 30, 2002, at 0:10:57
So, I was perscribed Methylprednisolone for asthma and I took the first dose this afternoon - afterwhich I began to feel almost normal - I don't feel high, I don't feel manic, I don't feel hyper - I feel like me before the depression and anxiety. What does this mean? What can it mean? How can it be? I've read/heard stories of people getting severely depressed while taking these powerful corticosteriods - but I've never heard of them making people feel "normal." I truely, and I don't use this workd lightly, feel almost "cured." Is that terrible? I am certainly going to bring this up with my doc - but can anyone out there tell me more about my reaction? It has to mean something - as far as my biology goes and this chemical depression - What could it be possible effecting in my brain to make me feel "good." I'm at a complete loss -this must lead to some clues as to why I have been treatment resistant.
I've called friends I haven't called in months, I've been laughing at funny stuff on TV and I even have been wanting to listen to music. Someone please tell me what's going on - this is almost the "me" before the dark hell of depression took over my life.
Does anyone have any insight? Any info is much appreciated.
Jerry
Posted by oracle on July 30, 2002, at 0:49:48
In reply to Corticosteriods: I feel almost as if I am cured, posted by Jerrympls on July 30, 2002, at 0:10:57
> Does anyone have any insight? Any info is much appreciated.
>
> Jerry
years ago we thought Corticosteriods were the answer, till
everyone went psychotic on them. They are fine for short term
conditions. Long term you will be looking at
optic nerver damage, loss of bone, not being able to heal
wounds, acne, dependent on them, because you are replacing
what the body makes, possible death and without a doubt
psychotic if you stop taking them at once.Lovely, and that is a just a small part of a long list.
Posted by BekkaH on July 30, 2002, at 1:14:42
In reply to Corticosteriods: I feel almost as if I am cured, posted by Jerrympls on July 30, 2002, at 0:10:57
I've had two dexamethasone suppression tests in my life. I had to take some dexamethasone late at night, and the next morning at 8 or 9, I had my blood drawn. The day after the first night I took dexamethasone, I felt a sense of well-being that I had not known in years and had perhaps never known. I didn't feel high, and I didn't feel low; I just felt fine. "A sense of well-being" is the best way to describe what I felt that day. Several years later, I had another DST, and I felt horrible the day after the night I took dexamethasone. I don't know why there was such a difference. In any event, long-term corticosteroid use is something that should be avoided -- if possible. The disadvantages far outweigh the advantages. A friend of mine has to take prednisone for an autoimmune disorder. Many of her current medical problems stem NOT from her autoimmune disease, but from the damages wrought by years of high-dose prednisone. If you MUST take corticosteroids for a medical condition, then, of course, you have to work out the dosing with your doctor. I think it's best, if possible, to keep doses low and to avoid long term use, if that's an option for you.
Posted by Seamus2 on July 30, 2002, at 2:19:17
In reply to Corticosteriods: I feel almost as if I am cured, posted by Jerrympls on July 30, 2002, at 0:10:57
I had a similar reaction to eyedrops containing prednisolone 1% q.4h. I have no idea what it was all about, but I do know that corticosteriods are nothing to mess around with.
(and yes, I've been told my reaction was "all in my head" -- yeah, right!)
Let us know if you learn something from your local neuropsychoendrocrinologist.
<BG>
Seamus
Posted by jazzdog on July 30, 2002, at 11:29:31
In reply to Corticosteriods: I feel almost as if I am cured, posted by Jerrympls on July 30, 2002, at 0:10:57
You could be suffering from adrenal exhaustion and getting too little cortisone. Perhaps you should see an endocrinologist for an adrenal test. The problem with taking cortisone is that is shuts down your body's ability to manufacture it itself, so you become steroid dependent with various unpleasant results. In the case of adrenal exhaustion, however, longterm lowdose cortisone might well be the answer, since your adrenals aren't making enough anyway. Also, there are some quite potent cortisone boosters in herbal form - particularly licorice tea and high-dose ginseng. Just do a google search on adrenal exhaustion, and you'll find out more than you ever wanted to know.
Posted by Jerrympls on July 30, 2002, at 16:00:13
In reply to Re: Corticosteriods: I feel almost as if I am cured, posted by oracle on July 30, 2002, at 0:49:48
I'm only on them for a week - but it's amazing how I feel. There has to be some connection.....
> > Does anyone have any insight? Any info is much appreciated.
> >
> > Jerry
>
>
> years ago we thought Corticosteriods were the answer, till
> everyone went psychotic on them. They are fine for short term
> conditions. Long term you will be looking at
> optic nerver damage, loss of bone, not being able to heal
> wounds, acne, dependent on them, because you are replacing
> what the body makes, possible death and without a doubt
> psychotic if you stop taking them at once.
>
> Lovely, and that is a just a small part of a long list.
>
Posted by inertia on July 30, 2002, at 16:55:46
In reply to Re: Corticosteriods: I feel almost as if I am cured, posted by oracle on July 30, 2002, at 0:49:48
Jerry, I'm so happy for you!!! It's so great to feel "normal," isn't it? I remember how I stayed well for years on just one AD years ago. Now I'm treatment resistant and on 4 meds.
As far as the dangers, my depression is so serious, I often wonder if having a chance at a normal life (even if it lasts just a year or two) is worth all the dangers. As I see it, I'm barely living now and would rather be dead, so if the steroids worked for me, I might take them.
Posted by katekite on July 30, 2002, at 20:33:51
In reply to Re: Corticosteriods: I feel almost as if I am cure, posted by Jerrympls on July 30, 2002, at 16:00:13
There's a huge difference between the nasty effects of corticosteroids at a chronic dose higher than normal, and the same drug at a dose that makes up for dysfunction of the adrenal or pituitary glands.
The dose that has to be used for auto-immune disease or even for arthritis or poison ivy is way higher than one's body produces (which is why extra has to be given). Its called an 'immunosuppressive dose' versus a 'physiologic dose'.
The dose that is used in replacement for someone who's adrenals or pituitary is not functioning is very low and not hurtful unless you already have high cortisol or are sensitive to its effects.
This does not necessarily mean that if you suddenly feel better on steroids its because you had underfunctioning adrenals or pituitary! It can apparently make normal people feel even better.
What's wrong could be something that is just affected by steroids. It could even be something as bizarre as a low-grade infection like mono that just feels better although its really getting worse, due to less inflammation. So its important to make sure you are completely healthy before taking steroids for the beneficial feeling. In addition, taking steroids will most likely suppress your own body's production and that can take a long time to recover after you stop.
It could also be some other hormonal problem that is simply helped by steroids. For example I think it's likely people with low testosterone (male or female) would feel better with more cortisol as it can act a bit like testosterone. Well-being, sense of drive, etc. Or growth hormone problems. Probably other things too.
Not only tell the doctor, but try to get a referral to an endocrinologist and get worked up. Check out Addison's disease as the relevant disease to worry about. Some people may have mild Addison's which is called adrenal exhaustion. True Addison's is very rare. There are tons of websites on adrenal exhaustion but it is supposedly a fad diagnosis these days and isn't as easy to diagnose as some websites suggest. Nevertheless, I have one friend who now takes very low prednisone supplement for months and is up working again after a couple years of exhaustion. If you think you have that you may have to find a sympathetic doctor.
I am starting my very own dexamethasone suppression test tomorrow. This test is used to diagnose causes of abnormally high cortisol levels (Cushing's) and has nothing to do with either Addison's or adrenal exhaustion.
You would want an ACTH level and an ACTH stimulation test and maybe a 24hr urine cortisol. Also a screen of the levels of the rest of your hormones such as testosterone, growth hormone, and insulin.
You most likely would have to be off of all steroids and cortisol affecting supplements for one month prior to testing.
If or when you have to go off of the steroid you are on be sure to exactly follow the instructions on tapering or go even slower than they recommend. Slow is better if you have any chance of having an insufficiency. You could get really deathly ill by stopping cold turkey.
If you can't get docs interested or appointments are months away and you want to increase your cortisol levels you can try eating licorice. Not licorice flavored items as that's not real licorice, but true licorice. It's sold as a supplement I'm sure. It truly can increase cortisol and throws tests off, so be careful with it if you get hormonal testing done.
If you are concerned that you have adrenal insufficiency (Addison's) you might want to avoid eating excess potassium (ie not taking a vitamin containing it) as people with Addison's have too much already.
Hope all that helps.
kate
Posted by awake at last on July 31, 2002, at 16:53:36
In reply to Corticosteriods: I feel almost as if I am cured, posted by Jerrympls on July 30, 2002, at 0:10:57
> So, I was perscribed Methylprednisolone for asthma and I took the first dose this afternoon - afterwhich I began to feel almost normal - I don't feel high, I don't feel manic, I don't feel hyper - I feel like me before the depression and anxiety. What does this mean? What can it mean? How can it be? I've read/heard stories of people getting severely depressed while taking these powerful corticosteriods - but I've never heard of them making people feel "normal." I truely, and I don't use this workd lightly, feel almost "cured." Is that terrible? I am certainly going to bring this up with my doc - but can anyone out there tell me more about my reaction? It has to mean something - as far as my biology goes and this chemical depression - What could it be possible effecting in my brain to make me feel "good." I'm at a complete loss -this must lead to some clues as to why I have been treatment resistant.
>
> I've called friends I haven't called in months, I've been laughing at funny stuff on TV and I even have been wanting to listen to music. Someone please tell me what's going on - this is almost the "me" before the dark hell of depression took over my life.
>
> Does anyone have any insight? Any info is much appreciated.
>
> Jerry
*************************************************
Jerry, is your doctor an endocronologist or a Doctor of Interal Medicine, if not, I'd switch to one and have a full work up done. You are right that corticosteriods usually cause depression not cure it, because they increase cortisol levels. If it is making you feel better then I would be suspicious that your depression my be derived from a low cortisol level. I have a child that has severe asthma and is on inhaled steroids daily and liquid corticosteriods a couple of times a year (we try to avoid these because of their effects on the growth hormone, as well as the many other side effects).
My advice to you would be to have one of the above doctors look at the following things: Thyroid, DHEA level, testosterone level, liver/spleen function, adrenal glands (cortisol levels) and insulin levels. And as well since you fight asthma, I would have your oxygen saturation levels checked as well(preferably by an arterial blood gas method - much more accurate). All of the above have a way of effecting each other and you could very well find that your depression goes away once an underlying cause is determined. This sudden change by the methylprednisone may be a hint to lead you in the right direction. (It took me 3 years to finially find the right pieces to the puzzle that cured what the doctors described as "depression" (although none of the anti-depressants they gave me ever worked) - but it was well worth the time and expense - it's nice to have my life back....ps, my problems were 3 fold, hypoglycemia, low testosterone and narcolepsy: So don't be suprised if you find more than one problem along the way).
Good luck
Posted by EarlyWakening on July 31, 2002, at 20:59:18
In reply to Corticosteriods: I feel almost as if I am cured, posted by Jerrympls on July 30, 2002, at 0:10:57
I’ve had experience extremely similar to yours.
For years I’ve suffered primarily from early-morning awakenings, generally considered to be related to depression, in spite of taking anti-depressants. It’s been really debilitating.
About two years ago, I had to take Methylprednisolone for about a week in the form of a Medrol DosePak for a foot injury (plantar fasciitis). You take a DosePak over the course of six days: 24mg – Day 1; 20mg – Day 2; 16mg – Day3; . . . . . . 4mg – Day 6.
It caused me some difficulty getting to sleep while I was taking it, but I generally felt better starting with the third day. For the next two months, I felt better than I had in over a decade. As BekkaH said, Not High, just Fine. I was sleeping well, wakening up refreshed, and had a full charge to get me through the day. I was very productive during this time, both at work and outside of it. . . . And then one morning I woke up early again, and everything was back to the way it had been before.
About a year and a half later, I again had to take a Medrol DosePak for the same injury. And just as with BekkaH, it did nothing for me at all this second time.
As a result of this experience, I’ve done a great deal of research. It’s long and technical, and I won’t be hurt if you lose interest before the end.
----------------------------------------------There is a system in the body called the HPA axis (hypothalamic-pituitary-adrenal). The hypothalamus is a part of your brain that releases a hormone called CRH (corticotropin-releasing hormone, also called CRF or corticotropin-releasing factor). CRH signals the pituitary to release another hormone which, in turn, signals the adrenal glands to release cortisol. Cortisol is the body’s main stress hormone which triggers the “Fight or Flight” response. Much research points to cortisol as a key player in depression.
The release of cortisol in the body is supposed to be controlled by a “negative feedback loop”. Excess cortisol signals the hypothalamus to stop releasing CRH, which stops the chain from releasing more cortisol. However, if this negative feedback loop is malfunctioning, the process never stops. The result can be depression, sleeping problems, and other stress-related disorders.
Pharmaceutical companies like Organon are starting to believe that problems with the HPA axis are more central to depression than are monoamines (serotonin, norepinephrine, dopamine). Organon is working on a glucocorticoid antagonist currently in Phase III clinical trials. Mifepristone, another glucocorticoid antagonist among other things, is also being studied, but right now it’s only being studied for depression with psychotic features. Neurocrine is the furthest along in trials of a CRF antagonist, but its partner GlaxoSmithKline is making the process longer than it needs to be. The drug is still in Phase I, a good seven years away from your nearest Walgreen’s.
The best research on CRF antagonists is being done at the Max Planck Institute in Germany by Florian Holsboer. Pertinent to my particular problem, he has shown that CRF antagonists significantly increase deep, Slow-Wave sleep in depressed patients without suppressing REM. Charles Nemeroff at Emory University has been the biggest champion of CRF research, but he’s been very quiet lately. Alex Vgontzas at Penn State is doing the most research on CRF from a sleep perspective. He has shown that too much CRF can really interfere with sleep. Men middle-aged and older start waking up too early and not sleeping as soundly because of it.
------------------------------------------------Bottom line is . . . you’ve stumbled on to something important, but taking steroids is not the answer. They’re extremely bad for you long-term. And unfortunately for you and me both, a really good, clean solution is still several years off.
Posted by Jerrympls on July 31, 2002, at 21:50:53
In reply to Re: Corticosteriods: I feel almost as if I am cured, posted by EarlyWakening on July 31, 2002, at 20:59:18
I too am taking the Medrol Pack which means I won't be taking these long-term. but you have helped tremendously with the information posted. My doctor is a research psychiatrist and I am sure will be open to this new clue I've stumbled upon - and I'm sure he's got some inside scoops too - I'll keep you posted!! One thing I have noticed is that Ihaven't taken any Dexedrine in the past days. I was on 60mg but haven't felt the need for it since starting the Medrol. Interesting. Very interesting. It's the only thing that was keeping my head above water (the dexedrine). This has got to lead somewhere....
I too have a little trouble getting to sleep - but once I get to sleep I'm fine and wake well rested in the morning. I've been laughing at work and am so positive now--I just hate for it all to end in 6 days. We'll see.......
...I just remembered that I was given Decedron (similar to the Medrol pak) for an anaphalactic (sp?) allergic emergency and I remember the fog lifted then too - this was 10 years ago.....but I just thought the "well-being" was from the adrenal they gave me......weird.....
Thanks to all who have posted! You've helped me so much!
Jerry
Posted by awake at last on August 1, 2002, at 9:19:02
In reply to Re: Corticosteriods: I feel almost as if I am cure » EarlyWakening, posted by Jerrympls on July 31, 2002, at 21:50:53
> I too am taking the Medrol Pack which means I won't be taking these long-term. but you have helped tremendously with the information posted. My doctor is a research psychiatrist and I am sure will be open to this new clue I've stumbled upon - and I'm sure he's got some inside scoops too - I'll keep you posted!! One thing I have noticed is that Ihaven't taken any Dexedrine in the past days. I was on 60mg but haven't felt the need for it since starting the Medrol. Interesting. Very interesting. It's the only thing that was keeping my head above water (the dexedrine). This has got to lead somewhere....
>
> I too have a little trouble getting to sleep - but once I get to sleep I'm fine and wake well rested in the morning. I've been laughing at work and am so positive now--I just hate for it all to end in 6 days. We'll see.......
>
> ...I just remembered that I was given Decedron (similar to the Medrol pak) for an anaphalactic (sp?) allergic emergency and I remember the fog lifted then too - this was 10 years ago.....but I just thought the "well-being" was from the adrenal they gave me......weird.....
>
>
>
> Thanks to all who have posted! You've helped me so much!
>
> Jerry***********************************************
Jerry,
I have another approach for you to consider as well. You've now mentioned that you suffer from asthma and anaphalactic allergies....have you had your allergies tested? My son suffers from severe asthma and anaphalactic allergies to peanuts, tree nuts, eggs and sesame seeds. He is also allergic to Salicylates, this is natures natural preservative, found in many fruits and veggies. If I allow him to eat too many of these at one time, he becomes very cranky. It is used in many cosmetics and sunscreens, and this is how we were able to determine his allergy because salicylates are not a common allergy and are not regulary tested. If I apply a sunscreen with this in it, he breaks out in a horrible rash.
Anyway, my point is that many food allergies can have an effect on mood and how we fell, but not show in other more obvious signs. There is no doubt that corticosteroids have a tramatic healing power over these conditions. Perhaps the feelings you are experience is your bodies reaction to a food or environmental allergen.
I don't have food allergies like my son, just environmenal and Zyrtec seems to take care of that. But I do have hypoglycemia, and I know that what I eat makes a tremendous effect on how I feel.Keep searching.....I don't think you are far from finding your cure....
This is the end of the thread.
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