Posted by Pfinstegg on October 19, 2002, at 18:15:13
In reply to Re: Remeron and cortisol, posted by Pfinstegg on October 19, 2002, at 15:51:36
Real Cushing's Disease is when you have a physical reason to have abnormal cortisol readings- such as a pituitary or adrenal tumor, either benign or malignant. Pseudo-Cushing's is when there isn't any tumor, but the cortisol is still abnormally high. In real Cushing's, you also tend to have physical signs like hypertension, skin stretch marks on your abdomen, as if you were pregnant, thin arms and legs and a thick body- and also the "buffalo hump". With pseudo-Cushing's, you can have some or all of these, or none.
If you have a normal 24-hour urinary cortisol, that is excellent, and almost surely means that you have nothing to be concerned about. However, if you are still concerned for any reason, you can have a Dexamethasone suppression test (DST) to be sure everything is OK. They do that by first measuring your normal 8 AM cortisol (4-22 is normal). Then you take 1 mg. of dexamethasone at 11 PM, and have the cortisol retested the following day at 8AM. A normal reading would be 5 or less. In brain terms, it means that your HPA axis is working well, so that when your body gets a big dose of cortisol (the dexamethasone), your hippocampus responds by telling the hypothalamus not to release any CRF. That tells your pituitary gland not to release any ACTH, which in turn tells your adrenal glands not to release any cortisol. When the HPA (hypothalamic-pituitary-adrenal) axis doesn't respond properly to the feedback message to shut down, and just keeps pumping out CRF, ACTH and cortisol, you have Pseudo-Cushings.
I hope this is clear- it took me a while to understand it!
Pfinstegg
poster:Pfinstegg
thread:124268
URL: http://www.dr-bob.org/babble/20021019/msgs/124290.html