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IMHO, Don't sweat the hypercortisolemia!

Posted by mattdds on April 8, 2003, at 19:05:58

In reply to IMHO Cortisol Club members get a raw deal!, posted by glenn on April 8, 2003, at 11:40:48

Hi,

I too was told that I had hypercortisolemia about a year and a half ago when I was in my worst stage. I was also a DST "non-suppressor".

Frankly, I am pretty skeptical that anyone's root problem is primary hypersecretion of cortisol. It seems MUCH more likely that high cortisol is occurring "downstream", therefore representing more of a biological marker for someone with severe anxiety / depression rather than the root cause of it all.

Also, unless they are being used to rule out Cushing's Syndrome from primary hypercortisolemia (from a pituitary adenoma or an adenoma or hypertrophy of the adrenal cortex), I really think cortisol and DST tests are worthless (and wasteful) from a clinical standpoint. It just gives an already stressed out person another thing to worry about. I actually spoke to an endocrinologist about this and she told me she thought that psychiatrists who try to determine how to treat depression based on serum cortisol or DST tests were "quacks". This being because knowing that one has high cortisol does not give any useful clinical information! It does not predict who will respond to a certain drug, or therapy, etc. So why do them and why worry about it? Sure, it is an interesting observation, but clinically, it is totally useless!

I see all these people on here worrying (and therefore increasing cortisol!) about their hypercortisolemia. Their worry creates distess and only exacerbates the problem. Do you see how this could become a self fulfilling prophecy? Oh no! I will never recover because I have the dreaded hypercortisolemia! I worried many nights about this, especially after reading about the hippocampal shrinkage business. Looking back, it was a waste of time to worry about this.

I'm sure there are countless brain chemicals that are out of whack during depression, but to say any one is the "cause" is not likely.

Don't mean to sound unsupportive, because, hey, I'm in the club too. I just think that we may be worrying about nothing, or at least missing the bigger picture, which involves a whole lot more than cortisol!

Thanks,

Matt


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