Dexamfetamine sulphate how much does it raise Plasma cortisol and does it effect ACTH Synacthen cortisol stim test ?

[LadyPascha]

Hi I am hoping someone can help me out on this
I am taking Dexamfetamine sulfate for ADHD, I did a morning serum cortisol test as have been very tired I had taken 30mgs dex earlier before the test, I am seeing research that Dexamfetamine and lisdexamfetamine can raise Plasma cortisol quite considerably
My cortisol levels are borderline low my lowest being 127nmol and highest being around 189nmol
I was givent an STT to test my adrenals
baseline 127 range said below 180 its concerning
30 ins 537
60 mins 498 and level to stim to was 430 so passed that bit
my growth hormone which I also have seen is raised iOn Dex was 0.30
DHEA was the very bottom of the range also dex raises

I told the endo that II had taken my dose of Dex before the test, he said that it doesn't affect the cortisol level. I wrote to Takeda who were formally Shire as I had found on the FDA that Vyvanse and dexamfetamine raised Plasma cortisol, after a bit of pushing Takeda sent me a research paper saying it did,
My endo doesn't seem to want to believe the truth, could anyone here please tell me how much Dex actually raises plasma cortisol and does it make you stim the test normal..
Im quite concerned as not much info available on the internet to exactly how it affects the synatchen test but see it does.
My question is it masking Addisons or Adrenal insufficiency in me or should I not worry and push for further testing?
I feel like I have flu when I wake up most mornings feel sick till dex kicks in more lately I have to take my daily dose in one go 60mcgs and still I cant get going and have huge headaches
I was given a continuos glucose monitor as I go hypoglycemic every 3 am and some times randomly in the day, the glucose monitor proves that i am going hypo but I am not diabetic one Endo said that Dex amfetamine was causing my glucose to speed out sytem, which doesn't add up as feel the dex if it works satys in system about 4 -6 hrs so I cant see it affecting me after eating pm in the early hours of the morning after being asleep hours

Any information on this would be really helpful. the specialists have not got a clue and I need to know if Dex is keeping me alive as have little cortisol on Dex I cant come off oit to test as wouldnt get out of bed as too ill, tried that just am very poorly
another Endocrinologist said as I stirmed past the 430nmol I had nothing to worry about and seems to think my under range cortisol is ok with Dex, I do not believe him.. Thanks for reading my post but Drs are I am finding very blinkered on all this Thank you if anyone can help me out on this, is there anywhere I can find exactly how much cortisol 30mgs makes in humans?

Another Endo told me dexamfetamine blunted cortisol but I can only find it blunts cortisol in depressed people I wasn't depressed at any point when testing Cortisol.

 

[JoEhJoEh]

You have to ask a ADHD-specialist . I guess others including myself are not able to answer that question ( no offense, perhaps a few here). And the cortisol levels are not always just a side effect of a medication but have much other reasons perhaps. Perhaps you have to change your intake of Dex to another time - 1 hour before or so - or you have to take more or less. I would look for a good Psych that is into ADHD in adults.

JJ

 

[negrogesic]

D-amphetamine from what i recall can increase endogenous corticosteroid (cortisol) levels and have other endocrine impacts (like decreased prolactin and increased growth hormone levels) but I would imagine that this effect is probably not clinically relevant with therapeutic doses of d-amphetamine or in most cases.

"My endo doesn't seem to want to believe the truth"

I think this is going a bit far?

You might simply consider stopping the d-amphetamine for a while to see if you see relief. If you have these concerns could also switch to something like methylphenidate which should have less potential for endocrine interactions at it is not a releaser of dopamine.

 

[LadyPascha]

You have to ask for an ADHD-specialist. I guess others including myself are not able to answer that question ( no offense, perhaps a few here). And the cortisol levels are not always just a side effect of the medication but have many other reasons perhaps. Perhaps you have to change your intake of Dex to another time - 1 hour before or so - or you have to take more or less. I would look for a good Psych that is into ADHD in adults.

JJ

Thanks my psych is pretty shit as well as the endocrinologist. I thin to get more sense out of you lot tbh, I did see weeks back on here some were saying raised cortisol but can't seem to find it again. I do take extra some days just to help me feel ok but only so much they will prescribe me they are a bit tight with them, I manage to sneal script I a week early so get a few more all help. I will see if I can get a different shrink as mine is not knowledgable in the slightest but maybe they have it in their journals so worth me checking out, they do not seem to have any info I can find available unless I part with money, which if I knew it was good info but probably rubbish thanks for that though My GP wrote to Endo asking him to prescribe me more as it made me feel better and obviously made cortisol in me, I asked the ADHD clinic if they would raise the dex as if is addisons I think rather take dex than steroids as less side affects, they said they would if the Endo agreed the stupid endo said no, the eeejit ,, I will try see shirnk I think see him xmas so will have to wait

 

[LadyPascha]

D-amphetamine from what I recall can increase endogenous corticosteroid (cortisol) levels and have other endocrine impacts (like decreased prolactin and increased growth hormone levels) but I would imagine that this effect is probably not clinically relevant with therapeutic doses of d-amphetamine or in most cases.

"My endo doesn't seem to want to believe the truth"

I think this is going a bit far?

You might simply consider stopping the d-amphetamine for a while to see if you see relief. If you have these concerns could also switch to something like methylphenidate which should have less potential for endocrine interactions as it is not a releaser of dopamine.

I cant take stop them as am very ill and cant even get out of bed I have what I think is addisons on noo dex, so cant stop it even for a day so think I am surviving on dex as cant think and have serious pains in legs back flank and feel dizzy till I take it, which isnt a side affect I see happen with dex, but tahnks for help most appprieciated at least you answer quicker tham the dumb doctors they have out working they are absolutely clueless, hopefully someone will know this info

cheers

 

[LadyPascha]

I cant take stop them as am very ill and cant even get out of bed I have what I think is addisons on noo dex, so cant stop it even for a day so think I am surviving on dex as cant think and have serious pains in legs back flank and feel dizzy till I take it, which isnt a side affect I see happen with dex, but tahnks for help most appprieciated at least you answer quicker tham the dumb doctors they have out working they are absolutely clueless, hopefully someone will know this info

cheers