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Symptoms and Cortisol - a causal relationship?

Martin aka paused||M.E.

Senior Member
Messages
2,291
Hi @ all!

I experience being in a better physical shape in the evenings. Even if my day is really bad with low energy levels and digestive problems, I often improve an hour or two after dinner (around 8 pm).

At first I thought it's because of the meals in the evening (in Germany we eat wholemeal bread for dinner). But doing the same in the morning and/or for lunch does not seem to have the same effect.

So I thought: What could cause these improvements. It might be that hormones fluctuate, especially cortisol (The psychiatrist I had to visit because my doc told me to said that he would recommend a 24 hours cortisol test. That's why I first thought about my improvements being linked to cortisol) ???

What do you think? And do you experience the same?

Thank you!
 

Martin aka paused||M.E.

Senior Member
Messages
2,291
I experience the same, I have no idea why, there are many elements in the body that follow a circadian daily rhythm. For me, the cortisol doesn't seem to be the problem if the labs are to be believed.

Very interesting. My psychiatrist said that the cortisol is linked to many other things that happen in the body/the immune system. If I only did not had this brain fog then I probably would remember... But he emailed me and said it could be linked to the parathyroid and that this has to be checked...

Fun fact: He - the psychiatrist - was the only doc who said that he does not believe in a mental disorder and that the whole body has to be checked...
 

ivorin

Senior Member
Messages
152
Sometimes, you run into a normal human being even among the psychiatrists. One I visited sent me on the path to a POTS diagnosis - the others thought I was "making up" having tachycardia and postural intolerance - they even diagnosed me with acute psychosis beacuse of it.
 

ukxmrv

Senior Member
Messages
4,413
Location
London
My daily functioning correlates to my saliva cortisol test. I've also had a blood test in the morning and a short synacten test at a hospital.
The finding of low morning cortisol has been known in ME and CFS patients for years now. My CFS doctor was testing his patients in the 1990's and there are sure to be other doctors before then.

https://www.ncbi.nlm.nih.gov/pubmed/9757853

RESULTS:
The number of patients showing improvement on the Wellness scale was 19 (54.3%) of 35 placebo recipients vs 20 (66.7%) of 30 hydrocortisone recipients (P =.31). Hydrocortisone recipients had a greater improvement in mean Wellness score (6.3 vs 1.7 points; P=.06), a greater percentage (53% vs 29%; P=.04) recording an improvement of 5 or more points in Wellness score, and a higher average improvement in Wellness score on more days than did placebo recipients (P<.001). Statistical evidence of improvement was not seen with other self-rating scales. Although adverse symptoms reported by patients taking hydrocortisone were mild, suppression of adrenal glucocorticoid responsiveness was documented in 12 patients who received it vs none in the placebo group (P<.001).
CONCLUSIONS:
Although hydrocortisone treatment was associated with some improvement in symptoms of CFS, the degree of adrenal suppression precludes its practical use for CFS.
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
That 1998 study showed a marked improvement in Wellness score, so it seems recipients of HC benefited.

They used 16mg/m squared as a dose, which for me would be about 30mg per day, which is above a physiological or replacement dose which seems to be between 15 and 25mg. That could be why they found adrenal suppression.

So, do you take it to function and feel better, with a slight risk of adrenal suppression, or do you not take it and spend your time sleeping?

As I've literally been in a heap on the floor without it, my doctor talked me into taking it, in divided doses, 10mg an hour after waking, 10mg around 11am, and 5mg if I need it around 3pm. I've found if I take too much, I start gaining weight around my middle, so I'm pretty motivated to stay well below that level.
 

Martin aka paused||M.E.

Senior Member
Messages
2,291
@Learner1 @ukxmrv But I seem feel better when Cortisol is low... does that make any sense with the study and taking hydrocortisone? Or ist morning cortisol in CFS lower then in the evenings? Sorry I am totally brain fogged... :-/
 

ukxmrv

Senior Member
Messages
4,413
Location
London
@Learner1 @ukxmrv But I seem feel better when Cortisol is low... does that make any sense with the study and taking hydrocortisone? Or ist morning cortisol in CFS lower then in the evenings? Sorry I am totally brain fogged... :-/

My saliva cortisol pattern (done twice now over many years) is very low in the morning and then rising throughout the day with a peak at night. Most of my family is like this tough and we are prone to ME as well. We start off as larks in my family and rise early, hit puberty and then change to owls for the rest of our lives.

In the morning my blood pressure and body temperature are low, I am sick / nauseous and prone to fainting., confused and have black spots in front of my eyes.

Had a short synacten test in a UK hospital. Nothing to eat and early morning. My blood cortisol was low but not Addison'd low they said. Within a short time of the injection used my normal morning symptoms lifted and I felt good. My blood cortisol was still on the low side but closer to a low / normal but once again not low enough for a Addison's DX.

Normal "healthy" cortisol levels should be highest in the morning so people with CFS and ME are unusual in that we often have low cortisol instead.
 

Martin aka paused||M.E.

Senior Member
Messages
2,291
My saliva cortisol pattern (done twice now over many years) is very low in the morning and then rising throughout the day with a peak at night.

Normal "healthy" cortisol levels should be highest in the morning so people with CFS and ME are unusual in that we often have low cortisol instead.

Thank you! Then I will check that. Could be an explanation.
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
You might try a product called Seriphos by Interplexus, taken at night before bed if your cortisol is too high to sleep. It helps to reregulate when you make cortisol, and I've seen some people have amazing results with it.

If it seems a little strong, you could try Jarrow or similar phosphatidyl serine which is a fraction of the strength.

B5 is helpful for supporting adrenals, too.
 

Martin aka paused||M.E.

Senior Member
Messages
2,291
You might try a product called Seriphos by Interplexus, taken at night before bed if your cortisol is too high to sleep. It helps to reregulate when you make cortisol, and I've seen some people have amazing results with it.

If it seems a little strong, you could try Jarrow or similar phosphatidyl serine which is a fraction of the strength.

B5 is helpful for supporting adrenals, too.

Luckily I don't have any problems with falling asleep. But thank you!
 

Wishful

Senior Member
Messages
5,665
Location
Alberta
There's definitely some sort of changes due to circadian rhythm. I used to feel abruptly worse around 2:30 PM, regardless of changes in sleep, diet, etc. Now it seems to occur around 5:30 PM. I don't know whether it's linked to cortisol or something else, but it seems fairly precise and reliable.

When I first tried prednisone, it did nothing for four or five days, but then I woke up feeling wonderfully healthy. That tapered off with the dosage. I got another prescription and had the same result after two days. The doctor wouldn't give me a renewal, but I discovered that cumin seed (likely the cumin aldehyde) had the same effect as prednisone. After a few weeks of that, I realised it wasn't working anymore. I tried prednisone twice after that--once at higher dosage--but it had no effect. I try cumin seed occasionally, but it has no effect either. I've had other treatments that worked initially, but then no longer had any effect. Whatever the feedback loop is in ME/CFS, it sure seems determined to keep us in this state.

Hmmm, maybe ME/CFS is actually an important defensive mechanism to protect us from the upcoming zombie plague or whatever. :)
 

drob31

Senior Member
Messages
1,487
I think it's related to many thing, but cortisol and blood sugar are the two big ones.

Try using alpha lipoic acid + vitamin C to control blood sugar with every single meal, and energy levels may improve or become more steady.
 

Martin aka paused||M.E.

Senior Member
Messages
2,291
I think it's related to many thing, but cortisol and blood sugar are the two big ones.

Try using alpha lipoic acid + vitamin C to control blood sugar with every single meal, and energy levels may improve or become more steady.

The thing is that I seem to feel better after eating fast food and drinking Cola. Only slightly better and as I am mostly bed bound and would gain much weight if I would do this every day I am no Pizzamaniac now... But there seems to be a link to blood sugar... even if it’s not a healthy one :-D
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
Infection causes a stress response in the body by increasing the amount of certain hormones such as cortisol and adrenaline. These hormones work against the action of insulin and, as a result, the body's production of glucose increases, which results in high blood sugar levels.

Steroids like hydrocortisone and prednisone can also raise blood glucose levels.
 

sb4

Senior Member
Messages
1,654
Location
United Kingdom
Has anyone been able to raise morning cortisol through pregnenolone?

We start off as larks in my family and rise early, hit puberty and then change to owls for the rest of our lives.

I strongly believe this is not genetic and that you could probably easily switch back to propper circadian rythms by blocking blue light after sun down and setting alarm for sun rise and staring at the sun for 10-15mins first thing every morning.

I also strongly believe that proper ciradian rhythm is massive when it comes to health.
 

ukxmrv

Senior Member
Messages
4,413
Location
London
Has anyone been able to raise morning cortisol through pregnenolone?



I strongly believe this is not genetic and that you could probably easily switch back to propper circadian rythms by blocking blue light after sun down and setting alarm for sun rise and staring at the sun for 10-15mins first thing every morning.

I also strongly believe that proper ciradian rhythm is massive when it comes to health.

We've been there done that sadly. Large families in different countries and different life styles. Going back decades. I'm not saying it is genetic.

Staring at the sun for me in the morning leads to sickness/vomiting / headaches and increased weakness in the day. I went for years trying these approaches and my ME was much worse.

Not sure why you think this is an easy problem to solve?
 

sb4

Senior Member
Messages
1,654
Location
United Kingdom
Not sure why you think this is an easy problem to solve?
Perhaps I was too rash. I falsely assumed you hadn't tried these things. For non ME people with life long night owl habits have this completely reversed when spending a couple days camping, think it was in a study.

No idea why the sun in the morning would make you feel sick. Could it be you need to get used to it again?
 

frozenborderline

Senior Member
Messages
4,405
\
Has anyone been able to raise morning cortisol through pregnenolone?



I strongly believe this is not genetic and that you could probably easily switch back to propper circadian rythms by blocking blue light after sun down and setting alarm for sun rise and staring at the sun for 10-15mins first thing every morning.

I also strongly believe that proper ciradian rhythm is massive when it comes to health.
i may try this, sort of wanna do cortisol under a doctor's supervision