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Have Chiari Malformation, Facing Swallowing Difficulty. Experiencing Nausea, Low Appetite With Elevated Cortisol Level. Related?

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Posted on Tue, 30 Apr 2013
Question: Hello,

I was diagnosed with a Chiari 1 malformation 2 years ago when I went in for an MRI because I had extreme difficulty swallowing. It was distending 6 mm. I had many of the other symptoms on list as well, but they tend to come and go, and the neurologist didn't offer any suggestions (I'm in Canada).

For the last 9 months I have been experiencing extreme nausea and no appetite at all. The nausea is so extreme that in February I was only able to physically consume 3000 calories over a 3 week period - and I vomited most of that up. In spite of this, I gained 12 pounds over that period (which have to be water).

My cortisol levels have been elevated (850 am, 600 pm) since October, but go down with a dexamethasone suppression test.

I am at a loss for what to do regarding the high cortisol. (I am doing absolutely everything possible in terms of lifestyle to keep it down).

Could the Chiari malformation be causing this issue? Do you have any suggestions on how I may be able to lower my cortisol? I am hoping my nausea, stomach issues and lack of appetite have to do with it's elevation.

The only changes I made were to work out LESS intensely (down to an hour of yoga a day, and about 10 km of outdoor walking or hiking per day, and 20 minutes of weight training 3x per week). I used to work out anaerobically for a couple hours a day for most of my life (which always made me feel better and increased my ability to think), but have been told that doing so just creates further stress on the body, therefore increasing cortisol production.

I'm really at a loss for what to do, and am tired and wired all the time. I can't concentrate, I lose words mid sentence, memory is dreadful, I have major rage issues, and I'm constantly nauseous or vomiting. (I have the classic headaches, neck pain, inability to tilt my neck back, dizziness, XXXXXXX shaking feeling, inability to regulate my body temperature, inability to sleep etc. as well), but those have been part of my life since I've been a child.

Could the Chiari malformation be causing the increased cortisol, or do you have any suggestions on what I could do to improve the situation? My body feels anxious all the time, but there is no psychological/cognitive component to it.

(I don't drink, don't consume caffeine, eat mostly organic, never any hormones in food, and consume a high protein diet (consisting of vega protein shakes, Whey Isolate and Cassien .... from hormone and antibiotic free animals).

Any thoughts, suggestions or guidance would be really appreciated.

Oh - I also have adult ADHD, and just began taking dexedrine again (I stopped in the Summer, as well as reduced the intensity of my working out then because it was suggested that I had hypoadrenia at that time - though my cortisol was actually a low normal)

Thank you so much!

May your spirit be filled with peace, your heart with love,and your body with health!

doctor
Answered by Dr. Gopal Krishna Dash (42 minutes later)
Hello,

Thanks for the query,

I understand your problem

Your symptoms could be related to high cortisol and/or other autoimmune disorder which can have systemic manifestations like this. I do not feel that your symptoms can be explained by chiari 1 malformation. You need to have a high resolution MRI of the pituitary regions of the brain/abdomen to see if there is any ACTH/cortisol secreting tumor. I suggest you to get jointly evaluated by a group of neurologist/endocrinologist/ and rheumatologist who will address these issues.

Let me know if I can help you any way
Best wishes
Wish you good health

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Gopal Krishna Dash (21 hours later)
Thank you!

I appreciate you taking the time to respond.

Have a wonderful weekend!
doctor
Answered by Dr. Gopal Krishna Dash (10 minutes later)
Hello,

My heartfelt wishes to you

I wish you a speedy recovery

Wish you good health

Let me know if I can help you in any way

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Gopal Krishna Dash

Neurologist

Practicing since :2001

Answered : 706 Questions

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Have Chiari Malformation, Facing Swallowing Difficulty. Experiencing Nausea, Low Appetite With Elevated Cortisol Level. Related?

Hello,

Thanks for the query,

I understand your problem

Your symptoms could be related to high cortisol and/or other autoimmune disorder which can have systemic manifestations like this. I do not feel that your symptoms can be explained by chiari 1 malformation. You need to have a high resolution MRI of the pituitary regions of the brain/abdomen to see if there is any ACTH/cortisol secreting tumor. I suggest you to get jointly evaluated by a group of neurologist/endocrinologist/ and rheumatologist who will address these issues.

Let me know if I can help you any way
Best wishes
Wish you good health