Cortisol cream/ Isocort buy where?

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    Cortisol cream/ Isocort buy where?


    I am using Hydrocorisone cream 15g tube,active ingredient hydrocortisone acetate 1%. The tricky bit is how do I appply the equivelent of 5mg Cortisol per day and whats the most accurate way to measure it out. Also any idea where it should be applied if trying to replace cortisol for adrenal fatigue.

    similarly does anyone know where I can buy in the internet either Hydrocortisol tablets or Isocort form a reputable source who accept credit cards ( I found one in US but no ccards!)

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    VitaminMD - Home was recommended to me. I just placed an order last week. They called today and said that the credit card info didn't come through on my on-line order. I immediately thought of a scam, but they read off the info that I had entered during the order. I went ahead and gave them my credit card info. They said that I should have the Isocort by Saturday. We'll see...
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    Quote Originally Posted by kincaiddave
    VitaminMD - Home was recommended to me. I just placed an order last week. They called today and said that the credit card info didn't come through on my on-line order. I immediately thought of a scam, but they read off the info that I had entered during the order. I went ahead and gave them my credit card info. They said that I should have the Isocort by Saturday. We'll see...
    This is where I get my Isocort and they send me it the first of the month without my having to re ordering it. When you start on this make dam sure you don't run out of it you can have big problems not comming off this dam slow. I keep an extra bottle. Also when you start taking this you need to go slow upping the dose.
    Here is a link on how to start on HC or Isocort.
    Stop The Thyroid Madness » How to treat adrenals–for the patient and their doctors
    Phil
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    Quote Originally Posted by 1Ainslie
    I am using Hydrocorisone cream 15g tube,active ingredient hydrocortisone acetate 1%. The tricky bit is how do I appply the equivelent of 5mg Cortisol per day and whats the most accurate way to measure it out. Also any idea where it should be applied if trying to replace cortisol for adrenal fatigue.

    similarly does anyone know where I can buy in the internet either Hydrocortisol tablets or Isocort form a reputable source who accept credit cards ( I found one in US but no ccards!)
    What is you exact application for the isocort? Remember, continuous use leads to skin atrophy.
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    Quote Originally Posted by DeerDeer
    What is you exact application for the isocort? Remember, continuous use leads to skin atrophy.
    Isocort comes in pill form he is trying to get the cortisol out of the OTC creams for rash's to get some cortisol.
    Phil
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    Quote Originally Posted by pmgamer18
    Isocort comes in pill form he is trying to get the cortisol out of the OTC creams for rash's to get some cortisol.
    Phil
    I'm not sure I am understanding the exact application - he states that he has "adrenal fatigue". How does one know this without actually having baseline cortisol leveles and the results of a cosyntropin stim test - which is where a baseline is measured then an injection given (250mcg of cosyntropin) which should stimulate cortisol production, cortisol levels are then remeasured at 30 and 60 minutes post injection.

    If the cortisol increases by <9 on the stim test then the patient is a nonresponder and treatment is to provide steroids.

    I guess I just need some more info :-)
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    Quote Originally Posted by DeerDeer
    I'm not sure I am understanding the exact application - he states that he has "adrenal fatigue". How does one know this without actually having baseline cortisol leveles and the results of a cosyntropin stim test - which is where a baseline is measured then an injection given (250mcg of cosyntropin) which should stimulate cortisol production, cortisol levels are then remeasured at 30 and 60 minutes post injection.

    If the cortisol increases by <9 on the stim test then the patient is a nonresponder and treatment is to provide steroids.

    I guess I just need some more info :-)
    Most do a saliva test one like this.
    A C&P.
    LAB WORK from Canary Club, where the saliva test is for a full spectrum: thyroid (TSH, free T3, free T4), adrenals (cortisol and DHEA), estrogen, progesterone, testosterone.
    Canary Club : Environment and Health : Home saliva testing - Diagnos-Techs

    Because most Dr.'s don't believe there is such a thing as Adrenal Fatigue yet in there Phy. Reference Book it states to check Cortisol levels before treating Thyroid.

    A good book out is the Adrenal Fatigue the 21st. Century in the book is a list of questions that can tell you if you have Adrenal Fatigue. Also you can do this.
    Temperature Patterns of low adrenal and thyroid function
    Phil
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    Quote Originally Posted by pmgamer18
    Most do a saliva test one like this.
    A C&P.
    LAB WORK from Canary Club, where the saliva test is for a full spectrum: thyroid (TSH, free T3, free T4), adrenals (cortisol and DHEA), estrogen, progesterone, testosterone.
    Canary Club : Environment and Health : Home saliva testing - Diagnos-Techs

    Because most Dr.'s don't believe there is such a thing as Adrenal Fatigue yet in there Phy. Reference Book it states to check Cortisol levels before treating Thyroid.

    A good book out is the Adrenal Fatigue the 21st. Century in the book is a list of questions that can tell you if you have Adrenal Fatigue. Also you can do this.
    Temperature Patterns of low adrenal and thyroid function
    Phil
    The cosyntropin stim test will actually evaluate the response of the adrenals to the stimulation (ie a stress) which would determine fi they are responding or not.

    I think it is in his best interest to be fully evaluated by an MD for any other underlying issue, rather than try to interpret the results and treat himself.
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    Quote Originally Posted by DeerDeer
    The cosyntropin stim test will actually evaluate the response of the adrenals to the stimulation (ie a stress) which would determine fi they are responding or not.

    I think it is in his best interest to be fully evaluated by an MD for any other underlying issue, rather than try to interpret the results and treat himself.
    I agree with you but were do you find a Dr. that will tests and treat this Dr. John will but most can 't get to him. I am telling you if you have problems like this and you test in the low normal range your ok. My morning cortisol levels were 8 and my Dr. told me I am ok. I showed him the book I was reading Adrenal Fatiuge and he blew it off. Most Dr.'s look for Addison's or below normal levels of cortisol. Or Cushing's syndrome above normal levels.

    Hell a lot of people are low Thyroid and Dr.'s don't see this because they go by the labs range yet if on has a TSH over 2 or a Free T3 and Free T4 below mid range they are told there ok when you complain about how bad your feel they tell you your depressed WTF is with that.
    Phil
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    They only take US c cards,





    Quote Originally Posted by pmgamer18
    This is where I get my Isocort and they send me it the first of the month without my having to re ordering it. When you start on this make dam sure you don't run out of it you can have big problems not comming off this dam slow. I keep an extra bottle. Also when you start taking this you need to go slow upping the dose.
    Here is a link on how to start on HC or Isocort.
    Stop The Thyroid Madness » How to treat adrenals–for the patient and their doctors
    Phil
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    Quote Originally Posted by 1Ainslie
    They only take US c cards,
    Can you send them a money order of some other way of paying for it. I sure if you send them a check they would send it to you.
    Try this search.
    Isocort - Google Search
    Phil
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    Phil
    Thanks for the help, I may end up doing just that.


    Quote Originally Posted by pmgamer18
    Can you send them a money order of some other way of paying for it. I sure if you send them a check they would send it to you.
    Try this search.
    Isocort - Google Search
    Phil
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    Quote Originally Posted by pmgamer18
    I agree with you but were do you find a Dr. that will tests and treat this Dr. John will but most can 't get to him. I am telling you if you have problems like this and you test in the low normal range your ok. My morning cortisol levels were 8 and my Dr. told me I am ok. I showed him the book I was reading Adrenal Fatiuge and he blew it off. Most Dr.'s look for Addison's or below normal levels of cortisol. Or Cushing's syndrome above normal levels.

    Hell a lot of people are low Thyroid and Dr.'s don't see this because they go by the labs range yet if on has a TSH over 2 or a Free T3 and Free T4 below mid range they are told there ok when you complain about how bad your feel they tell you your depressed WTF is with that.
    Phil
    Amen Phil, Luckily I found a MD that agree that my thyroid is too low for my metabolic functions. The thing that saved me was that I had pre existing free t-4 levels before I got sick to show this was not all in my head. With my ranges in the upper 3/4 ranges vs bottom end of tottem pole now. I tried to apply for social security, because I was so week and today my lawyer saw me after 6 weeks and said "WTF you been doing" I told him i found a dr thar dealt with athleres that was willing to listen and help and understand this was not all in my head as 4 other drs beleives. So he writing a letter stating that my case was easily identified and was properly handled from beginning for court hearing. finally after 2 years I found light !!
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    I see my Dr. next Tue. everytime I get to the point I feel he can't help me he comes through. Just it is going dam slow I am doing Isocort and feel it's not doing the job and need to get on HC so we will see what happens next Tue.
    Phil
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    missing isocort and HC seems to be working just fine for me. Its the anxiety from the damn serotonin deficiency from low thyroid causing alot of the major bowel problems. My spincter can not relax. Looking back I brought this on my self because of getting up at 3 am eating nd going back to bed to train at 530 WTF was I thinking !!
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    Quote Originally Posted by hardasnails1973
    missing isocort and HC seems to be working just fine for me. Its the anxiety from the damn serotonin deficiency from low thyroid causing alot of the major bowel problems. My spincter can not relax. Looking back I brought this on my self because of getting up at 3 am eating nd going back to bed to train at 530 WTF was I thinking !!
    So what is it causing bowel problems I am having problems with this it's not to bad not like water comming out but it's a problem. At first I thought it was the generic Armour I got but stopped it and still have the problem. I take 4 pills of Isocort in the morning before eating this is what I was told to do and I take 2 at noon and 2 at dinner. I started taking it after eating and still have the problem. I have one normol bowel movemen first thing in he morning then 2 to 3 more before noon that are like diarrhea. Is this my Thyroid needs more armour or my low sugar in the mornings upsetting my stomach. How do you take your Isocort. I posted on the Thyroid boards and they feel it's the low cortisol levels and the Isocort is not doing the job a lot of them tried this and did mush better on HC.
    Phil
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    Thyroid drive serotonin metbolism and with out serotonin melatonin can not be produced. With out melatonin zinc can not be absorbed across the intestinal membrane and with out zinc melatonin can not work. As you can see things are so intertwined. To relax you 200 mgs theanine every 4-6 hours with 500 mgs gaba (break open and dissolve on tongue.) Majortiy of hypothyroid people have altered mineral metabolism which can really start mess up enzymatic reactions. Melatonin increases conversion of t4 to t3 how by increasing zinc absorption (hmm interesting). Bascially you need to put the breaks on your brain chemistry which is causing adrenaline to run rampant which is causing diahreaa.
    Gaba, theanine, P5P, magnesium glycinate, zinc, glycine will help this..
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    Quote Originally Posted by hardasnails1973
    Thyroid drive serotonin metbolism and with out serotonin melatonin can not be produced. With out melatonin zinc can not be absorbed across the intestinal membrane and with out zinc melatonin can not work. As you can see things are so intertwined. To relax you 200 mgs theanine every 4-6 hours with 500 mgs gaba (break open and dissolve on tongue.) Majortiy of hypothyroid people have altered mineral metabolism which can really start mess up enzymatic reactions. Melatonin increases conversion of t4 to t3 how by increasing zinc absorption (hmm interesting). Bascially you need to put the breaks on your brain chemistry which is causing adrenaline to run rampant which is causing diahreaa.
    Gaba, theanine, P5P, magnesium glycinate, zinc, glycine will help this..
    Thanks I will look into this dam I take some much stuff now I need to check my Vit's to see if any of it is in them first.
    Phil
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    Phil make things easier
    liver/serotonin/gluthione pathways - samme or TMG, methylcobalin, p5p, folonic acid, zinc
    inhibitory neurotransmitters - gabba, glycine,theanine, magnesium glycinate.

    Magnesium 200mgs 2-4 times a day
    zinc - 30 mgs morning and before bed
    gaba - 500 mgs x3
    glycine 500 mgs x3
    theanine 100-200 mgs x3
    p5p - 50 mgs am and pm
    Tmg - 500 mgs 1/2 before 3 meals
    folonic acid - 800 mcgs breakfast and dinner
    methycobalin 5000 mcgs 1 time
    .500 mcg melatonin time released

    Sunlight hour each day A MUST..
    30 minurtes relaxation any time durinf day with belly breathing emphasized
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    Quote Originally Posted by hardasnails1973
    Phil make things easier
    liver/serotonin/gluthione pathways - samme or TMG, methylcobalin, p5p, folonic acid, zinc
    inhibitory neurotransmitters - gabba, glycine,theanine, magnesium glycinate.

    Magnesium 200mgs 2-4 times a day
    zinc - 30 mgs morning and before bed
    gaba - 500 mgs x3
    glycine 500 mgs x3
    theanine 100-200 mgs x3
    p5p - 50 mgs am and pm
    Tmg - 500 mgs 1/2 before 3 meals
    folonic acid - 800 mcgs breakfast and dinner
    methycobalin 5000 mcgs 1 time
    .500 mcg melatonin time released

    Sunlight hour each day A MUST..
    30 minurtes relaxation any time durinf day with belly breathing emphasized
    Thanks
    Phil
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    Quote Originally Posted by 1Ainslie
    I am using Hydrocorisone cream 15g tube,active ingredient hydrocortisone acetate 1%. The tricky bit is how do I appply the equivelent of 5mg Cortisol per day and whats the most accurate way to measure it out. Also any idea where it should be applied if trying to replace cortisol for adrenal fatigue.

    similarly does anyone know where I can buy in the internet either Hydrocortisol tablets or Isocort form a reputable source who accept credit cards ( I found one in US but no ccards!)
    god! just use dexamathasone at 0.5 mg at night,but first take an AM Cortisol blood test and ACTH test.

    by me at cuttingedgemuscle.com

    Water Retention - Cutting Edge Muscle Forums

    Water retention by androgens
    Oswaldo Salcedo (my ruminations)

    HYPOPITUITARISM -> HYPOADRENALISM ->HYPONATREMIA
    ......................... -> HYPOTHYROIDISM ->HYPONATREMIA


    one of the main mechanisms responsible for water retention is induced Hypopituitarism (reduced output of any pituitary hormone) by displaced Glucocorticoids (GC) through Androgens at the GC receptors, acting by antagonist mode, therefore decreasing Corticotropin (ACTH) w/wo decreased Thyrotropin (TSH) release. Subsequent to the ACTH decreased secretion, inhibits cortisol segregation at adrenals (Central Hypoadrenalism - Secondary Adrenal Insufficiency). The cortisol suppression produces in the hypothalamus, vasopressin (AVP) release, also known like anti diuretic hormone (ADH), this way GC insufficiency increases AVP mRNA expression, elevating abnormally, AVP levels, gives an increase in free water retention, decreased sodium pump activity, shift of extracellular sodium into cells and decreased delivery of filtrate to diluting segments of the nephron as a result of decreased glomerular filtration rate and effective renal plasma flow . GC inhibit AVP secretion by impairing AVP gene transcription.
    The possible decreased TSH produces a central hypothyroidism ( trophoprivic, suprathyroid hypothyroidism) , which can contribute more to edema by augmented AVP release at the hypothalamus, decreased atrial natriuretic hormone (ANH), and decreased renin-angiotensin-aldosterone system (RAAS), diminished salt delivery to the loop of Henle, and hialuronic acid (D-glucoronic acid and N-acetyl-D-glucosamine) and chondroitin sulfate b (L-iduronic acid and N-acetyl-D-galactosamine sulfate) hydrophilic deposits,this two mucopolysaccharides (Glycosaminoglycans, GAGs) which attract water strongly, results in more total body water. Characteristic of hypothyroidism too, is myxedema megacolon; a distended and hanging colon, facial edema and others.
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    Quote Originally Posted by hardasnails1973
    Thyroid drive serotonin metbolism and with out serotonin melatonin can not be produced. With out melatonin zinc can not be absorbed across the intestinal membrane and with out zinc melatonin can not work. As you can see things are so intertwined. To relax you 200 mgs theanine every 4-6 hours with 500 mgs gaba (break open and dissolve on tongue.) Majortiy of hypothyroid people have altered mineral metabolism which can really start mess up enzymatic reactions. Melatonin increases conversion of t4 to t3 how by increasing zinc absorption (hmm interesting). Bascially you need to put the breaks on your brain chemistry which is causing adrenaline to run rampant which is causing diahreaa.
    Gaba, theanine, P5P, magnesium glycinate, zinc, glycine will help this..
    I really don't understand these claims and how this is substantiated in any way whatsoever. I think we should all be caustious about how we address these issues, each individual is different. I dont see how you can make these direct connections - it is true that hypothyroid individuals have slower metabolism which as a symptom, they should have constipation - I don't knwo how you are linking melatonin with zinc absorption whatsoever.
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    I guess its time to go dumpster diving again to dig up research articles

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    To everyone here, remember you can live without thyroid,you can live without testosterone but you cannot live without the adrenals(known as Addison's disease and before corticosteroids were discovered this disease was fatal).So let's give our dues first and foremost to the adrenals first and take care of them first.

    On a side note pantothenic acid(vitamin B5) is extremely important for adrenal health.Megadosing on this has been shown to increase endurance.
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    Quote Originally Posted by hardasnails1973
    1.-Thyroid drive serotonin metbolism and with out serotonin melatonin can not be produced. With out melatonin zinc can not be absorbed across the intestinal membrane and with out zinc melatonin can not work. As you can see things are so intertwined. To relax you 200 mgs theanine every 4-6 hours with 500 mgs gaba (break open and dissolve on tongue.) Majortiy of hypothyroid people have altered mineral metabolism which can really start mess up enzymatic reactions. 2.-Melatonin increases conversion of t4 to t3 how by increasing zinc absorption (hmm interesting). Bascially you need to put the breaks on your brain chemistry which is causing adrenaline to run rampant which is causing diahreaa.
    Gaba, theanine, P5P, magnesium glycinate, zinc, glycine will help this..
    1.-All the Contrary (serotonin drives thyroid,without trh there is not t4 nor t3):

    J Physiol, Paris.91(6):307-10.

    Thyroid hormone plasmatic levels in rats treated with serotonin in acute and chronic way.

    Brizzi G, Carella C, Foglia MC, Frigino M.

    Department of Human Physiology and Integrated Biological Functions, Second University of Naples, Italy.

    Many experiments show that serotonin (5-HT) controls thyroidal function at hypothalamic level, inhibiting the TRH secretion. The majority of experiments are done in an acute way, consisting of a single serotonin dose injected intraperitoneally (i.p.) or intracerebroventricularly (ic) with the effect registered after a short time (usually 1 h) as in normal environmental conditions similar to the TSH stimulation test, that consists of transfer of the experimental animals from 30 degrees C to 4 degrees C for 30 min, thus inducing stimulation of the hypothalamus-hypophysis-thyroid axis. The aim of the present research was to study the correlation between 5-HT and the thyroidal function, measuring plasmatic thyroid hormone levels in rats i.p. treated in chronic (injected daily for 10 days with different doses of 5-HT), and in acute way (after 1 h from a single 2.0 mg/kg bw 5-HT dose) in normal environmental conditions to evidence the serotonin site action activity outside the blood-brain barrier. The results of the chronic experiment show an inhibitory effect of 5-HT, on T3 and T4 plasmatic level, only when it is injected at medium doses (0.2 and 0.4 mg/kg bw for T3, and 0.2 for T4).



    2.-
    fatal flaw, hypothyroidism is T4 defficiency,this way,there is not enough t4 to convert to t3.
    Without enough tsh or trh,there is not sufficient t4,central hypothyroidism (trophoprivic, suprathyroid hypothyroidism) if the gland works badly, there is peripheral hypothyroidism (thyroprivic hypothyroidism,peripheral hypothyroidism),it does not matter if there is enough tsh or trh .

    and:

    Eksp Klin Farmakol;60(4):46-9.

    The effect of melatonin and mexamine on the human thyroid under in-vitro conditions

    Rom-Bugolavskaia ES, Shcherbakova VS, Komarova IV.

    In in vitro study of the human euthyroid and thyrotoxic thyroid gland melatonin (N-acetyl-5-methoxytryptamine) and, to a lesser measure mexamine (5-methoxytryptamine) had a dose-dependent inhibiting effect on thyroxine secretion. Moreover, melatonin weakened the TSH stimulating effect in relation to the secretory process in the thymus while mexamine did not. Despite the similarity in the quality of the effect of both methoxyindoles on the release of thyroxine, the mechanism of its realization differs: the action of melatonin is mediated by the adenylate-cyclase-cAMP system, but in the action of mexamine the cAMP-dependent mechanism does not take part. Maintenance of the sensibility of the human thyroid to the effect of TSH is an obligatory condition for realization of the action of both methoxyindoles on the secretory process in it.


    -------------------------------

    from L.Zlatos, Pathophysiology of Endocrine System.

    "Thyroid hormone deficiency and successive myxedematous
    infiltration of mucous membranes of
    GIT cause decrease of peristaltic activity, as well
    as of intestinal wall tonus. Decreased peristaltic activity,
    together with the decreased food intake, is
    responsible for the frequent complaint of constipation.
    These intestinal disorders may be extreme,
    leading to fecal impaction and great distention of
    colon (myxedema megacolon). Gaseous distention of
    the abdomen may also occur (myxedema ileus, adynamic
    ileus)."
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    It all still comes down to hypothalmic dysfunction is the root of majority of problems caused by numberous internal and external factors. Sounding like a broken record "when addressing thyroid issues adrenals must also be addressed before or simulaneously." if you look on thyroid medication information it specifically saids to address the adrenal insufiency first before adminstering thyroid medication
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    I guess its time to go dumpster diving again to dig up research articles

    Wiley InterScience :: Session Cookies
    This article has nothing to do with your assumption that melatonin affects Zinc absorption - on the contrary, Zinc intake affects melatonin - if you have LOW zink or overstimulate melatonin, you can use up and decrease zinc stores, per the article.


    Quote Originally Posted by FYI777
    To everyone here, remember you can live without thyroid,you can live without testosterone but you cannot live without the adrenals(known as Addison's disease and before corticosteroids were discovered this disease was fatal).So let's give our dues first and foremost to the adrenals first and take care of them first.

    On a side note pantothenic acid(vitamin B5) is extremely important for adrenal health.Megadosing on this has been shown to increase endurance.
    You can live without your adrenals - it would require cortico and mineralocorticoid supplementation. Sometimes individuals in stressfgul situations (ie trauma, surgery) may be adrenally suppressed and require stress level steroids to compensate for hypotension namely.
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    Quote Originally Posted by hardasnails1973
    It all still comes down to hypothalmic dysfunction is the root of majority of problems caused by numberous internal and external factors. Sounding like a broken record "when addressing thyroid issues adrenals must also be addressed before or simulaneously." if you look on thyroid medication information it specifically saids to address the adrenal insufiency first before adminstering thyroid medication
    if is a central hypothyroidism (secondary-pituitary,tertiary-hypothalamus) yes.

    if is primary it does not matter.
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    Quote Originally Posted by franke
    if is a central hypothyroidism (secondary-pituitary,tertiary-hypothalamus) yes.

    if is primary it does not matter.
    I agree - then one worries about panhypopituitarism... bad news!
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    Is that Trouble with a new name
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    apart.

    but i agree with the importance of the serotonin.

    Aliment Pharmacol Ther. 2004 Nov;20 Suppl 7:3-14.

    Serotonin receptors and transporters -- roles in normal and abnormal gastrointestinal motility.


    Gershon MD.

    Department of Anatomy & Cell Biology, Columbia University, New York, NY 10032, USA.

    The gut is the only organ that can display reflexes and integrative neuronal activity even when isolated from the central nervous system. This activity can be triggered by luminal stimuli that are detected by nerves via epithelial intermediation. Epithelial enterochromaffin cells act as sensory transducers that activate the mucosal processes of both intrinsic and extrinsic primary afferent neurones through their release of 5-hydroxytryptamine (5-HT). Intrinsic primary afferent neurones are present in both the submucosal and myenteric plexuses. Peristaltic and secretory reflexes are initiated by submucosal intrinsic primary afferent neurones, which are stimulated by 5-HT acting at 5-HT(1P) receptors. 5-HT acting at 5-HT4 receptors enhances the release of transmitters from their terminals and from other terminals in prokinetic reflex pathways. Signalling to the central nervous system is predominantly 5-HT3 mediated, although serotonergic transmission within the enteric nervous system and the activation of myenteric intrinsic primary afferent neurones are also 5-HT3 mediated. The differential distribution of 5-HT receptor subtypes makes it possible to use 5-HT3 antagonists and 5-HT4 agonists to treat intestinal discomfort and motility. 5-HT3 antagonists alleviate the nausea and vomiting associated with cancer chemotherapy and the discomfort from the bowel in irritable bowel syndrome; however, because 5-HT-mediated fast neurotransmission within the enteric nervous system and the stimulation of mucosal processes of myenteric intrinsic primary afferent neurones are 5-HT3 mediated, 5-HT3 antagonists tend to be constipating and should be used only when pre-existing constipation is not a significant component of the problem to be treated. In contrast, 5-HT4 agonists, such as tegaserod, are safe and effective in the treatment of irritable bowel syndrome with constipation and chronic constipation. They do not stimulate nociceptive extrinsic nerves nor initiate peristaltic and secretory reflexes. Instead, they rely on natural stimuli to activate reflexes, which they strengthen by enhancing the release of transmitters in prokinetic pathways. Finally, when all the signalling by 5-HT is over, its action is terminated by uptake into enterocytes or neurones, which is mediated by the serotonin reuptake transporter. In inflammation, serotonergic signalling is specifically diminished in the mucosa. Transcripts encoding tryptophan hydroxylase-1 and serotonin reuptake transporter are both markedly decreased. Successive potentiation of 5-HT and/or desensitization of its receptor could account for the symptoms seen in diarrhoea-predominant and constipation-predominant irritable bowel syndrome, respectively. Symptoms associated with the down-regulation of the serotonin reuptake transporter in the human mucosa in irritable bowel syndrome are similar to the symptoms associated with the knockout of the serotonin reuptake transporter in mice. The observation that molecular defects occur in the human gut in irritable bowel syndrome strengthens the hand of those seeking to legitimize the disease. At least it is not 'all in your head'. The bowel contributes.
  32. Registered User
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    Quote Originally Posted by franke
    god! just use dexamathasone at 0.5 mg at night,but first take an AM Cortisol blood test and ACTH test.

    by me at cuttingedgemuscle.com

    Water Retention - Cutting Edge Muscle Forums

    Water retention by androgens
    Oswaldo Salcedo (my ruminations)

    HYPOPITUITARISM -> HYPOADRENALISM ->HYPONATREMIA
    ......................... -> HYPOTHYROIDISM ->HYPONATREMIA


    one of the main mechanisms responsible for water retention is induced Hypopituitarism (reduced output of any pituitary hormone) by displaced Glucocorticoids (GC) through Androgens at the GC receptors, acting by antagonist mode, therefore decreasing Corticotropin (ACTH) w/wo decreased Thyrotropin (TSH) release. Subsequent to the ACTH decreased secretion, inhibits cortisol segregation at adrenals (Central Hypoadrenalism - Secondary Adrenal Insufficiency). The cortisol suppression produces in the hypothalamus, vasopressin (AVP) release, also known like anti diuretic hormone (ADH), this way GC insufficiency increases AVP mRNA expression, elevating abnormally, AVP levels, gives an increase in free water retention, decreased sodium pump activity, shift of extracellular sodium into cells and decreased delivery of filtrate to diluting segments of the nephron as a result of decreased glomerular filtration rate and effective renal plasma flow . GC inhibit AVP secretion by impairing AVP gene transcription.
    The possible decreased TSH produces a central hypothyroidism ( trophoprivic, suprathyroid hypothyroidism) , which can contribute more to edema by augmented AVP release at the hypothalamus, decreased atrial natriuretic hormone (ANH), and decreased renin-angiotensin-aldosterone system (RAAS), diminished salt delivery to the loop of Henle, and hialuronic acid (D-glucoronic acid and N-acetyl-D-glucosamine) and chondroitin sulfate b (L-iduronic acid and N-acetyl-D-galactosamine sulfate) hydrophilic deposits,this two mucopolysaccharides (Glycosaminoglycans, GAGs) which attract water strongly, results in more total body water. Characteristic of hypothyroidism too, is myxedema megacolon; a distended and hanging colon, facial edema and others.
    Good post I have Hypopituitary problems and had my Aldosterone and Renin tested and they look good yet I started adding Sea Salt to my filtered water and now I don't how as much water.
    Phil
  33. Gold Member
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    Quote Originally Posted by franke
    apart.

    but i agree with the importance of the serotonin.

    Aliment Pharmacol Ther. 2004 Nov;20 Suppl 7:3-14.

    Serotonin receptors and transporters -- roles in normal and abnormal gastrointestinal motility.


    Gershon MD.

    Department of Anatomy & Cell Biology, Columbia University, New York, NY 10032, USA.
    Exactly - it is on this premise that Zelnorm and is effective on patients with IBS specifically Type-4 (5-HT4) receptors in the gut.

    (Zelnorm Online, Description, Chemistry, Ingredients, Blackbox - Tegaserod Maleate - RxList Monographs)
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    also the reason if I take Paxil I get loose bowels and/or diahrea.
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    Quote Originally Posted by Dr. John
    Androgens can cause edema because they cause the kidneys to retain sodium.

    And lets keep in mind corticosteroids do this as well. Ask anyone who is on methylprednisone.
    sodium retention is just a posible consequence,there is states of water retention without sodium excess,hyponatremia that is euvolemic, hypervolemic or hypovolemic,there is a lot of process that produces excess vasopressin release,androgens that become estrogens by means of the aromatase,wr by progesterone,wr by estradiol,wr by prolactin etc.we are speaking about hyponatremia genesis,the fundamentals.
    the underlying etiology is the vasopressin excess.
    i have done cycles with low sodium and retain water anyway.


    Med Sci Sports Exerc. 1990 Jun;22(3):331-40.
    Glucocorticoid antagonism by exercise and androgenic-anabolic steroids.

    Hickson RC, Czerwinski SM, Falduto MT, Young AP.

    Naunyn Schmiedebergs Arch Pharmacol. 2003 Dec;368(6):487-95.
    Effects of dehydroepiandrosterone on corticosterone release in rat zona fasciculata-reticularis cells.

    Chang LL, Wun WS, Ho LL, Wang PS.

    J Steroid Biochem. 1986 Feb;24(2):481-7.
    Binding of glucocorticoid antagonists to androgen and glucocorticoid hormone receptors in rat skeletal muscle.

    Danhaive PA, Rousseau GG

    J Neuroendocrinol. 1996 Jun;8(6):439-47.
    Androgens modulate glucocorticoid receptor mRNA, but not mineralocorticoid receptor mRNA levels, in the rat hippocampus.

    Kerr JE, Beck SG, Handa RJ.

    J Am Vet Med Assoc. 1993 Oct 15;203(8):1166-9.
    Adrenal insufficiency associated with long-term anabolic steroid administration in a horse.

    Dowling PM, Williams MA, Clark TP.

    Eur J Endocrinol 2003 Jun; 148(6) :609-17.
    Severe hyponatremia due to hypopituitarism with adrenal insufficiency: report on 28 cases.

    Diederich S, Franzen NF, Bähr V, Oelkers W .

    N Engl J Med 1998; 321(8) :492-6.
    Hyponatremia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism.

    Oelkers, W.

    Nippon Naika Gakkai Zasshi. 2006 May 10;95(5):936-8.
    Hyponatremia associated with secondary adrenal insufficiency.

    Kondo T, Mizubayashi R.

    J Endocrinol Invest 2006 Mar; 29(3) :267-9.
    Beyond semantics: defining hyponatremia in secondary adrenal insufficiency.

    Faustini-Fustini M, Anagni M.

    Am J Kidney Dis. 2006 May;47(5):727-37.
    Vasopressin excess and hyponatremia.

    Pham PC.

    Am J Med. 2006 Jul;119(7 Suppl 1):S47-53.
    Water and sodium retention in edematous disorders: role of vasopressin and aldosterone.

    Schrier RW.

    Endocr Metab Immune Disord Drug Targets. 2006 Sep;6(3):249-58.
    Vasopressin-receptor antagonists: a new class of agents for the treatment of hyponatremia.

    Olson BR.
    Endocrinology and Metabolism, 850 Straits Turnpike, Suite 204, Middlebury, CT 06762, USA.

    Cleve Clin J Med. 2006 Sep;73 Suppl 3:S24-33. AVP receptor antagonists as aquaretics: review and assessment of clinical data.
    Verbalis JG.
    Department of Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.


    Tissue-specific expression patterns of nuclear receptors, 2006,NURSA.ORG
    Bookout AL, Jeong Y, Downes M, Yu R, Evans RM and Mangelsdorf

    Cell 126, 801-810, 2006.
    Nuclear receptor expression links the circadian clock to metabolism.

    Yang X, Downes M, Yu R, Bookout AL, He W, Straume M, Mangelsdorf DJ and Evans RM.

    Nephrol Dial Transplant. 2001 Sep;16(9):1799-806.
    Thyroxine treatment induces upregulation of renin-angiotensin-aldosterone system due to decreasing effective plasma volume in patients with primary myxoedema.

    Park CW, Shin YS, Ahn SJ, Kim SY, Choi EJ, Chang YS, Bang BK.


    ESTRADIOL RELATED:

    Am J Physiol Endocrinol Metab. 2002 Oct;283(4):E711-21.
    Estrogen effects on osmotic regulation of AVP and fluid balance.

    Stachenfeld NS, Keefe DL.

    J Appl Physiol. 1999 Sep;87(3):1016-25. e
    Effects of oral contraceptives on body fluid regulation.

    ........To test the hypothesis that estrogen reduces the operating point for osmoregulation of arginine vasopressin (AVP).......................
    Stachenfeld NS, Silva C, Keefe DL, Kokoszka CA, Nadel ER.

    Am J Physiol. 1998 Jan;274(1 Pt 2):R187-95.
    Estrogen influences osmotic secretion of AVP and body water balance in postmenopausal women.

    Stachenfeld NS, DiPietro L, Palter SF, Nadel ER.

    J Appl Physiol. 2001 Oct;91(4):1893-901.
    Sex differences in osmotic regulation of AVP and renal sodium handling.

    Stachenfeld NS, Splenser AE, Calzone WL, Taylor MP, Keefe DL.

    PROGESTERONE AND PROLACTIN RELATED:

    J Appl Physiol. 2005 Jun;98(6):1991-7.
    Progesterone increases plasma volume independent of estradiol.

    Stachenfeld NS, Taylor HS.
    The John B. Pierce Laboratory, Yale University School of Medicine, 290 Congress Ave., New Haven, CT 06519, USA.

    Neuroendocrinology. 1997 May;65(5):335-43.
    RU 486 blocks and fluoxetine augments progesterone-induced prolactin secretion in monkeys.

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    Division of Reproductive Sciences, Oregon Regional Primate Research Center, Beaverton 97006, USA.

    Neuroendocrinology. 1996 Jun;63(6):569-78.
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    Pecins-Thompson M, Widmann AA, Bethea CL.

    ------------------------------------------

    Principles And Practice Of Endocrinology And Metabolism
    by John P. Bilezikian, et al.

    Endocrinology and Metabolism
    by Philip Felig, Lawrence A. Frohman

    Williams Textbook of Endocrinology
    by P. Reed Larsen, et al.

    Neurohypophysis: Recent Progress of Vasopressin and Oxytocin Research : Proceedings of the 1st Joint World Congress of Neurohypophysis and (International Congress Series) by Japan Joint World Congress of Neurohypophysis and Vasopressin (1st : 1995 : Nasu-machi, Kiyoshi Kurokawa, Sho Yoshida, and Toshikazu Saito)

    Vasopressin by G.J. Boer and D.M. Gash.

    Vasopressin and Oxytocin: From Genes to Clinical Applications by D. Poulain, S. Oliet, and D. Theodosis, Oct 1, 2002.
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    Quote Originally Posted by hardasnails1973

    Sunlight hour each day A MUST..30 minurtes relaxation any time durinf day with belly breathing emphasized
    There are sun lamps on the market.

    On topic of light,
    over my computer monitor I have a lamp, it is two incandescent tubes
    10000K normally used in reef tank. It is supposed to simulate light at noon on equator.
    Wonder how smart it is to have those tubes.

    I did not dare to use halogen ligts that are usually a part of the complete light system as I think they emit UV plus lots of heat.

    Most of the light I receive indirectly, so hopefully any radiation is stopped by lamp's shield.
  37. Gold Member
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    Quote Originally Posted by Dr. John
    There's nothing wrong with "therapeutic testing", by adding 5mg PO early in the afternoon, and then 5 more later on if necessary, when testing is an issue--for patients who exhibit the symptoms of adrenal fatigue.
    In my clinical experience, though short, I have yet to ever come across such an example of "therapeutic testing" in this manner and would never recommend it without complete evaluation.

    How does one address adrenal fatigue - the differential and workup for conditions with overlapping symptoms is exhaustive.
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    I would not nor would most other MD's blindly administer 5mg prednisone to any patient without a complete clinical picture.

    Please tell me how you could bill for hypothyroidism, hypoadrenalism without any labs? If you did, it would be fraud. Labs are fundamental to the workout, blind Rxing without a diagnosis and workup is bad medicine.

    Overlapping symptoms do not confuse but are part of the differential and the workup, which 99% of physicians will never embark on blindly.
  39. Gold Member
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    You're missing my point - you were sugesting Rxing prednisone, no mention of labs, etc whatsoever.

    In the workup for fatigue, you do MUCH MUCH more than a TSH, cortisol, especially if you read my previous posts which would include a cosyntropin stim test among several labs. As I said, the differential is huge and INCLUDES a MALIGNANCY! You cannot rule out cancer in this patient nor hypogonadism for that matter just as an aside.

    Patients are very far from pieces of paper and in no way shape or form would either of us ever dismiss the physical exam for relying solely on lab values.

    You see a patient with a Hgb of 7.2, you're telling me you are not going to transfuse a couple of units even though the patient is asymptomatic?? Obviosuly you would liek to rule out a source of the bleed etc etc.

    How about a patient with a hyperkalemia of 7 who walks in feeling great? it is wquite common that some issues are quite chronic that the physcial exam ALONE may not offer the best insight. Put the two together, you've got yourself the tools to practice great medicine. Relying solely on either of the two is idiotic.

    Physical exam + appropriate labs = the best medicine.

    Cheers - this discourse shoul dbe able to provide some insight on the practice of good medicine.
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    I am not her to question your work nor do I look at one's past in addressing any of the issues presented. I am providing accurate information to the best of my knowldge, which of course does not substitute for a complete and accurate evaluation by a physician.

    I hope you understand the context of my use of those terms and it does not merit discredit in any way.

    Let's recap my use of those terms: idiotic - relying solely on physcial exam or lab values, of course, one does not treat the value, nor does one treat subjective and objective values alone. It owuld be idiotic, we can all agree on that.

    Diagnosis without the appropriate laboratory measure = fraud, end of story. Try to see how that would hold up in court if you treated someone's presumed adrenal fatigue and subsequently found them to have a malignancy of some sort.

    I see these cases all too often, I like to get the complete story and there have been numerous occasions where we took moeny from our pool to fund some of these diagnostic exams or provided the resources to fund and GIVE the accurate diagnosis and results.

    These are nto meant to offend but more to shed light ont he subject. Gotta make use of my ivy league md outside of work sometimes too! :-)

    Keep up the good work.

    Cheers!
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