UCPPS - Prostatitis, Interstitial Cystitis Forum

garyholc wrote:

This thread has gone somewhat quiet, just wondered if studies were continuing or if research has slowed down for the time being pending funding/project approvals etc?

Rufus wrote:I'm just thinking here wondering if the HPA Axis in men like us is on the fritz then what will potentially be done about it?

JOURNAL OF CHRONIC FATIGUE SYNDROME • VOLUME 14:3 (pub) 2008

Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

Kent Holtorf M.D.
Medical Director, Holtorf Medical Group, Inc. Torrance, CA

There is controversy regarding the incidence and significance of hypothalamic-pituitary-adrenal (HPA) axis dysfunction in chronic fatigue syndrome (CFS) and fibromyalgia (FM). Studies that utilize central acting stimulation tests, including corticotropin-releasing hormone (CRH), insulin stress testing (IST), d-fenfluramine, ipsapirone, interleukin-6 (IL-6) and metyrapone testing, have demonstrated that HPA axis dysfunction of central origin is present in a majority of these patients. However, ACTH stimulation tests and baseline cortisol testing lack the sensitivity to detect this central dysfunction and have resulted in controversy and confusion regarding the incidence of HPA axis dysfunction in these conditions and the appropriateness of treatment. While both CFS and FM patients are shown to have central HPA dysfunction, the dysfunction in CFS is at the pituitary-hypothalamic level while the dysfunction in FM is more related to dysfunction at the hypothalamic and supra-hypothalamic levels. Because treatment with low physiologic doses of cortisol (<15 mg) has been shown to be safe and effective and routine dynamic ACTH testing does not have adequate diagnostic sensitivity, it is reasonable to give a therapeutic trial of physiologic doses of cortisol to the majority of patients with CFS and FM, especially to those who have symptoms that are consistent with adrenal dysfunction, have low blood pressure or have baseline cortisol levels in the low or low-normal range.

Key words: HPA axis dysfunction; hypothalamic-pituitary-adrenal axis; chronic fatigue syndrome; fibromyalgia; CFIDS; cortisol, hydrocortisone

webslave wrote:I think this study may hint at an interesting parallel in people who have CFS/FM (both of which are often comorbid with CPPS):

JOURNAL OF CHRONIC FATIGUE SYNDROME • VOLUME 14:3 (pub) 2008

Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

Kent Holtorf M.D.
Medical Director, Holtorf Medical Group, Inc. Torrance, CA

There is controversy regarding the incidence and significance of hypothalamic-pituitary-adrenal (HPA) axis dysfunction in chronic fatigue syndrome (CFS) and fibromyalgia (FM). Studies that utilize central acting stimulation tests, including corticotropin-releasing hormone (CRH), insulin stress testing (IST), d-fenfluramine, ipsapirone, interleukin-6 (IL-6) and metyrapone testing, have demonstrated that HPA axis dysfunction of central origin is present in a majority of these patients. However, ACTH stimulation tests and baseline cortisol testing lack the sensitivity to detect this central dysfunction and have resulted in controversy and confusion regarding the incidence of HPA axis dysfunction in these conditions and the appropriateness of treatment. While both CFS and FM patients are shown to have central HPA dysfunction, the dysfunction in CFS is at the pituitary-hypothalamic level while the dysfunction in FM is more related to dysfunction at the hypothalamic and supra-hypothalamic levels. Because treatment with low physiologic doses of cortisol (<15 mg) has been shown to be safe and effective and routine dynamic ACTH testing does not have adequate diagnostic sensitivity, it is reasonable to give a therapeutic trial of physiologic doses of cortisol to the majority of patients with CFS and FM, especially to those who have symptoms that are consistent with adrenal dysfunction, have low blood pressure or have baseline cortisol levels in the low or low-normal range.

Key words: HPA axis dysfunction; hypothalamic-pituitary-adrenal axis; chronic fatigue syndrome; fibromyalgia; CFIDS; cortisol, hydrocortisone

Full paper: http://www.hormoneandlongevitycenter.co ... L_CFSF.pdf

Rufus wrote:The links I posted about refer to TMS (Transcranial Magnetic Stimulation) has been approved by the FDA to treat depression. There is some evidence of TMS benefit to the HPA axis.

Tweaking Hormones Might Ease Chronic Stress

TUESDAY, Jan. 27 (HealthDay News) -- U.S. and Canadian scientists say they've devised a potential new method of promoting recovery from chronic stress disorders by utilizing the natural dynamics of the body's "fight or flight" response.

The approach focuses on the hypothalamic, pituitary, adrenal (HPA) axis, one of the body's major control systems. The HPA axis uses hormone feedback regulatory loops to help maintain body homeostasis (balance of systems).

A team led by Amos Ben-Zvi, of the University of Alberta, Edmonton, say that when the HPA axis is pushed far from its natural homeostatic rest point, it may be unable to fully recover. When that happens, HPA axis dysfunction may become permanent, according to background information in the study.

HPA axis dysfunction has been linked to disorders such as chronic fatigue syndrome, depression, post-traumatic stress disorder, and Alzheimer's disease.

The researchers created a short-term intervention designed to help restore normal HPA axis. This method involves temporarily reducing the availability of cortisol, a hormone involved in immune function. Reduced cortisol levels prompt the HPA axis to overcompensate and re-set itself into normal regulation.

This new model, which needs to be tested in clinical tests, was described in an article published Jan. 23 in the journal PLoS Computational Biology.