Posted by bulldog2 on April 27, 2010, at 14:05:30
In reply to Re: Prednisone and Immediate AD Response » bulldog2, posted by SLS on April 27, 2010, at 12:52:18
> How do you think this figures in?
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> I'm having a hard time understanding this stuff.
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> Is your baseline cortisol level high or low?
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> My baseline salivary cortisol is high and I am a dexamethasone non-suppressor.
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> I tried a one-week treatment using mifepristone. It didn't help. However, I felt sort of washed-out afterwards. Do you think this was from adrenal exhaustion? I don't know.
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> - Scott
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> Antidepressant treatment with mirtazapine, but not venlafaxine, lowers cortisol concentrations in saliva: A randomised open trial
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> Barbara ScharnholzaCorresponding Author Informationemail address, Bettina Weber-Hamannb, Florian Lederbogena, Claudia Schillinga, Maria Gillesa, Vera Onkena, Pascal Frankhauserc, Daniel Kopfd, Michael Deuschlea
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> Received 4 January 2009; received in revised form 17 August 2009; accepted 26 August 2009.
> Abstract
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> Lowering the concentrations of free cortisol in depressed patients may be an important prerequisite to prevent glucocorticoid-related sequelae of depression. We tested the hypothesis that the hypothalamuspituitaryadrenal (HPA) system-dampening effects of venlafaxine and mirtazapine differ. We compared the course of morning (08.00h) and afternoon saliva cortisol (16.00h) in 42 mirtazapine- and 45 venlafaxine-treated depressed patients during a 1-week wash-out and a 4-week treatment period in a randomised open trial. Mirtazapine lowered afternoon cortisol from week 1 to 4. In contrast, during the course of the entire treatment period, venlafaxine did not attenuate saliva cortisol concentrations. Treatment effects of mirtazapine on cortisol concentrations did not differ in remitters and non-remitters to treatment. High baseline cortisol concentrations, on the other hand, were related to an unfavourable course during venlafaxine treatment and patients remitting during venlafaxine treatment had significantly lower afternoon cortisol concentrations in saliva, when compared to non-remitting patients. Thus, mirtazapine and venlafaxine show different effects on HPA system activity as measured by saliva cortisol. This may be of relevance with regard to physical sequelae of depression
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>Scott
Your questions are past my understanding. I believe my urine 24 hour cortisol levels were normal. But this doesn't take into account ebbs and flows.
I think the test using hydrocortisone is more looking at clinical results rather than lab values. You take hydrocortisone starting at 5mg and if no result 10 mg and go as high as 20 mg. If you feel better you probably have adrenal fatigue.
Adrenal fatigue happens in two stages. In the first stage your cortisol levels would be high as stress causes your body to produce more cortisol. In the final stage your cortisol levels would be low as your adrenals are now exhaused. Whatever stage of adrenal fatigue your body is in the extra hydrocortisone would relieve the burden.
poster:bulldog2
thread:945160
URL: http://www.dr-bob.org/babble/20100425/msgs/945285.html