Buprenorphine affect cortisol levels?

[smilingjane]

Hello RLS colleagues

Some of you may remember that I was prescribed a low dose of Buprenorphine to alleviate my (almost) lifelong RLS last year. Before that I was prescribed Oxycodone for a year or so.

The Buprenirphine works well and completely covers my RLS.

I was diagnosed with ME/CFS 2 years ago after being poorly for several years.

I have recently tested for Cortisol. The saliva test , (4 times over 12 hours) was below the ref range for 2 out of the 4 tests and the other 2 tests were just within the ref' range.

The 9am blood test was 113 - (ref range 135 - 532).

I am wondering whether any of you who take RLS meds have found that the meds affect their adrenal glands. producing low cortisol results.

I am exploring all avenues before my doctors appointment.

I will also post this on the HU thyroid group.

Thank you in advance for any responses.

I hope people out there are managing to get RLS medication okay. I know it can be a long and often difficult road but there are some knowledgeable doctors out there. Just not enough 🙄

Thanks all 😊

[SueJohnson]

What is your blood test referring to?

[smilingjane in reply to SueJohnson]

Hello SueIt is a cortisol test, to see if my adrenal glands are producing enough cortisol.

[ChrisColumbus]

Opioids can reduce stress levels and can therefore depress salivary cortisol test results, but a blood test taken at 8-9AM giving a result not much above 100 *could* be more concerning and should be discussed with your GP and possibly referred to Endocrinology.

The following taken from a US FDA Drug Safety Communication:

"Taking opioids may lead to a rare, but serious condition in which the adrenal glands do not produce adequate amounts of the hormone cortisol."

"The most commonly reported opioids associated with adrenal insufficiency were fentanyl (n=10) and oxycodone (n=10), followed by buprenorphine"

fda.gov/media/96472/download

NB: this is only based on quick reading of various pieces of research and is not based on personal knowledge - please just raise it with your doctor

[smilingjane]

Thanks so much for your response.This is particularly concerning.

Particularly the thought of the possibly my RLS med could be an issue.

Thanks for researching for me. I will carry that forward.

🤔

[ChrisColumbus in reply to smilingjane]

The FDA communication does say 'rare' so do take medical advice before taking action.

NHS guidelines at Oxford University Hospitals for investigating adrenal insufficiency are:

"Between 100 and 500 nanomol/L — refer the person to endocrinology for further investigations, including an adrenocorticotrophic hormone stimulation (Synacthen®) test."

[smilingjane in reply to ChrisColumbus]

Thanks ChrisI'll keep that in my notes for the doctors appointment.

I'm assuming here that nobody goes beneath 100 nmol/Ls?

[ChrisColumbus in reply to smilingjane]

"Less than 100 nanomol/L — admit the person to hospital, adrenal insufficiency is highly likely."

I believe that this is because of the possibility of a rare condition called Addison's disease, where the adrenal glands make too little cortisol.

However, as per the FDA perhaps your low reading may be caused by using oxycodone followed by buprenorphine and have no link to a disease. Or perhaps it's nothing to do with either possibility.

I must stress again that I am not a medic and have no personal knowledge here. All that I have written here, based on a little research, could be misleading.

Your doctor must advise and refer you to endocrinology if necessary.

[smilingjane in reply to ChrisColumbus]

Thanks for that.Understood 😊