Posted by Elroy on January 30, 2006, at 11:44:43
In reply to Re: This story might be hard to believe... » Elroy, posted by tomv on January 29, 2006, at 21:20:17
> No, I've never attempted to find a therapist who specializes in EMDR. I'm seeing a therapist, but we're not practicing anything like this. I might ask him about this at our next session.
>
> I noticed you mentioned something about elevated cortisol levels. How did you find this out? Are you treating this specifically?
>
> Tom
>Tom,
The only really accurate method of measuring your daily cortisol levels is to perform a 24-hr UFC (Urinary Free Cortisol) test. You basically collect your urine over a 24-hr time period in a specially provided plastic jug (and you have to keep it refrigerated between collections).
Ideally your doctor would have you do two of those over the course of a week. That is done because cortisol secretion is done on a cyclical basis - both daily and during the course of a day - and you can have a non normal day here and there. If your levels come back elevated on either test, then you want to do preliminary testing to see if you might have Cushing's Disease (versus hypercortisolism that is based on a psychological disorder - which is technically known as Pseudo Cushing's). That should be done by repeating the two 24-hr UFC tests while doing a "Late Night Salivary Cortisol Test" on each of the two nights that you do 24-hr UFCs. You simply collect saliva in provided test tubes and mail them in. These salivary tests are not designed to determine total cortisol levels, but simply to give a picture of what your cortisol levels are between 11 PM and Midnight. If you have Cushing's, your cortisol levels will be elevated on those tests.
If you have very mildly elevated levels of cortisol or "high normal levels", then there's a number of OTC supplements that work at varying degrees to reduce cortisol. The better OTC supps in that regard include Phosphatidylserine, Holy Basil Extract, Magnolia Bark Extract (main ingredient in Relora), Epimedium Extract, Rhodiola Rosea Extract, and Ashwagandha Extract. Also 2 grams of glutamine daily combined with 1/2 gram of NAC (amino acids).
Unfortunately if you have highly elevated cortisol levels or elevated levels that are due to a dysfunctional HPA Axis, then the OTC supplements are simply not going to be very effective at reducing cortisol levels - and levels will boucne right back up when you cease supplementing.
For a three month time period I supplemented with the above supplements as well as GH3, Melatonin, Gingko Biloba, and Beta-sitosterol (all of which have lesser anti cortisol effects). Prior to this I had tested cortisol levels of 214. At the end of this cycle I tested at 108 (reference range of 20 - 100). I stayed with this supplementation (quite expensive by the way) for 2 1/2 more months and then stopped it two weeks before next round of testing. My cortisol level was back up to 222.
I also went on a five month cycle of Remeron this last summer. My first test (about six weeks into the cycle) was a 97 (range 20 - 100). The next test (at end of cycle) was a 52 - but range had changed due to enw Lab with range now 4 - 60. So Remeron did bring me down into high normal ranges... but again the levels went right back up as soon as Remeron was stopped (indicating that HPA Axis is still dysfunctional / hyperactive). With Remeron I had extreme sedation (sleeping 16 - 18 hours at 15 - 30 mg, 14 - 16 hours at 45 mg and 12 - 14 hours at 60 mg). In addition, while on Remeron I put on 25 lbs of weight in those five months and cholesterol jumped up 60 points.
Last month I spent two weeks at NIH Hospital in Bethesda, Md, having all kinds of advanced testing done. There bottom line was that I didn't have any form of Cushing's (other than apparent Pseudo Cushing's), that the hypercortisolism - and various physical symptoms that I have with it - seems to be purely the result of the psychological disorder, and that control / correction of the psychological disorder "should" eventually lead to a full-scale reduction in the elevated cortisol. Aside from that, they had NO idea as to what was causing my hypercortisolism "for sure" nor what could be done to address it.
Interstingly, the "team of doctors" at NIH included two psychiatrist. One of them was highly informed about EMDR and recommended continuing that line of treatment. Both suggested (at different times) that perhaps I was under-medicated for my condition (at the time I was taking 1 mg of Xanax XR twice daily, plus Ambien as a sleep aid... they felt this to be a very low dose for anxiety severe enough to cause a hypercortisolism condition).
NOTE: Many doctors will test for cortisol levels by doing a blood test. Do NOT accept a blood test as an accurate picture of what your cortisol levels look like. A blood test simply takes a momentary "snapshot" of what your cotrisol levels in the blood are right at that moment, and since cortisol secretion cycles high and low throughout the day - and the cycle is frequently off kilter with those who have hypercortisolism - so the blood test (or a salivary test) for purposes of determining total daily levels.
Also.... do NOT simply assume that cortisol levels are either high or low. Some forms of depression and at least one form of anxiety (PTSD) are characterized by LOW cortisol levels, so taking anti cortisol supplements or meds would not be advisible (in fact excessively low cortisol levels can led to adrenal shock and even death).
As to the EMDR, would continue to strongly suggest that you explore that option as a talk therapy option. I believe that ultimate control and / or curing of psychological disorders generally requires a combination of both medications (to achieve balances that have gone out of kilter, allow one to function somewhat normally, etc., etc.) while the talk therapy helps one sort through any causation traumas.
The main EMDR site is located at:
The link for finding a certified therapist in your area is at:
http://www.emdr.com/clinic.htm#search
Simply talking to a general therapist who has no experience with EMDR would probably not be very productive.
Elroy
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