Posted by Elroy on May 9, 2005, at 20:51:30
In reply to Re: Urine Test to Measure Neurotransmitter Levels???, posted by Larry Hoover on May 9, 2005, at 11:29:18
Lar,
If only your statement would have been true.
My endo was only concerned about my high cortisol levels and his hopes that it would end up being a legitimate Cushings case and he could "Dr House" a diagnosis that located the offending tumor and refer it for surgical intervention. From Day One he has never concerned himself with my high anxiety levels (he in fact mostly refuses to concede the relationship between the two - in spite of the facts: see my previous post).
In fact, having tested and found initially that even if it was Cushings, it definitely wasn't coming from an adrenal source, he had written off the KNOWN adrenal tumor as being nothing to be concerned about. It was only when my PCP doc began making noises about it being possibly a "Pheo" tumor that he (the main endo) decided abruptly to do tests to check that out (and yes, you're right, if it had been a "Pheo", the catecholamines of epoinephrine, NE, etc., would have been wildly elevated... mine were noticeably LOW, especially the NE).
And now that the latest tests have completely ruled out Cushings at all, he has declared that the elevated cortisol is "Pseudo Cushings" and that there's nothing that he can do for it, that my psych doc should be treating my anxiety "more aggressively" and that will bring the cortisol levels down...
Meanwhile my psych doc believes that the HPA Axis is malfunctioning and that the cortisol - which probably was caused to be elevated by tears of ongoing stress and milder anxiety - is now controlling the ballgame and is actually causing the severe anxiety and many of the physical symptoms (just as it would with real Cushings, symptom wise there's no difference between "real" Cushings and "Pseudo" Cushings)...
So there's NO "differential diagnosis" going on. Simply a disappointment that it wasn't a tumor caused Cushings and an "ol' well, sorry about that"....
Elroy
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> > I had a urinary catecholamine test years ago. It was the first thing my doc did before putting me on medication.
> >
> > I had fairly severe anxiety/social phobia, such a test can help determine any medical problems that may be contributing to (in my case) anxiety.
> >
> > Some rare cases of treatment resistant anxiety are caused by Pheochromocytoma (tumors that increase catecholamines).
> >
> > The catecholamine test was one of a few tests (including a CBC) that I received.
>
> Exactly the point. Your doctor was ruling out exotic, but medical, causes of your anxiety. It's part of the differential diagnosis. If you had a pheo, your urine would have had bizarrely elevated catecholamines and metabolites.
>
> Lar
>
poster:Elroy
thread:493827
URL: http://www.dr-bob.org/babble/20050504/msgs/495768.html