Tramadol Induced Adrenal Insufficiency

General Info on Adrenals (Anyone with fatigue should read)

I want to wait to post something more detailed here and in the forums, but for now I'm posting a short reply.  I want to say to my spine trauma friends and to anyone with general fatigue, to make sure you are nourishing your adrenal system.  If you show signs of severe fatigue, hypoglycemia, weight gain, intolerance of stress, cold, light, please look into "Adrenal Fatigue".  Read books such as Dr Wilson's book on adrenal fatigue to start.  You can order a saliva test to see how you cortisol is responding.  Seek out a good nautropath who has an good understanding of the adrenal glands.

This article is a good basic overview: http://www.lef.org/protocols/emotional_health/stress_management_01.htm

Adrenals and Opiates/Tramadol

*Adrenal issues (low cortisol) has been causing my neuropathic pain to be severely amplified.  Taking more opiates made it worse.  Watch your adrenals on opiates and tramadol.  If your adrenals are strong and you are handling it well, great, but if you get weaker and weaker then seek out help.  B5, Vitamin C, and healthy fats are especially important for the adrenal cascade.  Avoid sugars, eat fat/carb/protein each meal, split meals up to try and keep blood sugar more even. Chromium can help.  Reduced adrenal function reduces body's ability to deal with blood sugar stabilization. Regular sleep and salt supplementation is important.

I have not had ANY abnormalities show up on bloodwork except for low vitamin D and over time higher prolactin.  It can easily be missed.  I ignored my cortisol saliva results for a while because they were borderline normal.  It spiraled down quickly.  Check your Blood pressure, if it's low and you are too tired and weak to stand often.  Please work on researching this issue.

The results on opiates are mixed.  There's virtually no record of tramadol and adrenals except for the once patient and the additional study below.
This is an endocrinologist paper on a case of Tramadol induced adrenal insufficiency.  My symptoms were identical to patient in paper, high prolactin and low cortisol, as well as the abdominal cramping.  http://hal.archives-ouvertes.fr/docs/00/66/08/93/PDF/PEER_stage2_10.1007%252Fs00228-011-0992-9.pdf

I was prescribed Hydrocortisone and adrenal support formula to raise my natural cortisol levels and immediately began slow reduction of tramadol.   I will report back in a couple months to see if my levels began to stabilize at all.  Tramadol withdrawal itself is stressful on the body.  It should never be stopped cold turkey.   Small reductions in the drug over time will minimize stress.

My cortisol was also low on ibuprofen.  I obviously had adrenal issues to begin with, the medications made the issue more difficult for me.  That is all I am trying to say about it.  However, I've seen fellow spine tumor patients presenting the same symptoms, only better on steroids.  They have a right to know that this is a possibility.