Follow up Brain Tuberculoma Completed 13 Months of ATT

Dear all,

It is to update you all, that my wife has done another MRI brain with contrast at 13th month of ATT, and it reported to Clear MRI Brain, there was no tuberculoma in brain and it resulted clear however doctor further suggested to continue taking anti TB pills at least 18 months in order to complete the treatment course.

Nevertheless patient was complaining of dizziness, weakness and low blood pressure, then doctor advised to test serum Cortisol and serum ACTH, then we check these levels the cortisol resulted in 6.7 where the normal range was 6-23 and ACTH resulted in 34 where the normal was 6-46, the blood is tested for both tests in the morning 8:15 AM.

After cortisol test results doctor planned to start steroids but when saw ACTH result then he told there is no need for steroids, but further advice us to keep control of cortisol levels.

So could you please let us know that Does anti-TB pills affect cortisol levels??

and what should we do to increase the cortisol level to its normal range?

the patient takes Rifampicin 600mg and isoniazid 300mg =once daily Levetiracetam 250mg twice daily, along with vita 6 and multivitamin tablets once in a day.

patient loss her weight by 5 kilo, total weight is 53 but takes TB pills by 150mg more than her weight, what is your suggestion for it, should we again talk with the doctor to decrease it?

we are very worried about her cortisol level, and afraid of the level to not decrease because the doctor told to takes TB pills 5 months more to complete the course, and we afraid that in these 5 months the cortisol level might decrease more, so what should we do what is your advice?

With Respect and waiting for your kind feedback.

Samim Hameedi

[Soul01]

If the cortisol Level is 6.7 and the lower end of the range is 6, it seems that you don’t need to be concerned because it is within the normal range. Ask the doctors to monitor it regularly so that they will know if it drops too low.

Your wife is doing really well! It has been a long journey for her but she is getting towards the end.

[Hidden in reply to Soul01]

Thank you for the kind feedback, yes we will check the levels regularly. However is there anything natural which balance or higher a little bit the cortisol level?

With thanks

[hottchoc in reply to Hidden]

Hi Shameedi - grapefruit can help to boost cortisol levels as can a liquorice supplement x

[Hidden in reply to hottchoc]

Thank you so much.

[Hidden in reply to Hidden]

We checked the cortisol and ACTH levels after one week of having grapefruits it increase to 15 and its normal. ACTH level was also normal. thank you.

[HelenC Partner TB Alert]

Hi Shameedi,

That is such good news that your wife's MRI scan showed she is clear of TB in the brain - this is a real achievement. I know it may sounds like a long road ahead of you to continue for another 18 months after getting so far, but this next stage is crucial to ensure the bacteria are gone for good and can never return to cause new damage.

I am afraid that I lack the training to offer advice on the cortisol levels, but as ever with TB treatment one of the best things you can do is ensure adequate rest and nutrition - as this gives the body the best opportunity to recover and tolerate the medications.

With best wishes,

Helen

[Hidden in reply to HelenC]

Thank you HelenC for the nice words, yeah coming five months are very crucial we hope the overall 18 months course complete safely. and for sure she is taking enough rest and nutrition, besides this we keep eyes on the liver, kidney, Hemoglobin, all other related tests and cortisol levels as well, we are going to test the cortisol level in coming time and will share the result, I also google and found that rifampicin affect the cortisol level.

Thank you for comments and being always here

With Respect

Samim Hameedi

[zafr]

Hi

It s sad to hear that there s one nutritionist doctor in Pakistan

You can consult with him your health matter

I strongly recommend you that expert

Good luck

[Hidden in reply to zafr]

Dear Zafr, we already get treatment advice from Dr. Haroon Khan, Northwest Hospital Peshawar Pakistan. could you please give the nutritionist doctor name and complete address.

With Thanks.

WhatsAPP: [phone]

[zafr]

00924235881324

Dr azmat 00923008489524