[Smileyferret]

https://en.wikipedia.org/wiki/Apparent_mineralocorticoid_exc...

We actually learned about this in med school last week, but I never thought it actually happened to people... Licorice contains glycyrrhetinic acid which inhibits the conversion of cortisol to cortisone. If you have too much cortisol floating around because of this, that cortisol starts activating receptors in your kidneys that are normally activated by aldosterone. This in turn increases your sodium resorption and potassium excretion, so you get high blood pressure and low potassium which can cause arrhythmias. It's called the Syndrome of Apparent Mineralocorticoid Excess and is a usually genetic problem with the enzyme that breaks down cortisol.

[anonuser123456]

Can this imbalance occur transiently?

One time, I was awake for ~3 days straight. I ended up in the hospital (visual hallucinations) and the only thing remarkable was low potassium and high BP.

But I've had this long running hypothesis that body has trouble with cortisol regulation when I'm extremely fatigued. If I miss a night of sleep, the next night it is extremely hard for me to fall asleep (cortisol inhibits sleep) and I have that terrible 'stress sweat' odor.

Remeron will then knock me out... where as hypnotics will not. Remeron being interesting because it inhibits the production of cortisol.

[pfundstein]

I would suggest that the hallucinations were simply a symptom of your sleep deprivation. I've experienced the same after a similar amount of time awake coding.

[mrkstu]

I starting to suspect I have a variety of such genetic endowments- gout because I can't break down uric acid, high blood pressure that gets instantly elevated when I eat black licorice (which I loved as a kid), variety of allergies, Type II Diabetes (along with most of my sibs, regardless of their diets.)

Hopefully Dad's Parkinsons isn't genetic...

[pkaye]

So it would me even more deadly if they were taking Prednisone?

[Smileyferret]

Not necessarily. Believe it or not, dexamethasone (another corticosteroid) is actually a second-line treatment for this disease because it reduces endogenous cortisol production without binding too tightly to the mineralocorticoid receptor in the kidneys.

[randerson]

Would there be some way to use this to your advantage?

[ip26]

... if you had low blood pressure and potassium poisoning perhaps?