Welcome to ThisIsMS, don.
First, you have found many supportive friends at this site. We are here to help in any way we can. We come from diverse experiences and hold diverse ideas. We do not necessarily agree with each other in our thoughts on MS; you will probably not agree with some of us either; we only ask for tolerance when we express unconventional ideas.
MY personal suspicion is that too much insulin starts the MS cascade. The pancreas can produce excess insulin for any number of reasons; a diet heavy in carbohydrates and sugar is probably the most common reason. The hormone insulin irritates the inside of blood vessels (especially the small ones first – in the eyes, capillaries everywhere including extremities) – I think this causes the tingling (a "raw" or "sunburned" feeling) I have in my legs and feet.
Solu-Medrol is a glucocorticosteroid (as is prednisone) which is often prescribed for MS symptoms; I know it elevates blood sugar and temporarily engages or occupies the insulin, reducing the amount of both in the bloodstream. In my opinion, this is the mechanism that explains MS symptom improvement with Solu-Medrol. During this time the pancreas MAY reset to secrete a proper amount – adequate to handle glucose, but not in an excess amount. (Solu-Medrol has not been effective for me. My pancreas chronically secretes TOO MUCH insulin; I suspect that yours does too.)
Cortisol also elevates blood sugar and the body produces more insulin in response. In your case it may be that your elevated levels of cortisol are prompting your pancreas to overproduce insulin.
I think this imbalance of the hormone insulin causes other hormone imbalances – possibly thyroid hormones. With insurance issues you may not wish to incur the cost of testing these. But you may observe these things: brittle or thinning hair (hair loss) is one of the signs of a problem in the thyroid gland (underactive thyroid a.k.a. hypothyroidism). Other symptoms can include feeling tired (unrelenting fatigue), cold all the time, memory loss, brittle nails, leg swelling, constipation, loss of the outer third of eyebrows, difficulty losing weight because of slow metabolism. Could this be a possibility for you? A simple home test can also indicate underactive thyroid: if you take your basal body temperature (in the morning before getting out of bed) every morning for a week and it is consistently below 98°, you may have an underactive thyroid. I recently came across the following information: "Many medications also slow down the thyroid and also cause iodine deficiency. Lithium and corticosteroids [Solu-Medrol and prednisone] are thyroid-slowing and should be used sparingly if at all."
"Puffy eyes" are another symptom of a thyroid problem.
My recommendations for discussion with a GP: a request for a "fasting blood insulin test" (NOT to be confused with a glucose test). This test is one of the least expensive blood tests (about $80, I think). The optimal insulin test result should be 3 UU/ML or lower. (Mine is never been below 9.)
From this day forward, I encourage you to eat a healthy diet. Many people find that diet can influence the symptoms of MS. In my opinion, this means a low-carb diet -- removing all sugar (including beer, wine, etc. which have sugar and trigger insulin production), removing all artificial sweeteners, including sugar alcohols like sorbitol, xylitol, etc. (These promote insulin production, too.), removing all trans fats (These also increase insulin.), and white flour, white bread, white potatoes, white rice (in fact, all carbs so far as possible) from your diet. I think that excess insulin plays a great part in MS and suspect that Fatty Liver Disease is also involved. Diet is important. You may find the account of Dr. Terry Wahls and her dramatic improvement interesting (
http://www.TerryWahls.com).
My hypothesis: excess insulin (hyperinsulinemia) plays a major role in MS, as developed in my initial post: http://www.thisisms.com/forum/general-discussion-f1/topic1878.html "Insulin – Could This Be the Key?"