Reducing Cortisol

[zadok]

I have recently found out that i have very high cortisol levels. What is the best way to reduce them. I have been using PS for 3 weeks now and no change. Ive heard taking cytadren is dangerous, cant get it any way. Are there any other drugs suitable for lowering/blocking cortisol?

[mranak]

Did you get a 24 hour cortisol assay done?

[stat1951]

Yes, main quesion that needs to be answered is "how do you know that you have 'very high' cortisol levels"?

You need to specifically request that a "24-hr Urinary Free Cortisol" test be ordered (you collect your urine in a supplied plastic jug over a 24-hr time period). That is "THE" test to ascertain if you truly have hypercortisolism or not.

Also see this thread:

Swale/Headdoc - Need help with Adrenal fatique

If you truly have hypercortisolism, you are going to find that the battle to correct it is a long involved process (I'm not talking here about where people have some "high normal" ranges of cortisol and are experiencing some difficulties because it's not in the "optimal range"... I'm talking about where one has a medical condition of hypercortisolism).

And if you do have hypercortisolism then you will want to immediately do testing to see if the condition of Cushing's Disease or Cushing's Syndrome might exist.

Larry

[MANWHORE]

Originally Posted by zadok

I have recently found out that i have very high cortisol levels. What is the best way to reduce them. I have been using PS for 3 weeks now and no change. Ive heard taking cytadren is dangerous, cant get it any way. Are there any other drugs suitable for lowering/blocking cortisol?

what brand PS are you using? I used that PRO something brand. they are right near the jersey shore or in OLD BRIDGE NJ i think. I just remember they are just south of me and their stuff has 500mg of PS per tab or cap. I took 2/day and got bad cramps after a few days so that made me think they were good

[love_en]

I have been told that the adrenals attempt to compensate for low T. A small percentage of androgens is produced by the adrenals. If your T is low, you can have high cortisol. I was recently tested for hypogonadism. My cortisol levels were close to the top of the reference range and an ACTH stim test caused my cortisol to rise only 20%above my high baseline. High cortisol can be caused by stress or pain. In my case, being hypogonadal caused my muscles and joints to break down, causing constant pain.

One of the tests for true hypercortisolism is a dexamethasone suppression test. Dexamethasone is a powerful corticosteroid. In normal people, a 1mg dose taken the night before a blood draw, cuts cortisol levels via pituitary feedback. Much like how T reduces LH and FSH. If you have hypercortisolism, your cortisol levels are not suppressed. I know this because, I thought I either had Addison's disease or Cushings. Come to find out, I am hypogonadal. Unless your cortisol levels are causing definite Cushings symptoms, playing with cortisol levels is risky. Low cortisol can be rapidly fatal. Cytadren has been known to cause adrenal crisis then death. Good call on your part to skip it.

[stat1951]

Likewise hypercortisolism can cause a condition of hypogonadism. It did with me.

The HPA Axis recognizes cortisol as a primary hormone (i.e., your body cannot live without it), so it will "rob" your body of "raw materials" - like the materials needed to produce testosterone or serotonin, etc., etc. in order to keep making cortisol. So at some point your testicles productions simply shut way down (not necessarily completely, but enough to become hypogonadal).

In my case I had cortisol levels that were very high. My first two tests (though there has been some concern as to the tests being processed right at the lab) showed cortisol levels 5 - 6X the normal maximum end of the reference range. After that time period my cortisol range has (until recently) been in the range of 1.3 to 2.7 X the maximum of the normal reference range.

That is what is meant by "hypercortisolism", not simply having levels that are in the high normal range. While not necessarily healthy, levels in the high normal range tend to respond to aggressive supplementation with OTC anti-cortisol supplements (legitimate ones!). Having hypercortisolism is an entirely different matter. It usually boils down to one of four types of Cushing's (the term Cushing's simply means hypercortisolism, the different types then are designators as to the causation):

1. Cushing's Disease: Caused by a pituitary tumor that (simple explanation) keeps "ordering" the adrenal glands to produce cortisol - even though excess amounts are already there. Treatment consist of locating the offending tumor (after going through testing to absolutely confirm that it is CD) and the surgical intervention to remove the offending tumor.

2. Cushing's Syndrome: Caused by either an adrenal gland tumor or a small-cell cancer secreting ACTH that keeps "ordering" the adrenal glands to produce cortisol - even though excess amounts are already there. Treatment consist of locating the offending tumor (after going through testing to absolutely confirm that it is CS) and the surgical intervention to remove the offending tumor. Of course if it is small-cell tumor secreting ACTH that process can be made much more difficult.

3. Exogenous Cushing's: Caused by either excessive use or prolonged use of artificial cortisol (cortisone, prednisone, etc. - these are synthetic corticosteroid used for suppressing the immune system and inflammation... Corticosteroids have many effects on the body, but they most often are used for their potent anti-inflammatory effects, particularly in those conditions in which the immune system plays an important role. Such conditions include arthritis, colitis, asthma, bronchitis, certain skin rashes, and allergic or inflammatory conditions of the nose and eyes). Treatment consists of weaning off of (or at least weaning down) on the artificial cortisol being used.

4. Pseudo Cushing's: This is the term for hypercortisolism that is caused by anything else. Acute chronic alcoholism can cause hypercortisolism in the form of PC. AIDS or acute active HIV can cause PC. Severe and/or chronic depression can cause PC. Severe and/or chronic anxiety can cause PC. This (which is the version that they "think" that I have at this point) can be somewhat easy to deal with (i.e., alcoholics who have PC generally clear up within weeks of removal of alcohol). Or can be almost impossible to deal with (how do ou address a PC condition brought on by AIDS?).

In my case, they believe that the PC was caused by a situation of chronic work stress over a period of 2 - 3 years, followed by further 2-3 years of now severe stress and low-level anxiety related to a forced termination lawsuit (etc., etc.), Bottom line... severe anxiety broke out around l became hypogonadal within a matetr of less than a month (nothing like going from a 9.6 - on a ten scale - to a zero "just like that"). Additionally developed several other symptoms (aside from the severe anxiety of course - painful icy cold feet, not quite as bad cold hands, peripehral neuropathy type pains of feet and hands, burning urethra type pains (constant, not prostatitis), severe tinnitus, etc., etc. - all coming on out of nowegere and all developing within about a one month time period.

Anyway, my efforts at solidifying my TRT treatments is actually just one element of several maneuvers being employed to treat the overall problem.

Abyone who would desire further information on "regular" Cushing's conditions, symptoms, etc. (i.e., as relates to Cushing's Disease or Cushing's Syndrome) would do well to check out this link:

http://cushings.invisionzone.com/index.php?

Must caution that there are quite a few "self-professed gurus" on this site who have quite a bit of information... just not necessarily quite correct! And also caution that Pseudo Cushing's is treated like someone with leprosy on this site (too many docs are too willing to write off Cushing's symptoms as either "simply PC" - as if it could somehow be "simple" - or as "just depression", etc., etc... so they tend to be quite defensive if you go there looking for PC information!).

Some pieces of advice....

1. Don't think that you have hypercortisolism simply because your cortisol is in the upper part of the normal range.

2. If there's any concern that you might have one of the hypercortisolism conditions, then definitely start out with the 24-hr UFC test. If it is high, then you should have a late night salivary cortisol test done. People with CD or CS generally return very high levels with that latter test while PC patients normally come back with normal levels.

3. The Dex Suppression Test (mentioned above) has more and mroe been replaced with the combined DEX / CRH Test as it has been found to be both more accurate and more reliable than the DEX (or CRH) tests that were previously run independently.

Larry

[marianco]

High normal cortisol levels usually indicates a person is experiencing a lot of stress (physical or mental) or is experiencing a mental illness (such as depression). There are multitudes of anti-stress and mental health interventions available. Addressing the source of stress and improving one's ability to adapt to the stress, I believe, would be better than trying to limit one's cortisol production with phosphatidylserine (PS).

The cortisol production is needed to address the stress. Capping one's cortisol production (unless frank psychosis is present) may be then counterproductive. It would be better to work at the level of the brain and one's relationship to the environment, than at the level of the adrenal glands when having high normal cortisol levels.

Above normal cortisol levels - particularly when measured by a 24-hour urine cortisol or other appropriate long-term measurement of cortisol production (as opposed to a point measurement such as a single blood test or saliva test) - would make me suspicious of Cushing's Syndrome. A visit to an endocrinologist would then be appropriate.