msg for tansy from pinkquartz

hi tansy

i know you said you cut and paste info that madwolf had posted and took it to your GP. can you tell me which info and where it might be ?
also i don't know how to cut and paste from the internet, could you explain it for me ?

thing is my GP rang me today. she is easing her way back into work and is concerned about the cortisol. she is worried it might have negatives like affecting bone density ??
i told her i haven't felt this way in 12 years. however i think it woukd be a good idea to have some info ready to show her just in case she is wobbling. or rather to reassure her. she says she has read that it can stop my adrenal gland working. i told her that Teitlebaum says it won't at this dose. again i would like to have ready the same info you showed to your GP.
she is going to arrange a bone scan, so we can track what happens.

also i asked her about the oestrogen test and she said yes. so i can have the *snapshot* blood test soon after all!

love, pinkquartz

but here goes -

I use PC so you may have to change any bits that are not relevant to macs, but I would have thought the principle was the same.

First I create a new word file than minimise it. Then I highlight the text in the message or web page I want. Right click then left click copy, restore the word file then right click on the page and left click on paste then I save it. Takes no time at all.

Might be a better way but this works for me and doesn't take too much concentration.

Will paste Dr Sarah Myhill's page on hydrcortisone, this helped to convince my GP because it quoted two studies as well. Madwolf's recommendations being similar helped clinch it.

Dr Sarah Myhill on prescribing hydrocortisone

Hydrocortisone is a steroid and steroids have nasty side effects. So how is it safe to use? All my patients, quite rightly, ask this question. The name of the game is the dose. All substances inside the body have a “right dose” from protein and fat to water and minerals. Too much of any one causes problems, as does too little of any one. The same is true for hormones. Too much causes side effects as does too little. Too much steroid causes immune suppression, high blood pressure, diabetes and osteoporosis. No steroid at all invariably results in death. Too little steroid causes fatigue. The key is to use the right amount. A normal adrenal gland produces 20-25mgs of hydrocortisone daily. Most of this is in the morning with production tailing off as the day progresses. It is linked in with the internal body clock. When I prescribe cortisol I only do so in patients with a proven deficiency, I use 5-10mgs (rarely 15mgs) to be taken either in the morning, or morning and lunchtime. Levels do not need to be monitored at this low dose. The safety of low dose cortisone has been long established but the following is an abstract from a recent paper in the Lancet. It shows how low dose cortisol in unselected patients not only improved symptoms in patients with CFS but there was no adrenal suppression at follow up. A New Hydrocortisone Trial Another randomised, controlled, crossover trial of low-dose hydrocortisone treatment for CFS has recently been published. 32 participants, fulfilling both the Oxford and CDC 1994 criteria, completed this short-term trial. Participants received 5mg or 10mg of hydrocortisone for 28 days and placebo for 28 days. The results revealed modest, statistically significant improvements in fatigue with this low-dose hydrocortisone treatment compared with placebo. The degree of disability was also reduced with hydrocortisone treatment but not with placebo. There was no significant difference in changes in fatigue score when 5mg and 10mg doses were compared. The authors suggest that, in view of the lack of dose response in this study, 5mg is a sufficient low dose of hydrocortisone. Participants who responded to this hydrocortisone treatment did not differ from ‘non-responders’ in terms of their pre-treatment cortisol levels. Although none of the participants in this study had a current psychiatric illness, those who responded to hydrocortisone treatment had fewer psychiatric symptoms prior to treatment. Based on the results of the insulin stress test, this short-term, low dose hydrocortisone treatment was not found to cause significant suppression of adrenal gland function. None of the participants dropped out of the study and only minor side effects were reported. The authors conclude that this low-dose hydrocortisone treatment resulted in “significant reduction in self-rated fatigue and disability in patients with chronic fatigue syndrome”. This study sheds interesting light on the possible role of low cortisol levels in the disease processes involved in CFS. Caution is required, however, in interpreting the results. Participants’ baseline cortisol levels could not predict their response to hydrocortisone treatment and participants appeared to have baseline cortisol levels within the normal reference range. In another randomised controlled trial of hydrocortisone therapy ( see Interaction 29, page 21 for a review), McKenzie at al., used a higher ‘low-dose’ hydrocortisone treatment of 25 - 35mg daily. They found that this dose was associated with some improvements in symptoms but caused significant adrenal suppression. Neither of these research teams currently recommended the use of hydrocortone as a treatment for CFS. The present study assessed the effects of hydrocortisone treatment in the short-term only. As the authors point out, further studies, involving longer durations of treatment and follow-up are required to assess the long-term effectiveness and safety of this treatment. Reference: Cleare et al; The Lancet, 1999, Vol. 353 February 6, p455-458

As you will see they only recommend short term use. Perhaps Madwolf as a medic himself, can advise on how to convince a GP to continue prescribing it. I'd have thought if it works and treats problems you've had for so long you should be able to persuade her to continue it until others problems have been resolved too. My GP's worried about bone density too but haven't researched that bit yet.

Good luck

Love

Tansy



[This Message was Edited on 08/08/2003]
[This Message was Edited on 08/08/2003]
[This Message was Edited on 08/08/2003]

i have to be quick , friend wants his laptop NOW !

thanks tansy i don't understand the computer bit, will try later

slowgirl...yes plkease.. i am being haraased
love pinkquartz

I e-mail them to you as well.

Love

Tansy

got to go, am tired out, have been food shopping with home help today and its caught up with me now.

love, pinkquartz

with the info from Dr Myhill's site that's on this post has been sent.

You have had an exhausting and trying time. Take care of your needs too and give yourself some well earned rest.

Love

Tansy