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PostPosted: Wed Jun 17, 2009 1:21 am 
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I'm new here so it's possible that my question has already been addressed. If so, I apologize.

My question is this: Can narcotics, Suboxone or otherwise, cause the adrenals to produce low cortisol. More specifically, can narcotics, Suboxone or otherwise, cause the pituitary to secrete less ACTH?

In December 2006 I had an ACTH Stimulation test done and, while everything came back normal, my ACTH level came back at 3 ug/dl. The cutoff number was 6 ug/dl. When the nurse called me to give me the results, she said, "You are on opiates, there is nothing we can do for you." And that was it. Nothing could be done, so nothing was done. And I've been struggling with my health ever since.

I've suffered from chronic migraines since I was 12 years old (I'm female, age 42), and I've had five surgeries from 2002 to 2006, all but one related to "female troubles." These surgeries meant, of course, exposure to narcotic pain medication. In 2004 I was prescribed 25 mcg/h Duragesic (Fentanyl) patches for my headaches and continued with this medication until 2007 when I switched to Suboxone. I've been on Suboxone, at 16 mgs per day, ever since.

I've talked to many doctors of various specialities about my symptoms and my test results and nobody knows whether the narcotics are the cause of my low ACTH level or not. And it's important that I find out the truth. I'm trying to get well and so, in the belief that Suboxone is interfering with my pituitary function and thus, with my health, I've been trying to wean off Suboxone.

But, I have a chronic pain condition and I'm addicted to narcotics. And I read here that there are permanant changes that take place within the brain after long term exposure to narcotics and that it's best to stay on Suboxone if possible. Also, the doctor who originally prescribed Suboxone for me told me once that he has several patients with chronic pain conditions who take just 2 mgs of Suboxone daily and do just fine with that.

If Suboxone is hurting me then I need to know and I need to get off of it. But if it isn't hurting me then I'd much rather stay on it than suffer from migraines all the time. And please don't just tell me that I need to see a doctor. I've been to doctor after doctor in the past three years. The doctor who ordered my ACTH Stimulation test was one of the two Endocrinologists in my area and he is long gone. The other Endo just blew me off. She said she didn't know why the other doctor said what he said or why my ACTH level was low, but that I didn't need to be put on steroids. She didn't seem to hear a word I said, kept talking about my libido issues even though I told her my biggest problem is fatique, and she never returned any of my phone calls so I haven't gone back to see her.

My case is rather complicated and I've been having a hard time getting the help I need. I did find a doctor recently that seems promising but I've had only one visit so far. Meanwhile, I'm barely functional and very discouraged.

Oh, and as I alluded to earlier, I am sexually DEAD. I don't respond to touch AT ALL. It wouldn't be a problem if I wasn't married but I am, so it's a problem.

Please help me. I need answers and I need them yesterday.


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PostPosted: Wed Jun 17, 2009 3:01 am 
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Joined: Mon Apr 27, 2009 12:47 am
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I'm sorry that I don't have any answers for you. I have endocrine issues too - thyroid, and I noticed that when I started tapering off Sub I needed more thyroid hormone, but that could be a coincidence.

You might want to send Dr. Junig a PM or email him with your question if you need an answer really fast. He tries to answer questions when he can. He's the site admin, suboxdoc.

Also, good for you for looking for a new doctor. I went to many doctors before I got my thyroid diagnosed and it wasn't until half my hair fell out that they finally tested me. The doctors kept telling me it was normal for a new mom to be tired, not listening to what I was trying to tell them.

You can't stop the waves, but you can learn to surf.

-Jack Kornfield

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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