RE: Cortisol/Insulin Resistance/CFS/ME/Doxepin

[Guest guest]

Hi, Amelia.

I think that http://www.diagnostechs.com ASI (adrenal stress index)

is a reliable test for cortisol. It's the original saliva test, and

it is done at several times during the day, so you can see the

diurnal profile. If your doctor won't order it, there is a list of

providers on the website.

It's true that in people who don't have CFS, weight gain is

associated with elevated cortisol, sort of a mild form of Cushing's

disease.

However, in CFS, the story is different. Most PWCs eventually go

low in cortisol, as the HPA (hypothalamus-pituitary-adrenal) axis

becomes " blunted. " I currently believe that results from

glutathione depletion in the pituitary, which causes a decrease in

the rate of formation of POMC (pro-opiomelanocortin) from which ACTH

is made, which is the hormone that signals the adrenals to secrete

cortisol.

Another effect of glutathione depletion is to put a monkey wrench

into the Krebs cycle of the muscle cells at the enzyme aconitase.

The result is that whereas normally carbohydrates in the form of

glutcose would be processed to pyruvate, and the pyruvate would be

fed into the mitochondria and be burned completely to carbon dioxide

and water, in PWCs this doesn't work very well, because of the Krebs

cycle block. As a result, pyruvate and lactate, which is made from

pyruvate, are put into the blood. Some is used by the heart muscle

for fuel, and the rest goes to the liver and is converted back to

glucose, which goes back into the blood. Thus, it is not possible

to get rid of the glucose by burning it completely to CO2 and water,

and this shows up as insulin resistance. As a result, the insulin

level rises higher, and at high enough insulin levels the glucose is

imported by the liver and fat cells and converted to stored fat,

giving the weight gain.

So, fundamentally, the problem is glutathione depletion, and this is

maintained because of a vicious circle involving the earlier parts

of the sulfur metabolism, which occurs because of genetic

polymorphisms in the enzymes there. That's what needs to be dealt

with to correct all the downstream problems, including the diastolic

dysfunction in the heart muscle, which causes the low cardiac

output, in my opinion.

Rich

>

> To Rich/Kurt/the group,

>

> Ok, I am, officially, confused...

>

> I have symptoms of insulin resistance:

>

> Tendency towards:

>

> Abdominal Weight Gain/Upper Body Weight Gain/hypertension/probably

> PCOS/ hypoglycemia, etc. I can gain weight on almost nothing...and

it

> has been this way, since, I lost my brain functioning to CFS/ME,

> about 20 years, ago.

>

> I have to really watch carbohydrates, whether complex/simple

> sugars..or weight gain is fast...high protein diet/low carbs-best

> diet for me

>

> However, cortisol is suppose to be low in CFS/ME..it is advertised

on

> TV, that in insulin resistance, cortisol is too high...

>

> I, also, take Doxepin (a trycylic antidepressant), which, also

lowers

> cortisol..

>

>

>

> Is there a good, reliable test for Cortisol levels, Rich, anyone?

> Can someone explain these contradictory problems?

>

> TIA,

> Amelia

>

[Guest guest]

Hi Amelia

Much of what Rich has described applies to me especially the

diastolic dysfunction. I had a 24 hour saliva test done a few years

ago for cortisol, DHEA, and the sex hormones. The latter indicated

the usual profile for PCOS, the former a skewed circadian cycle,

blunted cortisol/DHEA response. I still have to be careful am because

my cortisol and DHEA are too low then; in situations when there would

be a rise in cortisol, my body can produce adrenalin instead. Since

Tx have been helping this affects me less severely on my better days.

I would not want to have to go on a low protein diet because a

reasonable intake of protein and avoiding starchy foods really helps

with the IR. The severity of my symptoms fluctuate/cycle, so when

someone posted about insulin peaks and central fatigue, I recognised

it straight away. When this issue resurfaces I seem to do better on

lots of small meals and eating the protein portion first. I also use

cinnamon.

I have been taking molybdenum for over a year now because I

recognised the signs of problems with sulphur metabolism, it helps.

I've also been taking other things the support ATP-ADP (Mg, Co Q 10,

acetyl l carnitine); tests done many years ago picked up abnormal

pyruvate-lactate levels. All my EMGs picked up abnormalites including

those related to muscle metabolism, myopathy and myositis similar to

that found in Eaton Lambert Syndrome.

Currently taking supps to support methylation. Tests done an equally

long time ago, indicated problems metabolising some b vits including

folate.

In the last year I've lost another 14 lbs, not through a weight loss

diet, but because I am experiencing more good days; when everything

slows down on me the wieght can go back on but only temporarily now.

Hope you find what's aggravating your heart symptoms, I found mine

very scarey at times, but they've not returned in their most severe

form since the winter. Hawthorn seems to be helping.

Good luck.

TC, Tansy

> >

> > To Rich/Kurt/the group,

> >

> > Ok, I am, officially, confused...

> >

> > I have symptoms of insulin resistance:

> >

> > Tendency towards:

> >

> > Abdominal Weight Gain/Upper Body Weight

Gain/hypertension/probably

> > PCOS/ hypoglycemia, etc. I can gain weight on almost

nothing...and

> it

> > has been this way, since, I lost my brain functioning to CFS/ME,

> > about 20 years, ago.

> >

> > I have to really watch carbohydrates, whether complex/simple

> > sugars..or weight gain is fast...high protein diet/low carbs-best

> > diet for me

> >

> > However, cortisol is suppose to be low in CFS/ME..it is

advertised

> on

> > TV, that in insulin resistance, cortisol is too high...

> >

> > I, also, take Doxepin (a trycylic antidepressant), which, also

> lowers

> > cortisol..

> >

> >

> >

> > Is there a good, reliable test for Cortisol levels, Rich,

anyone?

> > Can someone explain these contradictory problems?

> >

> > TIA,

> > Amelia

> >

>

[Guest guest]

Dear Rich,

That is one ****good explanation...wish I had known you about 20 years, ago..

Do you think I need to get testing for Cortisol, since it is probably too

low, based on CFS/ME and Doxepin, then? Does one need to know this, if

eventually, I may be tested by Dr. Yasko? does she test for this?

I am taking Pregnenolone...a Master precursor hormone (but you probably know

that), which is suppose to help produce all the others..This has been one of

my most effective supplements..even, keeps me from having Hot Flashes,

during Menopause..wish I had known about it earlier..It is suppose to produce

adrenal hormones, if my factoids are correct.

Do you think that infections may, also, be the cause of the " pot-belly "

effect??..I just saw a book with that title, at the bookstore..which could be

causative as we don't have effective immune systems?!

TIA,

Amelia

[Guest guest]

Dear Kurt,

Well, that is a good **** explanation, too.

It looks like Modern Medicine is not very current for CFS/ME..am I right?

Well, you and Rich are, essentially, saying the same thing..It seems to

point to Glutathione status..

I am impressed that you know about Hans Selye..

How do you Detox, besides raising Glutathione?

Genetically, I have, always, had the watch my calories...but it changed to

watching carbs, after CFS/ME became really APPARENT to me..however, first I

lost a lot of weight to my lowest weight at 110 pounds, 5 ft, 6 inches, at the

onse. which goes with what you saying about High Cortisol.and I looked really

" skinny " to others, because I was, also, very toned..At that time, I was

trying to exercise my way out of this disease...despite feeling, like ****.

TC,

Amelia

..

[Guest guest]

Dear Tansy,

Do you think that I would need to go off Pregnenolone, before testing the

adrenal hormones? and for how long?

That has been my most effective supplement for hormones, period..and I am,

still, in the process of Perimenopause-Menopause..It stopped, my hot flashes,

completely! It has, also, seemed to help some weight loss...and helps with

my sleep process, too.

I was going to try Hawthorn, but I read that one should not mix that with a

Anti-hypertensive drug..and Micardis has been very effective for me, on the

dimension of lowering blood pressure, which is probably related to Insulin

Resistance.

I am doing Abdominal Crunches for Abdominal fat...but apparently, I need to

detox...and build Glutathione.

I need to try those supplements, you mention...

What do you think about Toprol XL for my Cardiac problems...high heart

rate..high blood pressure? If it lowers metabolism, that would not be a good

thing...but I need to find some way of lowering Heart Rate, in a safe manner.

TC,

Amelia

[Guest guest]

Amelia,

Yes, I know what you mean, I just saw that TV commercial. What is

worse, they are promoting a drug to actually lower the cortisol levels,

which I am sure has all types of unintended side-effects. A person

needs cortisol to detox, and detox is essential with weight loss.

Personally, I believe that the weight gain is somehow related to the

poor glutathione status, and that the body is sequestering toxins

somehow. There are some amazing stories of weight loss by chronically

ill people from heavy-duty detoxification clinics. Basically, if you

can detox, the weight will often come off. So I think the obvious way

to connect the dots here is that if CFS involves GSH depletion, we are

toxic, and when toxic, some people gain weight. Probably there is a

complicated genetic factor here, and perhaps Rich can explain the

biochemical details, but the simple message is that some people gain

weight when they become ill, and certainly the liver is involved.

As far as cortisol levels in CFS, this depends on the stage of CFS

involved. Early stage CFS often involves high cortisol, then over time

as depletion sets in, the cortisol goes down. This is consistent with

Cheney's stages of CFS, and also Selye's original ideas of adrenal

exhaustion progressively in a disease state. The Adrenal Stress Index

(ASI) test is a good and relative cheap way to measure this. It is a

saliva test.

As far as explaining the claims on TV, remember that modern medicine is

based on a statistical research model originally developed for

agriculture. There is far less bio-individuality in agriculture, so the

ideas developed there of using statistics to determine effectiveness of

treatments made some sense. Hopefully over time we will learn enough

about bio-individuality to stop this nonsense of prescribing treatments

that are guaranteed to harm a certain percent of the patients.

--Kurt

Cortisol/Insulin Resistance/CFS/ME/Doxepin

To Rich/Kurt/the group,

Ok, I am, officially, confused...

I have symptoms of insulin resistance:

Tendency towards:

Abdominal Weight Gain/Upper Body Weight Gain/hypertension/probably

PCOS/ hypoglycemia, etc. I can gain weight on almost nothing...and it

has been this way, since, I lost my brain functioning to CFS/ME,

about 20 years, ago.

I have to really watch carbohydrates, whether complex/simple

sugars..or weight gain is fast...high protein diet/low carbs-best

diet for me

However, cortisol is suppose to be low in CFS/ME..it is advertised on

TV, that in insulin resistance, cortisol is too high...

I, also, take Doxepin (a trycylic antidepressant), which, also lowers

cortisol..

Is there a good, reliable test for Cortisol levels, Rich, anyone?

Can someone explain these contradictory problems?

TIA,

Amelia

[Guest guest]

Amelia>> How do you Detox, besides raising Glutathione?

** This is a big topic often addressed in depth by Naturopathic type

healthcare practitioners. Basically, you must open the channels of

elimination, then provoke toxin elimination. There are many natural

approaches to this. One good site is co-cure.org, they detail many

detox protocols. Or look at 'The Detoxx Book' or perhaps 'Detoxify or

Die'.

I have had some difficulties with detox as I am underweight and can not

fast. But some herbal detox programs do not require fasting, and one in

particular has worked well for me, the product 'Ultimate Cleanse' by

Nature's Secret. There are many other good herbal detox methods, these

include herbs that both increase transit time (essential during detox)

and also herbs to provoke toxin release from the detox organ systems.

--Kurt

[Guest guest]

Hi Amelia

I don't see why you would need to stop taking Pregnenolone; it would

be helpful to know your current cortisol and DHEA levels whilst

supplementing with this hormone. If your heart and BP meds help then

I personally feel you should continue taking them until you find

alternatives that reduce your need for them.

Yes I do think you need to detox, and if possible lower you pathogen

load, but most of us need to go very slowly. Now that we're all going

through another steep learning curve hopefully there will be some

viable suggestions on Tx you can tolerate and afford for how you go

about this. I am detoxing better than I did, and my lymph flow has

improved. Neither is perfect but going in the right direction. The

exciting thing about Dr Amy Yasko's work, is there are some

suggestions that might make any detoxing safer, more effective, and

beneficial in the long term.

Ken's website has a lot of the info I've used to address inflammation

and ISAC, my son and I have benefited from some of the supps and

alternatives he features there.

A while back I became very frustrated with being told I should

persevere with NAC, and the specialist whey products, to raise my

glutathione levels; they just made me worse. Now the problems I had

with them are yet another indicator I have blocks in methylation.

More recent changes in what I having been doing were based on

observing health issues in relatives; now that Rich, Jill, and others

have been discussing the genetic factors I am more able to understand

what may be going on. Knowledge is empowering.

Hope you find the first step to improving your current health issues

soon.

TC, Tansy

>

> Dear Tansy,

>

> Do you think that I would need to go off Pregnenolone, before

testing the

> adrenal hormones? and for how long?

>

> That has been my most effective supplement for hormones,

period..and I am,

> still, in the process of Perimenopause-Menopause..It stopped, my

hot flashes,

> completely! It has, also, seemed to help some weight loss...and

helps with

> my sleep process, too.

>

> I was going to try Hawthorn, but I read that one should not mix

that with a

> Anti-hypertensive drug..and Micardis has been very effective for

me, on the

> dimension of lowering blood pressure, which is probably related to

Insulin

> Resistance.

>

> I am doing Abdominal Crunches for Abdominal fat...but apparently, I

need to

> detox...and build Glutathione.

>

> I need to try those supplements, you mention...

>

> What do you think about Toprol XL for my Cardiac problems...high

heart

> rate..high blood pressure? If it lowers metabolism, that would not

be a good

> thing...but I need to find some way of lowering Heart Rate, in a

safe manner.

>

> TC,

> Amelia

>

>

>

>

[Guest guest]

Hi, Amelia.

>

> Dear Rich,

>

> That is one ****good explanation...wish I had known you about 20

years, ago..

***Thanks, and me, too. But I guess that what is, is.

>

> Do you think I need to get testing for Cortisol, since it is

probably too

> low, based on CFS/ME and Doxepin, then? Does one need to know

this, if

> eventually, I may be tested by Dr. Yasko? does she test for this?

***I don't think she tests for it, but she does talk about cortisol

in her lectures. If you are going to pursue the Yasko program, which

I believe goes after root causes, then I don't think you need to

measure cortisol. I think the drop in cortisol in CFS is a

downstream effect in the pathogenesis.

>

> I am taking Pregnenolone...a Master precursor hormone (but you

probably know

> that), which is suppose to help produce all the others..This has

been one of

> my most effective supplements..even, keeps me from having Hot

Flashes,

> during Menopause..wish I had known about it earlier..It is suppose

to produce

> adrenal hormones, if my factoids are correct.

***I think those are good factoids! I'm glad pregnenolone helps

you. It's supposed to help people think better, too.

>

> Do you think that infections may, also, be the cause of the " pot-

belly "

> effect??..I just saw a book with that title, at the

bookstore..which could be

> causative as we don't have effective immune systems?!

***I know that parasites can do that. I think the question is

whether we are dealing with fat down there, or whether the gut

itself is occupying more volume because of what's inside it.

>

> TIA,

> Amelia

>

***Rich