Posted by bleauberry on June 26, 2009, at 19:39:28
In reply to adrenal spit test: anyone here taken one?, posted by floatingbridge on June 25, 2009, at 21:29:20
> Hello,
>
> I usually post on med board, but I'm branching out! Suspect adrenal issues at work with my ongoing fatigue. I don't think stimulants will work for me in the long run--anyways, to make a tedious story short, I'm gonna find out where and how to get the spit test under rx guidance, and maybe even under insurance. I'd love to hear any experience anyone wants to share.If you suspect adrenal weakness, stimulants indeed will make it worse.
The best place to start is diet. It takes months to make a difference, but it does in fact make a noticeable difference. Whatever you are accustomed to eating, food choices need to be changed to include:
Low or no caffeine.
Low or no sugars, low or no sugar substitutes (except Stevia).
Heavy on raw or slightly cooked veggies of all kinds.
Proteins from lean meats, nuts, and beans.
Fruits primarily berries.
The amount of carbs, such as breads or pastas, should be small in proportion compared to the above foods.Regular exercise is good, but avoid strenuous exercise. Go easy.
OK, the tests. I have had one every year for 3 years. I use Diagnos-tecs. The test is called Adrenal STress Index. It also shows DHEA, and some immune markers which is where I first discovered I was reacting to gluten badly enough that it showed up on a lab test (even though it wasn't suspected and we weren't looking for it, it was just part of the adrenal test).
I don't know if insurance will cover it. Mine didn't. Some might. You can order it without a doctor online through Integrated Psychiatry in Florida. It involves a saliva sample taken 4 times throughout a day and has all the materials and instructions. I think it was just over $100.
Over 3 years I've been able to watch my cortisol patterns. The first year, it was way below normal the entire 24 hours. The second year it was haywire...extremely elevated late night but below normal all day...looked like it was trying to make a comeback but was confused and going a little bonkers. Third year, it is below normal first thing in the morning, but fluctuates within the normal range during the day. Finally! The journey to get here involved food choices, time, and at one time I did 2.5mg Hydrocortisone for about 2 weeks.
The most interesting thing I have noticed is how my energy and moods follows my cortisol curve exactly. For example, all kinds of meds, such as Lexapro, Zoloft, Prozac, worked great in the evening almost every night, but I was deathly depressed all day. What the heck? My cortisol curve was extremely low all day, but began a quick rise into high normal in the evening. Bingo! Over the years I've noticed my symptoms change, and what time of the day I feel them, and they correlate exactly with what my cortisol is doing. That is why I strongly feel it is a under-recognized heavy hitter in psychiatry while most people probably think I'm nuts for considering it.
I have no way to prove it, but I am coming to believe that longterm use of purely serotonin meds causes adrenal fatigue. The adrenals try so hard to keep up with all that serotonin and eventually just collapse in exhaustion and crawl along at slow pace, and then the only way the body knows how to adjust to that is to turn the thyroid down. I saw that happen. All my life I have been borderline hyperthyroid. A year after adrenal fatigue set in, I was borderline hypothyroid.
Anyway, the test in my opinion has been very useful, unlike so many other things I've tested or tried, and it is actually fairly cheap compared to most lab tests. My opinion is that all psychiatrict patients should have the 24 hour adrenal spit test. I am also rapidly converting to the camp that says the only good antidepressant strategies are ones that involve serotonin+norepinephrine (as in SSRI+TCA), and ones that will likely be disappointing and cause more problems down the road are pure SSRIs and SNRIs.
poster:bleauberry
thread:903225
URL: http://www.dr-bob.org/babble/alter/20090410/msgs/903357.html