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Dr. Bob is Robert Hsiung, MD,
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Posted by Crazy Horse on August 23, 2006, at 9:48:25
In reply to Re: Pseudo Cushing's » Elroy, posted by invisibleman15010 on August 23, 2006, at 8:51:12
Posted by Elroy on August 23, 2006, at 11:13:58
In reply to Re: Pseudo Cushing's » Elroy, posted by invisibleman15010 on August 23, 2006, at 8:38:47
The most accurate test is called a "24-hour Urinary Free Cortisol Test". A blood test or a saliva test takes just a momentary "snapshot" of what your cortisol levels are at that exact moment, whereas the 24-hr UFC gives you a more accurate picture of the TOTAL daily output. As cortisol secretion - and therefore the levels on the blood / saliva - vary during the course of the day. You could therefore have highly elevated cortisol levels in general, but just happen to have a blood draw done at the one time of the day where your secretion levels just happened to be just within range. So the doctor says that you're fine. But erally you might be 2 - 3 times (or higher) the maximnum of the reference range for that hormone.
If your levels are in fact elevated, then the next follow-up step would be to have either a Late Night Serum Cortisol draw (blood test) or Late Night Salivaery Cortisol test (saliva test). Because now you DO want a "snapshot picture" of where your cortisol levels are at... if you have PC version then your cortisol levels will be not only within range, but in the lower levels of the reference range). If your late night levels are elevated above range, then it is likely that you have one of the "regular" versions of Cushing's (test is done between 11 PM and Midnight).
Posted by Elroy on August 23, 2006, at 13:53:36
In reply to Re: Pseudo Cushing's » Elroy, posted by invisibleman15010 on August 23, 2006, at 8:51:12
Don't get me wrong. Neither I - nor that article - is saying that ALL conditions of anxiety or depression is caused by or in turn causes elevated cortisol levels.
That's the problem with this field, is that there are so many numerous causes of anxiety / depression... some purely traumatic experiences, some chemical imbalances, some hormonal imbalances (a field - like with this stuff with cortisol that is just starting to get investigated).. and some conditions that are a combination of those causations.
For example, PTSD patients tend to have LOW levels of cortisol (though not usually below the reference range levels... if they do develop such low levels, then they would be developing Addison's Disease which, like Cushing's, is a very serious medical disorder). Not all, but many sufferers of Panic Attacks have low cortisol levels in between attacks - but during the attacks their cortisol levels will sjyrocket and remain elevted for many hours afterwards.
What is being said is that there ARE certain psychological disorders that are characterized by highly elevated cortisol levels and therefore are in fact the same disorder that Endos refer to a very specific form of PC.
As the 24-hr UFC is a quite simple - and fairly inexpensive test - I believe that if it was me that I'd play it safe and check out having the test performed. If nothing else, to rule out that possibility.
In fact, since hormones can have such a great deal of play on our psychological wel-being, I would also strongly request a full range of hormone testing to see if anything was too low, too high or simply out of balance with another hormone.
Posted by alimae on August 24, 2006, at 21:03:35
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Has anyone taken effexor for social anxiety disorder????? My 18 year old is about to start. Any info is greatly needed...
Posted by alimae on August 24, 2006, at 21:05:22
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Has anyone taken effexor for social anxiety disorder????? My 18 year old is about to start. Any info is greatly needed...
Posted by invisibleman15010 on August 25, 2006, at 11:41:02
In reply to Re: Anyone had success on Effexor XR?, posted by alimae on August 24, 2006, at 21:03:35
I know from past Dr. trial and errors, many are using some of the newer anti depressants that have been approved by the FDA for anxiety in it's various forms. I have suffered from socail anxiety from college thru my professional life. I never received any benefit from them for anxiety. The only true relief was from on of the benzo's, klonopin, ativan or xanax. But, a lot of Dr's afraid to prescribe them because of the real potential for addiction. But, they do work, I know they do for me and did in the past. For those that can use them on a as needed basis, that's great. Well, that's my limited input, goodluck, I hope your 18 year old can get a handle on it now.
e
Posted by Ts6639 on August 25, 2006, at 13:15:00
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
My doctor prescribed Effexor for me yesterday, but, after reading some of the postings I don't think I want to try it. I have battled depression for most of my life and tried many life style changes, therapy, and medications. I read in one posting that if you find a medicine that works and then take yourself off of it that the next time it may not work. That has certainly been my experience. If I ever find something that will alleviate this dark cloud, I WILL NOT start tampering again with my treatment and medication. This has been the worst bout with depression so far...but I guess we all feel that way when we are stuck in the thick of it. I've taken Prozac (didn't work); Wellbutrin (made me paranoid and feel crazy); Depakote (felt like a zombie and slept all the time); Zoloft (which worked great until I decided that I was well enough to stop using it) Two years later I could kick myself in the behind. I have had short term results with Prozac, but it stopped working and the cloud returned. For the past two months, I sleep most of the time, rarely eat, suffer from horrible panic attacks, as well as the hopeless inner narrative that many of you may experience. The doctor did put me on Ritalin to help me get myself out of bed and at least function, but the effects are very short term and I crash. Now I'm on Concerta, but not working as well as Ritalin did. Oh well, this is the most I've talked in a while. I think I'll reward myself by going back to bed. Hang in there guys...the mind can distort our reality.
Posted by Phillipa on August 25, 2006, at 21:02:01
In reply to Re: Anyone had success on Effexor XR? » alimae, posted by invisibleman15010 on August 25, 2006, at 11:41:02
Hey I've been on benzos for over 30years the Ad's don't work and they as well are addictive and have many side effects. That's my opinion. And I have gone off benzos with no problem at all. When stresses in life are low no need for them. Love Phillipa
Posted by Jason1972 on August 25, 2006, at 23:15:11
In reply to Re: Anyone had success on Effexor XR?, posted by alimae on August 24, 2006, at 21:03:35
> Has anyone taken effexor for social anxiety disorder????? My 18 year old is about to start. Any info is greatly needed...
I took effexor for 4 years. It worked very well for anxiety. It really takes the edge off of stressful situations.
I came off of it because of prostatitus symptoms. I did have a history of prostate problems years before I took effexor, however they had gone away to a very manageable level. After being on effexor for 2 years the prostate symptoms returned with a vengence. After researching on my own, with no advise from any doctors I discovered that effexor can cause prostate problems.
That's my story... Jay
Posted by HOPEFULL on August 26, 2006, at 8:37:27
In reply to Re: Horrible drug, posted by invisibleman15010 on August 12, 2006, at 9:17:44
Has anyone gained weight with EFFEXOR XR, eat and feel empty, retain water, unable to sleep even taking ambien sleep like 4 good hours when I was able to sleep 10 before taking EFFEXOR XR, and yawn all day...has anyone had these symtoms...I just started 5 days ago taking EFFEXOR XR ALSO NOW I DON'T WANT TO GET OUT OF BED AND FEEL WORSE THAN BEFORE
Posted by invisibleman15010 on August 26, 2006, at 9:05:23
In reply to Re: Anyone had success on Effexor XR?, posted by Ts6639 on August 25, 2006, at 13:15:00
Don't forget that every med. seems to work quite differently for a lot of us. I know that reading to much, ie Psycho Babble overload, can scare you from probably aspirin. I actually quit Effexor, about two years ago, mainly because of reading of the potential scary side effects and withdrawl issues. Yes, my cholesterol went way up, but I dealt with it with Omega 3 and Niacin and I had no problems getting off Effexor as I weaned myself off, even taking the capsule open and dumping out a certain amount of the little capsules inside.........Effexor is not for everyone. I am thinking about starting it again along with ECT, as I have battle the darkness for way to long and been through almost all the newer meds. along with the side effects or no benefit..
food for thought......Paxil and Zoloft almost killed me....others have done well.......go figure???
e
Posted by invisibleman15010 on August 26, 2006, at 9:07:34
In reply to Re: Anyone had success on Effexor XR? » invisibleman15010, posted by Phillipa on August 25, 2006, at 21:02:01
I agree, I agree, I agree!
e
Posted by inshadeoftree on August 26, 2006, at 13:12:27
In reply to Re: Anyone had success on Effexor XR? » Phillipa, posted by invisibleman15010 on August 26, 2006, at 9:07:34
effexor at 37.5 mgs and five days of use...way too little to have measurable side effects...yes....so we worry really well...are we good at worry.and analyzing to pieces our bits and pieces...my latest advice was to use meditation and yoga to stop thinking and get to the healing work...well jeeze I know that...How ?... is my question...I'm useing effexor for the sixth day....soon to go to the threshold of 75 mgs a day...am I concerned yup am I worried Yup am I going to be brave yup...am I gonna do meditation and yoga every day nope...do I want someone to fix me Yup...am I doing my share of the fixing/work nope...will I live and breath and dream another day You Bet...am I making progress in my search for the real me yup...I just put these words down here for you to read 'cause it makes me feel I'm not quite so alone in my confused hard to measure world...Luck and kisses to us all.
Posted by SLS on August 27, 2006, at 18:55:00
In reply to Re: Pseudo Cushing's (nm), posted by Crazy Horse on August 23, 2006, at 9:48:25
Posted by Elroy on August 28, 2006, at 10:47:08
In reply to How are you doing? (nm) » Crazy Horse, posted by SLS on August 27, 2006, at 18:55:00
Actually getting gradually better and better (although slowly - at leastsomewhat surely). The significant increase in the Xanax XR (as per NIH) seemed to help a lot. Both in the anxiety department AND in the area of starting to see a reduction in cortiosl levels - still elevated and reductions are slow and mild but still are reductions.
Also, having work continued to be done to get hormones levels tweaked via Hormone Replacement Therapy has also helped a lot too (bioidentical hormone replacement - NOT artificial synthetic hormone replacement that is not molecularly identical).
Most days am having very, very slight twinges of anxiety here and there. No real background anxiety anmore and any anxiety flare-ups are usually much more shorter in length and lesser intensity.
Elroy
Posted by corafree on August 28, 2006, at 11:37:04
In reply to Re: Pseudo Cushing's » invisibleman15010, posted by Elroy on August 23, 2006, at 7:50:07
Just throwing in simple 'too-sense' here.
When I was first asked if I was depressed, many years ago, my response was that I was so anxious 'it' (anxiety) was causing an alteration in my confident personality and maintaining relationships and making decisions and in my physical wellness.
The P said, "That's depression!" He/she, and all following Ps have put the main focus on 'depression'.(?) It was like putting the cart before the horse. It was really anxiety.
Prozac only worked w/ a benzo. Even Effexor only worked w/ a benzo. After trials of pretty much all ADs, and many years later now, and so much unhappiness, I believe that depression is, at least in me, sadness or grief, and I believe it is very hormonally related, as well as it is environmentally related (for example; a loss).
I'm on Valium and levothyroxine. I take Soma for sleep.
Afa the stress hormone idea, I'm convinced it is a cause of a lot of digestive problems I am currently having, mainly spastic colon, and extreme IBS. Because I am on Valium, a colo-rectal physician would not prescribe anything for me. I am reacting to many foods/drinks w/ hours of cramping and then diarrhea.
I switched from bio-identical HRT to synthetic estrogen in patch form just a week ago because, although plant-based estrogen really increased my sense of well-being, I was eating sugar and salt by the handfuls and weight was distributing itself around my mid section. I am a woman w/o a pear-shape body and it was just more than I could handle.
This HRT switch ALMOST(!) has me wanting an AD again, but I KNOW what is going on. I mean, I can cognitively tell myself these moody feelings are hormonally related and I just can't have a perfect figure and a stress free life too, or, can't 'have my cake and eat it too'. It's a trade off. I don't wish to be a zombie. I don't, today, desire to be on an AD to dull my passion to feel. Even if that means I must feel some sadness. If I find myself w/ suicidal ideation, I self-talk myself down/back.
Re: anxiety specifically, especially now w/ some increase since change in HRT, I've felt some break-thru panic and the need for fast-acting Xanax.Don't see P for over a month and a capsule of niacinamide and some other alternatives help to calm me. Self-talk helps too. (It's kind of like self praying.)
Basically what I'm saying here is anxiety (or stress really) began BEFORE 'depression' began in my life, and I'm proof that hormones can impact as anxiety w/o an environmental stimulant.
Hope made some sense. Sorry if comments aren't pulled-together or in proper order. Have a headache and can't be online long. Anyone identify or comment?
love, cf
Posted by corafree on August 28, 2006, at 14:04:30
In reply to New header/old topic, posted by inshadeoftree on August 26, 2006, at 13:12:27
Gave me chills ... :)
Yes Effexor-XR can be analyzed all over the place and do every dance and 'not'.
I lost weight while others gained.(?)
I've chosen 'not' to take it anymore. I've taken it five times and had different results each time.
It is the only AD I've ever taken that seemed to help alleviate anxiety ... yet, ... not enough that I didn't need a benzo of some sort.
Oh, and my GYN wanted me to take it for hot flashes. (And, as I recall, it did keep them at bay.)
Still, remaining AD free now.
bestwishes, cf
Posted by Phillipa on August 28, 2006, at 20:23:15
In reply to Re: New header/old topic » inshadeoftree, posted by corafree on August 28, 2006, at 14:04:30
Corafree how did you get AD free? What about brain zaps and all that stuff? Love Phillipa
Posted by corafree on August 28, 2006, at 20:56:30
In reply to Re: New header/old topic » corafree, posted by Phillipa on August 28, 2006, at 20:23:15
I was on Norpamin for a few months. Helped me fall asleep also. Quit it.
I was on Wellbutrin for a few days. (I felt 'mania' for the first time in my life and thought to myself, how horrible for anyone to have to try to 'live'. 'feeling frozen but moving a mile a minute'!) Quit it!
I woke up the next morning and noticed my thoughts were positive instead of negative and (okay ... this is going to sound cRaZy ;) I had this feeling that someone had been in the room with me as I slept. (I live alone.)
I began Soma a couple nights later for sleep.
You have to know, it's been 30yrs of trial and error w/ ADs for me.
Then you brought 'remission' to my attn. I'd never heard that theory.
I'm okay. A lot of feelings and, of course, sadness, but feel somewhat better able to handle. I'm proceeding w/ caution. Also, I don't work. I don't know if I could do this if I had to have a lot of people contact.
A negative; Now that head feels screwed on better, my body is getting screwed up! (I have a lot of digestion problems really flaring up recently and my neck injury that is not yet surgical. Five years ago, I ran, as a hobby. Now as my neck is deteriorating, I'm not able to bounce. Can 'fast-walk' I guess. Always thought looked silly. Not sure about my neighborhood. Thinking treadmill?!
Can't have everything .. ever! .. I guess?!
love, cf
Posted by Phillipa on August 28, 2006, at 21:01:27
In reply to Re: New header/old topic » Phillipa, posted by corafree on August 28, 2006, at 20:56:30
Corafree that's exactly what wellbutrin did to me but I took it for a week ended up in the hospital the doc thought I was manic. Wow!!! you're the only other person I've ever heard this happened to. Love Phillipa
Posted by alimae on August 31, 2006, at 13:43:03
In reply to Re: New header/old topic » corafree, posted by Phillipa on August 28, 2006, at 21:01:27
Son started effexor last week. After 3 days started noticing difficulty with urination(had to really strain) Doc took him off becasue of that side effect. Put him on Zoloft....
Any comments greatly appreciated.Was taking effexor for social anxiety....
Posted by Elroy on August 31, 2006, at 15:46:03
In reply to Re: effexor... urination problems????, posted by alimae on August 31, 2006, at 13:43:03
> Son started effexor last week. After 3 days started noticing difficulty with urination(had to really strain) Doc took him off becasue of that side effect. Put him on Zoloft....
> Any comments greatly appreciated.
>
> Was taking effexor for social anxiety....
One of side effects of Effexor in males is that it gives prostatitis type symptoms in certain males. I had that side effect occur almost immediately when I trieed this drug and it also greatly increased my anxiety levels (which was what I was getting treated for). When I read thru the fine print in the warning brochure that came with the meds, it was even listed there!Why do Pdocs prescribe AD meds for anxiety problems? And generally immediately think of AD medications.
At different times I was put on Wellbutrin (greatly increased anxiety levels), Effexor (brought on prostatitis symptoms plus greatly increased anxiety) and Cymbalta (brought on prostatitis symptoms plus greatly increased anxiety)...
Elroy
Posted by notfred on September 1, 2006, at 22:11:17
In reply to Re: effexor... urination problems???? » alimae, posted by Elroy on August 31, 2006, at 15:46:03
This is less a side effect and more a primary effect. This effect is not uncommon in AD's effecting norepinephrine. Common effects are vasoconstriction, increased heart rate, stroke volume and cardiac output; norepinephrine (Levophed)is used for some medical crisises due to these effects. Norepinephrine has effects on mood but is also a key player in all things cardiac. All AD's that effect norepinephrine have the potential to raise heart rate and blood pressure. For me urination problems were/are start up effects with Effexor and any other AD that effects norepinephrine; it went away with time.
Posted by vanni on September 2, 2006, at 13:23:55
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Thanks to everyone for participating on this website. When I started EffexorXR 5 months ago it was reassuring to hear other people's experiences (even though some did freak me out!). I am 53 and am taking 75mg Effexor, 50mg of trazadone at night and have a low dose estrogen patch...I call it my menopause cocktail! I have never taken any psychotropic medication before. Prior to this combo I was very anxious, couldn't sleep, had night sweats, was irritable, cried easily, my memory was lousy and I had trouble focussing. I was worried I was not doing my job well and that I shouldn't be driving. Well now I feel like a million bucks! I am sleeping at least 7 hours, have energy, feel calm and optimistic most of the time, can think straight, can laugh again, and am more active. I think I have had a low level of anxiety and depression my whole life and didn't know it. I think about how it might be when I have to go off all these drugs (if I have to) but that is not today and I am grateful to be enjoying my life again.
Vanni
Posted by invisibleman15010 on September 2, 2006, at 15:47:09
In reply to Re: Anyone had success on Effexor XR?, posted by vanni on September 2, 2006, at 13:23:55
Wow..that's great to hear. I am on my 4th day at restarting 75mg of Effexor XR. First two days were not bad at all, today I feel pretty wiped out. More or less like flue symptons. Today was the first day in a long time that I was not able to force myself to exercise after breakfast, just went back to bed. But, I have high hopes that in a few days it will pass. I had some luck on Effoxor about 1 and half years ago, but quit after reading to much about horrible withdrawl stories, plus my cholestorol did sky rocket and my family has a serious heart disease history on both sides. I easily weaned myself off of effexor and got my cholesterol back down on Omega 3 and Niacin as my Dr. did not want to add a statin to my new med. cocktail that followed Effexor......well the first step on my way to getting well is started, restarting Effexor, the second is over too, making the commitment to have ECT and going through the prescreening.
e
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