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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk2010 on March 24, 2018, at 16:13:39
In reply to Re: How can I block Cortisol? » ed_uk2010, posted by farshad on March 24, 2018, at 14:09:38
Hi F,
>that inhibits 11b hydroxylase. wouldnt that lead to less CRH release?
Not as far as I know. It leads to lower cortisol and higher ACTH like other cortisol synthesis inhibitors.
>btw what happens if u have high 11-Deoxycortisol lvls? Since inhibiting 11b hydroxylase will increase 11-Deoxycortisol, im wondering what the conseuqneses of that is .. increased aldosterone??
Metyrapone does increase 11-deoxycortisol, yes. The effects of this during Cushing's treatment aren't entirely clear.
In terms of aldosterone, metyrapone itself reduces aldosterone synthesis.... but because it increases ACTH, it may lead to the body attempting to produce more aldosterone. The overall effect could be either more OR less aldosterone being produced. During treatment, doctors carefully monitor potassium levels to help keep track of this.
>no havent been to the doc yet. becus i dont know what to test for.
I asked you but you didnt answer. am I supposed to test for Cortisol and ACTH ?I did answer :) Testing ACTH is not usual when initially looking for the possibility of high cortisol, no.
Although it's up to your doctor, and depends on your local lab, common tests when looking at the possibility of high cortisol are the overnight dexamethasone suppression test, and the 24 hour urinary cortisol collection test.
>is it possible to test for CRF1?
No, it's not possible to test for the level of CRF-1 receptors.
Alcohol is a common substance believed to activate CRF-1. So if you don't already, you could try a period of no alcohol and see if it helps your mental health.
Posted by farshad on March 24, 2018, at 16:22:21
In reply to Re: How can I block Cortisol? » farshad, posted by ed_uk2010 on March 24, 2018, at 16:13:39
> Hi F,
>
> >that inhibits 11b hydroxylase. wouldnt that lead to less CRH release?
>
> Not as far as I know. It leads to lower cortisol and higher ACTH like other cortisol synthesis inhibitors.
>
> >btw what happens if u have high 11-Deoxycortisol lvls? Since inhibiting 11b hydroxylase will increase 11-Deoxycortisol, im wondering what the conseuqneses of that is .. increased aldosterone??
>
> Metyrapone does increase 11-deoxycortisol, yes. The effects of this during Cushing's treatment aren't entirely clear.
>
> In terms of aldosterone, metyrapone itself reduces aldosterone synthesis.... but because it increases ACTH, it may lead to the body attempting to produce more aldosterone. The overall effect could be either more OR less aldosterone being produced. During treatment, doctors carefully monitor potassium levels to help keep track of this.
>
> >no havent been to the doc yet. becus i dont know what to test for.
> I asked you but you didnt answer. am I supposed to test for Cortisol and ACTH ?
>
> I did answer :) Testing ACTH is not usual when initially looking for the possibility of high cortisol, no.
>
> Although it's up to your doctor, and depends on your local lab, common tests when looking at the possibility of high cortisol are the overnight dexamethasone suppression test, and the 24 hour urinary cortisol collection test.
>
> >is it possible to test for CRF1?
>
> No, it's not possible to test for the level of CRF-1 receptors.
>
> Alcohol is a common substance believed to activate CRF-1. So if you don't already, you could try a period of no alcohol and see if it helps your mental health.
>hm... might try Alcohol then to disrupt my natural CRF1 activation, becuase it even has an effect on the CRF1 it should help my anxiety somewhat since its changing its natural course. And no I dont drink Alcohol ...So the only thing that would work for me is an CRH/CRF1 antagonist ...... F#ck!.... IM DOOMED..... Doctors dont prescribe CRF1 antagonists! And you can hardly find these online!
Posted by ed_uk2010 on March 24, 2018, at 16:51:50
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 16:22:21
>hm... might try Alcohol then to disrupt my natural CRF1 activation, becuase it even has an effect on the CRF1 it should help my anxiety somewhat since its changing its natural course.
No, alcohol stimulates CRF-1 more. Since you are concerned about CRF-1, it would make sense to keep avoiding it. Sure, it might help anxiety for a bit... but it can get worse when it wears off.
>the only thing that would work for me is an CRH/CRF1 antagonist ......
If you only learn one thing from this forum, it should be that you never really know what will work until you try it. I don't think you're doomed at all. If you want treatment suggestions, you will need to share a lot more about your actual symptoms and what you've tried before. Give us more about you. How old are you, when did symptoms start? How do you feel? You are getting into scientific theories which could be completely false.
Posted by farshad on March 24, 2018, at 17:07:16
In reply to Re: How can I block Cortisol? » farshad, posted by ed_uk2010 on March 24, 2018, at 16:51:50
> >hm... might try Alcohol then to disrupt my natural CRF1 activation, becuase it even has an effect on the CRF1 it should help my anxiety somewhat since its changing its natural course.
>
> No, alcohol stimulates CRF-1 more. Since you are concerned about CRF-1, it would make sense to keep avoiding it. Sure, it might help anxiety for a bit... but it can get worse when it wears off.
>
> >the only thing that would work for me is an CRH/CRF1 antagonist ......
>
> If you only learn one thing from this forum, it should be that you never really know what will work until you try it. I don't think you're doomed at all. If you want treatment suggestions, you will need to share a lot more about your actual symptoms and what you've tried before. Give us more about you. How old are you, when did symptoms start? How do you feel? You are getting into scientific theories which could be completely false.
>
>
well I told u everything to know. im stuck at this now. zyprexa is the only med that worked for me. I didnt know why until today. it inhibit stimulated CRH release from the hippocampus.
Posted by Phillipa on March 24, 2018, at 17:46:21
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 17:07:16
Hi F, Ed is extremly knowledgeable. It would be very helpful to know your age. And especially a list of the meds you have tried. And if you have a doctor who prescribed them all? Also the country you are living it might help Ed as he knows what meds are available in different countires. So you have been on zyprexa. But it didn't help you? Do you have any sort of diagnosis? thanks Phillipa
Posted by ed_uk2010 on March 24, 2018, at 18:05:20
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 17:07:16
>Zyprexa is the only med that worked for me. I didnt know why until today. it inhibit stimulated CRH release from the hippocampus.
Olanzapine (Zyprexa) is a really broad-spectrum medication which hits many receptors. So it's difficult to pinpoint exactly why it helped.
So, if it helped, why did you stop taking it?
Posted by ed_uk2010 on March 24, 2018, at 18:09:20
In reply to Re: How can I block Cortisol? » farshad, posted by Phillipa on March 24, 2018, at 17:46:21
Thanks Phillipa.
Unfortunately, mental healthcare isn't the most scientific area. There are so many possible causes of symptoms, it's impossible to know the true cause of most people's illness. Genetic tests may appear scientific, but they don't really provide the answers. If they did, psychiatrists would be doing them as routine.
In general, a detailed history can provide clues as to what might help. Nothing definite, but it can point in the right direction.
Posted by farshad on March 24, 2018, at 20:03:47
In reply to Re: How can I block Cortisol? » farshad, posted by ed_uk2010 on March 24, 2018, at 18:05:20
> >Zyprexa is the only med that worked for me. I didnt know why until today. it inhibit stimulated CRH release from the hippocampus.
>
> Olanzapine (Zyprexa) is a really broad-spectrum medication which hits many receptors. So it's difficult to pinpoint exactly why it helped.
>
> So, if it helped, why did you stop taking it?
>
>well no other drug has worked for me and ive tried like 40 different drugs. various supplements etc. I always had an idea in my mind that this receptor was causing my problem etc and ive gone trough everything I know . Ive blocked NMDA, blocked serotonin receptors, increased serotonin , blocked DOpamine, many things... No drug has worked besides zyprexa.. and ive come to the conclusion its becuase it inhibits CRH in the hippocampus. then this all would make sense why zyprexa worked. and based on the SNPS/genes everything.. Im fairly certain my problem is related to CRF1 . I got a low dose zyprexa becuase I was at a hospital to help calm me down. I dont know why they used zyprexa no idea, but at the time i didnt care I just took the dose and I hadnt heard about zyprexa before.and I realized it helped tremoundsly with anxiety, since then this drug has been on my mind and ive always asked myself why it worked. I never got it prescribed .
Posted by ed_uk2010 on March 24, 2018, at 20:10:43
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 20:03:47
Have you taken any other atypical antipsychotics? If so, how did you respond?
About Zyprexa, do you mean you just took one dose in hospital to calm you down?
Posted by farshad on March 24, 2018, at 20:16:53
In reply to Re: How can I block Cortisol?, posted by ed_uk2010 on March 24, 2018, at 20:10:43
> Have you taken any other atypical antipsychotics? If so, how did you respond?
>
> About Zyprexa, do you mean you just took one dose in hospital to calm you down?yes it wasnt a hospital but one of those imaginary places people with mental issues can go to and you can like stay there and they can take care of you or somth.They gave me zyprexa before I went home.
I have tried seroquel that didnt work as well.
Posted by farshad on March 24, 2018, at 20:17:25
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 20:16:53
> > Have you taken any other atypical antipsychotics? If so, how did you respond?
> >
> > About Zyprexa, do you mean you just took one dose in hospital to calm you down?
>
> yes it wasnt a hospital but one of those places people with mental issues can go to and you can like stay there and they can take care of you or somth.They gave me zyprexa before I went home.
>
> I have tried seroquel that didnt work as well.
Posted by farshad on March 24, 2018, at 20:18:09
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 20:16:53
> > Have you taken any other atypical antipsychotics? If so, how did you respond?
> >
> > About Zyprexa, do you mean you just took one dose in hospital to calm you down?
>
> yes it wasnt a hospital but one of those imaginary places people with mental issues can go to and you can like stay there and they can take care of you or somth.They gave me zyprexa before I went home.
>
> I have tried seroquel that didnt work as well.wow did i really say imaginary places...I meant those places people with mental issues can go to so they dont kill themselves.
Posted by Phillipa on March 24, 2018, at 20:23:57
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 20:18:09
A psychiatric hospital? Is this what you meant to write? Phillipa
Posted by farshad on March 24, 2018, at 20:27:07
In reply to Re: How can I block Cortisol? » farshad, posted by Phillipa on March 24, 2018, at 20:23:57
> A psychiatric hospital? Is this what you meant to write? Phillipa
maybe but it was very small.. not sure what it was. well anyway I went there and i talked to them for a few hours and I got zyprexa then went home the same day.
Posted by ed_uk2010 on March 24, 2018, at 20:35:05
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 20:16:53
I did wonder what you meant my imaginary places :)
It sounds like an urgent care centre for mental health, right?
It's common for people with depression + anxiety/agitation to be calmed by olanzapine (Zyprexa) or a small amount of risperidone (Risperdal). The dose of risperidone used in non-psychotic illness is usually very small.
Posted by farshad on March 24, 2018, at 20:41:21
In reply to Re: How can I block Cortisol?, posted by ed_uk2010 on March 24, 2018, at 20:35:05
> I did wonder what you meant my imaginary places :)
>
> It sounds like an urgent care centre for mental health, right?
>
> It's common for people with depression + anxiety/agitation to be calmed by olanzapine (Zyprexa) or a small amount of risperidone (Risperdal). The dose of risperidone used in non-psychotic illness is usually very small.
>
>
>
>
>So what should I do man? is it possible to get zyprexa from the family doctor?
Also I wanna do a cortisol test. You say you cant test for CRH but can you test ACTH? is not really not possible to measure CRF1
Posted by farshad on March 24, 2018, at 20:42:10
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 20:41:21
> > I did wonder what you meant my imaginary places :)
> >
> > It sounds like an urgent care centre for mental health, right?
> >
> > It's common for people with depression + anxiety/agitation to be calmed by olanzapine (Zyprexa) or a small amount of risperidone (Risperdal). The dose of risperidone used in non-psychotic illness is usually very small.
> >
> >
> >
> >
> >
>
> So what should I do man? is it possible to get zyprexa from the family doctor?
> Also I wanna do a cortisol test. You say you cant test for CRH but can you test ACTH? is not really not possible to measure CRF1``Is it really not possible to measure CRF1 is what I meant
Posted by ed_uk2010 on March 24, 2018, at 21:11:12
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 20:41:21
>is it possible to get zyprexa from the family doctor?
Potentially. It is more common to get olanzapine from a psychiatrist.
I don't think it's appropriate to take antipsychotics with pramipexole. You might want to look at reducing and stopping that.
>You say you cant test for CRH but can you test ACTH? is not really not possible to measure CRF1CRF-1 is a receptor. You cannot test for receptors using a blood test.
Posted by farshad on March 24, 2018, at 21:23:38
In reply to Re: How can I block Cortisol?, posted by ed_uk2010 on March 24, 2018, at 21:11:12
> >is it possible to get zyprexa from the family doctor?
>
> Potentially. It is more common to get olanzapine from a psychiatrist.
>
> I don't think it's appropriate to take antipsychotics with pramipexole. You might want to look at reducing and stopping that.
>
>
> >You say you cant test for CRH but can you test ACTH? is not really not possible to measure CRF1
>
> CRF-1 is a receptor. You cannot test for receptors using a blood test.oh okay. Why can I not take zyprexa with prami? Its not the dopamine antagonism of the antipsychotic im out for its bcus it inhibits CRH. Is it just becuase it would be dangerous? Im willing to quit prami tho no problem... Im currently on 4 meds , I can quit the 3 I get online (prami, armmodafinil and selegline) and I get wellbutrin from my doc . So wellbutrin + zyprexa it will be then... But i doubt I will get zyprexa..
So I have to do a MRI scan for the CRF1? got it..
Posted by Farshad on March 24, 2018, at 22:08:13
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 21:23:38
> > >is it possible to get zyprexa from the family doctor?
> >
> > Potentially. It is more common to get olanzapine from a psychiatrist.
> >
> > I don't think it's appropriate to take antipsychotics with pramipexole. You might want to look at reducing and stopping that.
> >
> >
> > >You say you cant test for CRH but can you test ACTH? is not really not possible to measure CRF1
> >
> > CRF-1 is a receptor. You cannot test for receptors using a blood test.
>
> oh okay. Why can I not take zyprexa with prami? Its not the dopamine antagonism of the antipsychotic im out for its bcus it inhibits CRH. Is it just becuase it would be dangerous? Im willing to quit prami tho no problem... Im currently on 4 meds , I can quit the 3 I get online (prami, armmodafinil and selegline) and I get wellbutrin from my doc . So wellbutrin + zyprexa it will be then... But i doubt I will get zyprexa..
>
> So I have to do a MRI scan for the CRF1? got it..anyway thanks for all the help. just 1 last thing..Inhibiting crh will inhibit crf 1 and 2 also right
Posted by ed_uk2010 on March 25, 2018, at 9:52:36
In reply to Re: How can I block Cortisol?, posted by farshad on March 24, 2018, at 21:23:38
Hi,
>Its not the dopamine antagonism of the antipsychotic im out for its bcus it inhibits CRH.
Olanzapine (Zyprexa) acts at many receptors, so it's not possible to be so specific about why it can relieve agitation.
You said you found it calming before - after a single dose, I believe? That was probably due to action at multiple receptors, and not necessarily related to CRH.
>Is it just becuase it would be dangerous? Im willing to quit prami tho no problem... Im currently on 4 meds , I can quit the 3 I get online (prami, armmodafinil and selegline)
Taking strange combinations like pramipexole with olanzapine is really unknown territory. You don't want to make yourself more ill.
Pramipexole should not be stopped suddenly. Reduce gradually.
>and I get wellbutrin from my doc . So wellbutrin + zyprexa it will be then... But i doubt I will get zyprexa...
This is something you can speak to your doctor about. A lot of people find that olanzapine (Zyprexa) calms severe agitation after a small dose. Since a doctor has given it to you before, you can mention this.
For schizophrenia, olanzapine is taken every day. For relief of agitation in depressive illness, it is usually short-term.
A major issue with olanzapine is that some users gain a lot of weight.
>So I have to do a MRI scan for the CRF1?
No sorry, this wouldn't show on a MRI. Routine medical tests and scans do not show the function of this receptor.
As you know, there has been research into the possible role of CRF-1 receptors in mental health conditions . Much of the research has been on rats, but there have been some clinical trials in humans. As far as I can see, some trials showed possible evidence of efficacy, whereas others did not. As an example, a trial of pexacerfont, a selective CRF-1 receptor antagonist, found that it was not effective for generalised anxiety.
So, although a few CRF-1 antagonists have been developed by pharmaceutical companies such as GSK and BMS, it isn't entirely clear what they might be most useful for in humans.
Posted by farshad on March 25, 2018, at 17:06:47
In reply to Re: How can I block Cortisol? » farshad, posted by ed_uk2010 on March 25, 2018, at 9:52:36
> Hi,
>
> >Its not the dopamine antagonism of the antipsychotic im out for its bcus it inhibits CRH.
>
> Olanzapine (Zyprexa) acts at many receptors, so it's not possible to be so specific about why it can relieve agitation.
>
> You said you found it calming before - after a single dose, I believe? That was probably due to action at multiple receptors, and not necessarily related to CRH.
>
> >Is it just becuase it would be dangerous? Im willing to quit prami tho no problem... Im currently on 4 meds , I can quit the 3 I get online (prami, armmodafinil and selegline)
>
> Taking strange combinations like pramipexole with olanzapine is really unknown territory. You don't want to make yourself more ill.
>
> Pramipexole should not be stopped suddenly. Reduce gradually.
>
> >and I get wellbutrin from my doc . So wellbutrin + zyprexa it will be then... But i doubt I will get zyprexa...
>
> This is something you can speak to your doctor about. A lot of people find that olanzapine (Zyprexa) calms severe agitation after a small dose. Since a doctor has given it to you before, you can mention this.
>
> For schizophrenia, olanzapine is taken every day. For relief of agitation in depressive illness, it is usually short-term.
>
> A major issue with olanzapine is that some users gain a lot of weight.
>
> >So I have to do a MRI scan for the CRF1?
>
> No sorry, this wouldn't show on a MRI. Routine medical tests and scans do not show the function of this receptor.
>
> As you know, there has been research into the possible role of CRF-1 receptors in mental health conditions . Much of the research has been on rats, but there have been some clinical trials in humans. As far as I can see, some trials showed possible evidence of efficacy, whereas others did not. As an example, a trial of pexacerfont, a selective CRF-1 receptor antagonist, found that it was not effective for generalised anxiety.
>
> So, although a few CRF-1 antagonists have been developed by pharmaceutical companies such as GSK and BMS, it isn't entirely clear what they might be most useful for in humans.
>
>If I went on zyprexa since its an antagonist on the dopamine receptors and many others, would my body evnetually upregulate them? Since I heard if you use an agonist on a receptor too much your body starts decreasing the activity and if you block something too much your body starts increasing . is that true?
Posted by ed_uk2010 on March 25, 2018, at 17:25:52
In reply to Re: How can I block Cortisol?, posted by farshad on March 25, 2018, at 17:06:47
>If I went on zyprexa since its an antagonist on the dopamine receptors and many others, would my body evnetually upregulate them? Since I heard if you use an agonist on a receptor too much your body starts decreasing the activity and if you block something too much your body starts increasing . is that true?
Hi F,
There can be truth in that for some drugs. This can lead to unexpected effects. As an example, people who take benzodiazepines or opioids regularly can experience a reduction in effectiveness.
With antipsychotics, there is a theory that taking potent dopamine D2 receptor antagonists long term can lead to receptor upregulation. This may be a cause of tardive dyskinesia.
With olanzapine (Zyprexa) at low doses, and in younger people, tardive dyskinesia is not a high risk. The main risks are due to weight gain and associated metabolic issues.
Although I can't make any definitive suggestions for yourself because I don't know much about your medical and psychiatric problems, I can say that some people with agitated depression find small doses of olanzapine very calming, although it can be sedating initially. I'm unsure what you most want from a medication...
Posted by ed_uk2010 on March 30, 2018, at 14:46:01
In reply to Re: How can I block Cortisol?, posted by farshad on March 25, 2018, at 17:06:47
Hi Farshad,
How are you doing? Did you see your doctor to ask about tests, or maybe olanzapine?
Posted by farshad on March 31, 2018, at 0:25:48
In reply to Re: How are you doing? » farshad, posted by ed_uk2010 on March 30, 2018, at 14:46:01
> Hi Farshad,
>
> How are you doing? Did you see your doctor to ask about tests, or maybe olanzapine?Not yet my appointment is on 5 april. I have come to different conclusions now.. I think I have a tumor in the paraventricular nucleus that constantly releases CRH . So Im gonna ask for an MRI scan. Zyprexa Inhibits CRH. So if I do have a tumor I will get gamma knife surgery but if I cant for some reason have that particular surgery, since I dont want them to open my skull I will ask for medication that can help against the tumor and with that I will also ask my doctor for Zyprexa since thats the only drug that ever worked for my anxiety. Thats where I am at now. Now just waiting and trying to learn stuff about my situation.
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