Cortosol and Fibromyalgia

Discussion in 'Fibromyalgia Main Forum' started by PITATOO, Jan 2, 2011.


    PITATOO Member

    I am very confused as to the role of cortisol and fibromyalgia. I hear that excessive stress increases cortisol levels that it can cause muscle breakdown - catabolic. Why then are some talking about treating fibromyalgia with cortisol drugs? I have studied this for quite a while and am hoping someone out there can shed some light on the subject.


  2. IanH

    IanH Active Member

    If you look up this site it explains it quite well.

    Basically cortisol levels are low in many people with FMS. Cortisol is also an immune modulator, meaning it will downregulate some of the immune molecules (signals) responsible for low grade inflammation and the hypersensitivity to pain. High levels of cortisol are damaging so the dose is set at a low level for FMS and there is much evidence that it can be effective. However like many drugs, such as opiates, tricyclic antidpressants etc. there is always a downside to their long term usage.

    Over the 20 years I have had ME/CFS/FMS I have taken, prednisone, tricyclics, gabapentin, tramadol, dihydrocodeine and buprenorphine patch as well as numerous antibiotics to rid me of various enterobacteria. I thought of taking cortisol but decided for a more natural aproach. For the past two years I have decided to not compromise my health for the purpose of work and spend nearly half of each day in deep relaxation and physical exercise carried out very very carefully. After one year of this I stopped all meds except for some key absolutely essential supplements (magnesium, and vitamin D). I will never be well again but I am coping a lot better than when I was on the meds. I work part time, at my pace(I am a neuro-psychologist,). Just in case you think my illness is not serious, I have been unable to lift a spoon, had 18 years of constant diarrhea, fell down stairs twice, broke my back, fell into the road under an oncoming car, been hospitalized several times for many mysterious cardiac, neurological and musculo-skeletal problems.[This Message was Edited on 01/03/2011]
  3. mbofov

    mbofov Active Member

    Some people with CFS have high cortisol and some have low. So those with high cortisol definitely would not add cortisol to their regimen.

    A good way to check cortisol levels is the Adrenal Stress Index Test, a saliva test which measures cortisol levels 4 times throughout the day/evening. It will show how the levels fluctuate. When I was tested, I had high cortisol at night when it was supposed to be low, so it was causing severe insomnia. I was given Seriphos (phosphorylated serine) and it helped normalize my cortisol levels and also helped with sleep.

  4. gapsych

    gapsych New Member

    The saliva tests are not necessarily accurate. You need to get your blood tested.

    If you have concerns about your cortisol level, have your doctor check them out. Better yet, get a referral to a endocrinologist as they have had special training in this area.

    Good luck.

  5. mbofov

    mbofov Active Member

    Saliva testing is a valid test for cortisol levels, and even better than a blood test in some respects. You might recall a discussion you had with Richvank back in February 2010 (see

    The cortisol saliva testing was very helpful for me because it showed my too-high nighttime cortisol levels, which would not have been evident through a blood test, and this was crucial information.

    Here's an excerpt from Rich's responses to you re saliva testing (he has a much lengthier reply but won't copy here for reasons of space - you can see the whole response at the above link):

    "Hi, gapsych.

    "I don't believe the following statement from your post today is true:

    "'Also, the saliva test is not a valid test for your cortisol levels.'

    "In fact, saliva testing is the best way to test cortisol levels, for at least a couple of reasons.
    First, it measures free cortisol, which is the fraction that binds to the glucocorticoid receptors and is the active form. The blood test measures total cortisol, including that bound to the carrier protein, which does not reflect the levels of the active cortisol.

    "Second, it is important, especially in CFS, to measure the diurnal variation of cortisol over an entire 24-hour period. This is readily done by saliva testing at home, while blood testing is not.

    "Here is the abstract of a recent review paper on this topic:

    J Clin Endocrinol Metab. 2009 Oct;94(10):3647-55. Epub 2009 Jul 14.

    Utility of salivary cortisol measurements in Cushing's syndrome and adrenal insufficiency.

    Raff H.

    Endocrine Research Laboratory, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin 53215, USA.

    Context: The measurement of cortisol in saliva is a simple, reproducible, and reliable test to evaluate the normal and disordered control of the hypothalamic-pituitary-adrenal (HPA) axis. There are a variety of simple methods to obtain saliva samples without stress, making this a robust test applicable to many different experimental and clinical situations. EVIDENCE ACQUISITION: Ovid Medline and PubMed from 1950 to present were searched using the following strategies: [<saliva or salivary>and<cortisol or hydrocortisone>and<Cushing or Cushing's>] and [<saliva or salivary>and<cortisol or hydrocortisone>and<adrenal insufficiency or hypoadrenalism or hypopituitarism or Addison's disease>]. The bibliographies of all relevant citations were evaluated for any additional appropriate citations. EVIDENCE SYNTHESIS: Measurement of an elevated late-night (2300 to 2400 h) salivary cortisol has a greater than 90% sensitivity and specificity for the diagnosis of endogenous Cushing's syndrome. Late-night salivary cortisol measurements are also useful to monitor patients for remission and/or recurrence after pituitary surgery for Cushing's disease. Because it is a surrogate for plasma free cortisol, the measurement of salivary cortisol may be useful during an ACTH stimulation test in patients with increased plasma binding protein concentrations due to increased estrogen, or decreased plasma binding protein concentrations during critical illness. Most reference laboratories now offer salivary cortisol testing. CONCLUSIONS: It is expected that the use of the measurement of salivary cortisol will become routine in the evaluation of patients with disorders of the HPA axis.

    PMID: 19602555 [PubMed - indexed for MEDLINE]

    And you replied to Rich:

    "I may have mixed up the saliva test not being valid for another condition but will certainly check this out.



    But again I recommend looking at the whole discussion at the above link.

    Best wishes,


    [This Message was Edited on 01/03/2011]
  6. elliespad

    elliespad Member

    My docs used Salivary testing for Cortisol. This allows for a snapshot 4 times throughout the day and evening. I have taken 5 mg. Hydrocortisone, 4 times a day to try and even out my levels. Oddly, I get (slightly) better sleep if I take my last dose at bedtime.

    Today, I happen to be doing a 24 hr. Urine Collection to get a Cortisol level. This doc wants to determine if I am getting enough.