Cortisol levels and anti anxiety medication - PMRGCAuk

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Cortisol levels and anti anxiety medication

Bubble56 profile image
15 Replies

After 3 1/2 years with PMR I am down to 2 mg pred! I have just been reading your posts this morning about adrenal insufficiency and lethargy etc. I would be interested to know if anyone is on anti anxiety medication ( buspirone) and/or anti depressants ( fluvoxamine) and if these medications suppress the production of natural cortisol?

I see a psychiatrist regularly and have a GP who is amazing and at present doing blood tests to determine why I am so utterly exhausted ( I can’t explain the extreme tiredness but I am sure you know exactly what I mean!!) Neither have mentioned the correlation between the two, does anyone have any thoughts? Btw……. Not taking either of the medications is not an option, I am bipolar 2 and a massive depression would ensue🙀

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15 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Cannot help on the anti depressants, but the extreme exhaustion is most certainly down to your adrenals struggling to get going again.

Guess you have read this - but if not have attached -

healthunlocked.com/pmrgcauk...

 SnazzyD has written about her struggles with adrenals, sure she’ll be along shortly to give advice…

But really once you’ve had tests to prove they are capable of working (not that they necessarily are) it’s a matter of a very slow taper, very small reductions, resting as necessary, time and patience..

Bubble56 profile image
Bubble56 in reply to DorsetLady

I have read your link and thank you for your reply. I am wondering if the other meds I’m on slow down adrenal adjustment. Tbh ….. I know I’m lucky to have got to this point even although I was hospitalised twice because the steroid’s definitely “ messed with my head”.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to Bubble56

Yes unfortunately steroids do that…

SnazzyD profile image
SnazzyD in reply to Bubble56

It is hard to single out the exact cause of your tiredness. I assume your psych prescribed meds have been ok so far. Your prescriber is the one to ask about their effect on cortisol really, but logic tells me that if they did in any big way, you would have to carry a card or have bigger warnings coming with them.

What I can say is that low adrenal function gave me months and months of deep fatigue and low mood. I had to cut down on lifestyle activities in order to cope whichwasn’t great for mental health but needs must. Eventually my adrenal glands got going because of the persistent low levels feeding back to the brain. For some that doesn’t happen of course but it can take a long time and I think people don’t realise. Yes there are those for whom their adrenal glands come back on line seamlessly but you have to plough your own furrow and work with what you’ve got. The hardest part is not knowing how long that will be for.

Bubble56 profile image
Bubble56 in reply to SnazzyD

Thank you for both your replies and Snazzy you have hit the nail on the head when you say you had to cut down on lifestyle activities and that is most certainly not good for one’s mental health. I was really wondering if anyone was aware of the biochemistry involved in anxiety reducing meds and natural cortisol production. My psychiatrist does not seem to be concerned so I will stick with it…… I am so thrilled to be down to only 2 mg pred, that makes me happy😃

This forum has helped me stay semi-sane through it all, thank you.

PMRpro profile image
PMRproAmbassador

Normally, both buspirone and fluvoxamine increase cortisol in healthy patients.

Busipirone was found to have no significant effect on cortisol in patients with anxiety disorder

amjmed.com/article/0002-934...

As far as I can understand, fluvoxamine normalises cortisol in anxious patients and can lead to a suppression of the response in a synacthen stimulation test - I don't think that it necessarily suppresses the morning cortisol production. But this isn't my field!!!!

core.ac.uk/download/pdf/820...

It also seems to depend on WHY you are on the medications.

Even without the medications - your fatigue at this dose doesn't surprise me! Not sure you can blame the other medications - even non-users struggle big time sometimes.

Bubble56 profile image
Bubble56 in reply to PMRpro

Ok great that is exactly what I needed to hear and puts my mind at rest- thank you so much!

piglette profile image
piglette

I was like a beached whale when my adrenals were asked to start working again, I was totally knocked out.

Bubble56 profile image
Bubble56 in reply to piglette

I know the feeling!!!

Wizards profile image
Wizards

I know exactly how you feel. My tiredness started at 5mg but was extreme at 3mg and just got worse there after.

Getting dressed is a chore, lethargic all day with an occasional spirt to do something like get a snack. Food tastes different etc.

I went into borderline adrenal crisis and trust me you feel like your dieing. Don't do this!

Stick at your dose until they kick in. If your like most of us you can read your body. I knew when they started.

My Endicronologist wanted me at zero for testing by a certain date and that was no problem no flares etc but just to fast for adrenals.

My opinion is when between 4-3mg if Getting that fatigue stay put until you feel them kicking in. You'll save yourself a world of extreme exhaustion. Feeling like this can play with your psychic.

As a retired social worker in psychiatric hospitals know your ok but stay put for quite a bit. You don't need the stress. Another thing don't drink coffee, not great for adrenals. It just happened for me at 5mg I hated the taste but further read to stay away.

Best of luck.

Bubble56 profile image
Bubble56 in reply to Wizards

Strangely enough food tastes totally different to the point where I don’t feel like eating- not even chocolate! You are the first person I have heard comment on this. I am down to 2mg and desperate for this to pass. Steroids certainly helped me move about when I wasn’t able but my goodness it’s weird, complicated stuff ! Thank you for your reply- it’s always helpful to hear from other sufferers. I wish you all the very best . 😘

Wizards profile image
Wizards in reply to Bubble56

It took ne from Christmas to middle of February. So either stay put for 2-5 mos or up 1mg and stay put.

I wish you the best.

It's been since January I've been off and still tired but getting better.

I don't think I'll ever be what I was 8 yrs ago. We all age.

Bubble56 profile image
Bubble56 in reply to Wizards

Too true and that’s easy to forget. Thank you and my best wishes to you.

Wizards profile image
Wizards

If you start loosing weight up your dose and stay there. That's the beginning of crisis. I'm Ukrainian descent and I made dozens of perogies for Christmas and they were the only thing I could eat for weeks and I still lost 5lbs.

Normally if I ate those daily I would have gained 15+lbs. This is serious stuff.

If I had to do it over I'd stay at 3mg for months just to let adrenals kick in more.

If you get sick with anything up your dose to 5mg. Some say 7mg but my Endicronologist says 5mg.

Stay away from coffee and alcohol. It sounds like you are like me nothing tasts right.

At your point I could drop no problem but the adrenals were the problem and nothing to fool around with.

Reach out anytime if you want by message.

Bubble56 profile image
Bubble56

Thank you, I eat lots of plain yogurt and a little granola added to it!

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