good article about cortisol

Discussion in 'Fibromyalgia Main Forum' started by moreinfoplease, Jul 2, 2008.

  1. moreinfoplease

    moreinfoplease New Member

    From: http://www.medicinenet.com/script/main/art.asp?articlekey=88041


    Doctor Says He's Had Success With Hydrocortisone for CFS and Fibromyalgia Patients

    By Salynn Boyles
    WebMD Medical News

    Reviewed By Louise Chang, MD

    March 21, 2008 — Boosting levels of the stress hormone cortisol with low doses of hydrocortisone could help patients with chronic fatigue syndrome and fibromyalgia feel better, a California doctor says.

    Kent Holtorf, MD, says the simple treatment carries significantly less risk and greater potential for benefit than widely accepted treatments for the two conditions. But chronic fatigue syndrome (CFS) and fibromyalgia experts who spoke to WebMD were not so sure.

    Holtorf believes the majority of CFS and fibromyalgia patients have low levels of the steroid hormone cortisol due to dysfunction in a brain system that regulates response to stress, known as the hypothalamic-pituitary-adrenal (HPA) axis.

    The problem is that very sophisticated testing is needed to identify this dysfunction.

    As a result, while a number of studies have shown lower-than-normal cortisol levels to be common in CFS and fibromyalgia patients, many others have failed to show the association.

    "The overwhelming majority of these patients have [cortisol] dysfunction, whether testing shows this or not," he tells WebMD. His review of the research is published in the latest issue of the Journal of Chronic Fatigue Syndrome.

    Low-Dose Treatment
    Holtorf routinely treats patients with chronic fatigue syndrome and fibromyalgia with low doses (5 to 15 milligrams a day) of the steroid hydrocortisone, in addition to other treatments, to boost cortisol levels.

    Of 500 consecutive patients treated with the steroid at his Torrance, Calif., clinic, Holtorf says 94% showed some improvement and 62% showed substantial improvement by the fourth visit.

    William C. Reeves, MD, director of the chronic viral diseases branch of the CDC, believes that most patients with CFS and fibromyalgia could benefit from taking low-dose hydrocortisone, but he says the treatment is not without risks.

    Reeves and CDC colleagues recently published a study showing that women with CFS symptoms tend to have lower-than-normal cortisol levels upon waking in the morning — a time when levels typically spike.

    "It does appear that there is something different in HPA axis function in these patients, but that doesn't necessarily mean that this treatment is the answer," Reeves says.

    Hydrocortisone Benefits and Risks
    He cites a 1998 study from the National Institutes of Health examining low-dose hydrocortisone for the treatment of chronic fatigue syndrome.

    Although the treatment was shown to have some benefit, a significant number of patients also exhibited a common side effect seen with higher steroid doses — adrenal suppression, a reduction in the amount of hormones made by the adrenal glands.

    The researchers concluded that "the degree of adrenal suppression precludes [the steroid's] practical use for CFS."

    "This idea of using low-dose steroids has been around for a long time, but it may not be as simple as simply raising cortisol levels. And even if it does help, it is not without risks," Reeves says.

    Fibromyalgia researcher Lesley Arnold, MD, agrees.

    "The evidence in favor of using steroids to treat these conditions just isn't there," the University of Cincinnati associate professor of psychiatry tells WebMD. "We just don't have enough consistent data about abnormalities in the HPA axis."

    Arnold points out that some studies in fibromyalgia patients have shown the HPA axis activity to be increased and some have shown it to be decreased. "The only thing that has been consistent is that there is usually some kind of abnormality in function."

    SOURCES: Holtorf, K. Journal of Chronic Fatigue Syndrome, vol 13: pp 1-14. Kent Holtorf, MD, medical director, Holtorf Medical Group Inc., Torrance, Calif. William C. Reeves, MD, director, chronic viral diseases branch, CDC. Lesley Arnold, MD, associate professor of psychiatry, University of Cincinnati. McKenzie, R. The Journal of the American Medical Association, Sept. 23, 1998; vol 280: pp 1061-1066.

    © 2008 WebMD Inc. All rights reserved.

  2. Waynesrhythm

    Waynesrhythm Member

    Hi Moreinfoplease,

    You may want to check out a thread I started entitled:

    <a href="http://www.immunesupport.com/chat/forums/message.cfm?id=1058069&B=FM#1058069">Low Dose Cortef/Hydrocortisone for Adrenals – Jeffries Protocol</a>

    I describe the success I've had with it, and additional posts by others give good additional information. If you do a search here on adrenals, HPA, etc., you should be able to find a fairly large number of posts on this topic.

    I tend to think adrenal insufficiency is often overlooked and/or underappreciated in its relation to our health issues. I think it's one of the first things that should be looked at, not to necessarily cure us, but to provide badly needed support to help our body function as well as it can given our circumstances.

    Regards, Wayne
  3. mbofov

    mbofov Active Member

    To test for cortisol levels does not require hard-to-get sophisticated testing. Any doctor can prescribe an Adrenal STress Index Test. It's a 24-hour saliva test which measures cortisol levels at 4 different times during the day and evening.

    I had one done 5 years ago and my cortisol levels were high at the wrong time, causing severe middle of the night insomnia. I was started on Seriphos (phosphorylated serine) to lower my cortisol levels and it helped immediately. I started sleeping better and felt calmer.

    So a blanket statement that we're all low in cortisol can be dangerous, but it's probably true that all or most of us have screwed up cortisol levels, either too high or too low. But it's not hard to find out which.

    Mary
  4. Waynesrhythm

    Waynesrhythm Member

    Hi Mary,

    I see you just posted. Thought I'd mention that I always appreciate your replies. I wonder if it could be that I tend to think similarly to the way you do? :)

    Thanks for all your posts.

    Best, Wayne
  5. mbofov

    mbofov Active Member

    Thanks for your kind words. I haven't posted very much for awhile, I've been in a slump and keep hoping to climb out of it (still doing the methylation protocol off and on with attendant detoxing, still crash way too easily)

    I do appreciate you and everyone else on this board. I marvel at many of the posts because of the obvious time, energy and sheer brain power involved. I wish I had that kind of energy (not to mention brain power!)

    Anyways, we are muddling along, and hopefully will find our way out of this dark forest together.

    Take care --

    Mary