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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by katekite on August 1, 2002, at 10:59:21
Hi,
I'm doing a dexamethasone suppression test. The first two days are low dose (0.5 mg every 6 hours) and the second two days are high dose (2 mg every six hours).
My physical symptoms were doing better on the birth control pill but are mostly all back since I started the test: fatigue and and pounding heart with my pulse up at 97 at rest compared to its usual 65. Mentally on edge but handleable so far if I don't try to do too much.
I'm curious what other people have experienced with this test in terms of physical symptoms?
I'm also running a very tiny fever of 99.2 (my normal is around 97.5 so to me it means something). I may take a break inbetween the low and high dose especially if the temp increases. Of course, the longer I delay the test the longer I wait for results. I'm hoping it normalizes by tonight. I'm worried some subclinical infection could jeopardize the results but can't find any references on this except that sepsis would screw up the test -- and I'm not sick like that.
Mainly, I can't imagine quadrupling my dose tomorrow as I'm supposed to as I feel pretty yucky already. Has anyone here ever done the high dose and if so what physical and mental symptoms did you get? I can't imagine it can be easy mentally.
Dexamethasone test experiences?
Thanks,
Kate
Posted by Maximus on August 1, 2002, at 22:24:18
In reply to dexamethasone questions, posted by katekite on August 1, 2002, at 10:59:21
Sorry i can't answer to your questions.
However, may i ask why you are taking the test for? I thought the 24 hours urine collection test was much more relevant to determine a related cortisol disease: cushings, pseudo-cushings, addison, etc...
I may add that i asked a long time ago a dex-test to my pdoc. She refused and she told me that it was irrelevant because 95% of depressed, bipolar, anxious, schizo, etc. were already high on cortisol...
Thanks.
Posted by katekite on August 2, 2002, at 11:49:57
In reply to Re: dexamethasone questions, posted by Maximus on August 1, 2002, at 22:24:18
Hi,
Thanks for the interest. I ended up stopping the test due to increasing fever -- results would be uninterpretable because cortisol is stimulated in illness anyhow.
I've already had the urine cortisol test and it was high twice. So this is the next step, as a confirmation. The next test was to be the high dose, which would hopefully point toward the source of the extra cortisol.
I've had worsening mental and then physical symptoms for the last year. I find the birth control pill helps some so I may also be in peri-menopause.
I would guess if there has not been major worsening in your mental and physical health over the last years and there are not other symptoms of Cushing's besides the mental ones, Cushing's is unlikely.
My first physical symptoms were acne, and then 9 months later inability to tolerate caffeine without my blood pressure and pulse rising. Another month after that they were just high on their own, then muscle weakness. The mental symptoms started with the acne so there was no clear physical illness at that point.
I think the 24 hour urine cortisol is the best screening test. No test is perfect though, and some percentage of people with Cushing's actually test normal sometimes. Cushing's can be intermittent or cyclical. Since it isn't a horribly expensive test it is surely worth having it done once just in case.
I doubt your doc is right about 95%, but certainly the low dex test is a totally unreliable test without the additional support of other abnormal findings.
Thanks for writing in.
Kate
Posted by Maximus on August 2, 2002, at 19:10:55
In reply to Re: dexamethasone questions, posted by katekite on August 2, 2002, at 11:49:57
This is the end of the thread.
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