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
poster:katekite
thread:114297
URL: http://www.dr-bob.org/babble/20020725/msgs/114497.html