Is hair a good indicator of cortisol status?I remain to be convinced that low cortisol is a widespread problem in people with ME
e.g. This recent study of 107 people with ME:
https://www.s4me.info/threads/hair-...-syndrome-2018-roerink-et-al.4404/#post-80089
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Low dose hydrocortisone as a treatment for ME/CFS
- Thread starter Suffolkres
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https://stresscenter.ucsf.edu/measures/hair-cortisol
The authors of the study mentioned above also monitored salivary cortisol. Total daily salivary cortisol output did not differ between people with CFS and controls.
People with CFS did have a statistically lower 'cortisol awakening response' (4.2 nmol/L vs 6.3 mol/L for the controls).
There is a huge overlap in values - some people with CFS had higher values, some healthy controls had lower values. So, even though statistically significant, it is not a very impressive, consistent difference and explanations like an, on average, later usual waking time for people with CFS could easily explain it.
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I started this exact treatment 2 months ago. Today I finally tapered off the cortisol.
It does not work.
It did not help me at all.
I have a friend with severe ME and she tried this same low dose cortisol treatment too. It did not help her either.
When I took cortisol, my body temperature went up, but I felt just as exhausted, and horrible. The malaise felt no different.
It felt like someone pressing the gas pedal on a car with no petrol in the tank.
I did it with a doctor using an alternative American testing lab that showed low cortisol and thyroid hormones (My conventional blood tests for cortisol and thyroid are perfect.) It makes me wonder if all these diagnostic labs are a scam.
I have classic ME.
There is a risk of heart palpitations if you take cortisol together with thyroid hormones together, like I did and like stopthethyroidmadness recommends.
It does not work.
It did not help me at all.
I have a friend with severe ME and she tried this same low dose cortisol treatment too. It did not help her either.
When I took cortisol, my body temperature went up, but I felt just as exhausted, and horrible. The malaise felt no different.
It felt like someone pressing the gas pedal on a car with no petrol in the tank.
I did it with a doctor using an alternative American testing lab that showed low cortisol and thyroid hormones (My conventional blood tests for cortisol and thyroid are perfect.) It makes me wonder if all these diagnostic labs are a scam.
I have classic ME.
There is a risk of heart palpitations if you take cortisol together with thyroid hormones together, like I did and like stopthethyroidmadness recommends.
I hope that you fully recover from the experience.
Thanks @Hutan. I did wonder re the time period represented.
We have done hair testing for electrolyte balance and this was simply dismissed by medics. Showed significant issues.
James Morris-Lent
Senior Member (Voting Rights)
I had a very similar experience with HC. I felt noticeably warmer - for a while. Yes, the labs are making money for some private company, as well as helping to sell the idea of 'adrenal fatigue', while providing no value to the consumer, aka a scam.
In our case it was under the direction of an endocrinologist. The head if dept and a professor.Main focus diabetes as i suspect is the case for many UK endocrinologist s.
I think he did want to be able to do something, but seized on a lowish base cortisol level without trying to understand why it might be low, or indeed any impact glucocorticoids may have.
At drug interventions for vit D and hydrocortisone there have been horrendous facial skin reactions, each in a different area and now compounded during crashes, or when immune system under stress.
Tangentially if you look at asian/ oriental face reading for skin probkems - the vit D area corresponds to liver and kidney and the hydrocortisone corresponds to hormones. So perhaps something in it...
Suffolkres
Senior Member (Voting Rights)
I agree that it's not the case in all but a significant subset may exist, especially those with allergies.
The problem is mainly with the NHS Synathen test for these patients is a blunt instrument, and which fails to record subtle irregularities.
https://en.wikipedia.org/wiki/ACTH_stimulation_test
Versions of the test
This test can be given as a low-dose short test, a conventional-dose short test, or as a prolonged-stimulation test.
In the low-dose short test, 1 µg of an ACTH drug is injected into the patient. In the conventional-dose short test, 250 µg of drug are injected. Both of these short tests last for about an hour and provide the same information. Studies have shown the cortisol response of the adrenals is the same for the low-dose and conventional-dose tests.[9][10]
The prolonged-stimulation test, which is also called a long conventional-dose test, can last up to 48 hours. This form of the test can differentiate between primary, secondary, and tertiary adrenal insufficiency. This form of the test is rarely performed because earlier testing of cortisol and ACTH levels in association with the short test may provide all the necessary information.[8]
On the hand the adrenal saliva test does show irregularities but is only used for hyper not hypo patients ( ie Cushing Syndrome)
The problem is mainly with the NHS Synathen test for these patients is a blunt instrument, and which fails to record subtle irregularities.
https://en.wikipedia.org/wiki/ACTH_stimulation_test
Versions of the test
This test can be given as a low-dose short test, a conventional-dose short test, or as a prolonged-stimulation test.
In the low-dose short test, 1 µg of an ACTH drug is injected into the patient. In the conventional-dose short test, 250 µg of drug are injected. Both of these short tests last for about an hour and provide the same information. Studies have shown the cortisol response of the adrenals is the same for the low-dose and conventional-dose tests.[9][10]
The prolonged-stimulation test, which is also called a long conventional-dose test, can last up to 48 hours. This form of the test can differentiate between primary, secondary, and tertiary adrenal insufficiency. This form of the test is rarely performed because earlier testing of cortisol and ACTH levels in association with the short test may provide all the necessary information.[8]
On the hand the adrenal saliva test does show irregularities but is only used for hyper not hypo patients ( ie Cushing Syndrome)
Snow Leopard
Senior Member (Voting Rights)
It's not merely waking time, but differences in activity patterns, using alarms vs not using alarms etc. The primary purpose of cortisol is metabolic and is dependent on daily activity patterns/habits.
Sly Saint
Senior Member (Voting Rights)
Glucocorticoids and Central Nervous System Inflammation
This article provides a review of the current literature, showing that under certain circumstances GCs might fail to have anti-inflammatory effects and sometimes even enhance inflammation.
https://www.researchgate.net/public...coids_and_Central_Nervous_System_Inflammation
This article provides a review of the current literature, showing that under certain circumstances GCs might fail to have anti-inflammatory effects and sometimes even enhance inflammation.
https://www.researchgate.net/public...coids_and_Central_Nervous_System_Inflammation
DigitalDrifter
Senior Member (Voting Rights)
Where is he getting these figures from? There's no way 2.6% of GP visits are ME patients, chronic fatigue may be but not ME. Conflating the two is a tactic often used by Wessely and his colleagues.Simon Wessely said:
I doubt 50% of ME patients have major depression, unfortunately the references for his claims are unavailable in the PDF OP posted.
leokitten
Senior Member (Voting Rights)
I guess though steroids have some utility in ME, @Hip compiled a nice list of PEM shielders and relievers back on PR
https://forums.phoenixrising.me/ind...or-prevent-pem-post-exertional-malaise.48438/
Steroids seem to be the most complete PEM shielders is taken prior to physical or mental exertion. Though I guess it cannot be taken all the time.
https://forums.phoenixrising.me/ind...or-prevent-pem-post-exertional-malaise.48438/
Steroids seem to be the most complete PEM shielders is taken prior to physical or mental exertion. Though I guess it cannot be taken all the time.
Hip
Senior Member (Voting Rights)
It does not seem like an unreasonable figure. I would think that a large percentage of the population rarely go to their doctor; I imagine it's a hardcore of those with chronic diseases or protracted medical problems that most frequent the GP's surgery.
So although ME/CFS patients are only around 0.2% of the general population, they are going to be present at a higher percentage within this hardcore group with chronic diseases.
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perchance dreamer
Senior Member (Voting Rights)
I take 4 MG of HC upon wakening, and it does help me get through the day. My cortisol was very low in the morning, and this small dose of HC along with an adrenal-supporting supplement normalizes my morning cortisol.
Suffolkres
Senior Member (Voting Rights)
Likewise my husband. Now down to 2.5 mg in morning and occasionally additional 2.5 during afternoon to manage a big evening event.
This protocol is supported by GP who regularly reviews.
This protocol is supported by GP who regularly reviews.
This was prescribed by several Cfs doctors in USA some years ago.Initially, 5 mg, then as the illness was so severe with huge relapses and seizures, the dose was bumped up to until a dose of 20mg. It brought nothing but osteoporosis in a young person. Now the weaning down has been going on, very slowly and carefully. Hopefully, we can get rid of this. Much has been tried on this illness and nothing has brought anything good.
Someone please reassure me that the physicians and researchers know what they are now doing.
Someone please reassure me that the physicians and researchers know what they are now doing.
JaimeS
Senior Member (Voting Rights)
Yeah, I was prescribed hydrocortisone. NOT GOOD.
I've gone into it in depth before, so I won't bother revisiting in depth, but I was not surprised when de Vega's team hypothesized that some corticoids may have a neurotoxic effect in some pwME. That's an accurate description of my subjective symptoms.
But other patients have reported benefit over the years. It seems really individual.
Fructose/ steroids - liver?Yeah, I was prescribed hydrocortisone. NOT GOOD.
I've gone into it in depth before, so I won't bother revisiting in depth, but I was not surprised when de Vega's team hypothesized that some corticoids may have a neurotoxic effect in some pwME. That's an accurate description of my subjective symptoms.
But other patients have reported benefit over the years. It seems really individual.
JaimeS
Senior Member (Voting Rights)
???
Oh, you mean some kind of processing problem?
That's possible, but I definitely wouldn't see it as the only or major possibility I don't think.
Sly Saint
Senior Member (Voting Rights)
This post, and a number of subsequent posts, have been moved from
Cortisol levels in Chronic Fatigue Syndrome and atypical depression measured using hair and saliva specimens, 2020, Cleare/Chalder/others
not directly related to this study but Dr Mark Guthridge has just put together a thread where he asks:
Dr Mark Guthridge
@Dr_M_Guthridge
1/Thread: Is #MECFS caused by chronic low-level #inflammation due to adrenal insufficiency and low cortisol? And, are anti-inflammatory hyrdrocortisones effective?
Cortisol levels in Chronic Fatigue Syndrome and atypical depression measured using hair and saliva specimens, 2020, Cleare/Chalder/others
not directly related to this study but Dr Mark Guthridge has just put together a thread where he asks:
Dr Mark Guthridge
@Dr_M_Guthridge
1/Thread: Is #MECFS caused by chronic low-level #inflammation due to adrenal insufficiency and low cortisol? And, are anti-inflammatory hyrdrocortisones effective?
2/ This
@JAMA_current
clinical trial shows low dose hydrocortisone was associated with "minimal therapeutic benefit for CFS.." but adrenal suppression was a significant side-effect #MECFS #immunesystem #pwME #chronicillness
Low-Dose Hydrocortisone for Treatment of Chronic Fatigue Syndrome
Context.— Chronic fatigue syndrome (CFS) is associated with a dysregulated hypothalamic–pituitary adrenal axis and hypocortisolemia.Objective.— To evaluate the efficacy and safety of low-dose oral...
jamanetwork.com
3/ This
@TheLancet
#clinicaltrials shows that low dose hydrocortisone shows modest activity in some #MECFS patients #pwME #chronicillness #inflammation #immunesystem
Low-dose hydrocortisone in chronic fatigue syndrome: a randomised crossover trial
In some patients with chronic fatigue syndrome, low-dose hydrocortisone reduces fatigue levels in the short term. Treatment for a longer time and follow-up studies are needed to find out whether this...
thelancet.com
4/ This
@JAMA_current
paper found low-dose fludrocortisone does not provide significant benefit in #MECFS #MyalgicE #immune #pwME #inflammation #clinicaltrials
A Preliminary Placebo-Controlled Crossover Trial of Fludrocortisone for Chronic Fatigue Syndrome
Objective To provide a preliminary assessment of the efficacy and safety of fludrocortisone acetate treatment of chronic fatigue syndrome.Design A placebo-controlled, double-blind, random-allocat...
jamanetwork.com
5/ This paper showed that low-dose combination therapy of hydrocortisone and fludrocortisone was not effective in patients with #MECFS #clinicaltrials #pwME #MyalgicEncephalomyelitis #medtwitter
Combination therapy with hydrocortisone and fludrocortisone does not improve symptoms in chronic...
Chronic fatigue syndrome has been associated with decreased function of the hypothalamic-pituitary-adrenal axis. Although neurally mediated hypotension occurs more frequently in patients with chronic...
amjmed.com
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