Hydrocortisone replacement

#21

Edit: 20 characters.

#22

FWIW…

Notes some physician use;

#23

Also review the book;

“Safe Uses of Cortisol” by Jefferies William Mck MD

This is not a consumer book.

Attached is a PDF copy of the most current edition.

9780398075019.pdf (2.8 MB)

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#24

I used to have this book. I had no idea there was a copy of it available online. Thanks for posting it so I can go back and look again. I know it’s old but it seems like research on HC for non Addison’s Disease has been very minimal ever since.

#25

Important to remember this is in reference to injecting cortisol and taking the creams, not oral bioidentical cortisol

#26

Edit: 20 characters.

#27

You can likely explain this @DrFraser. It is one reason I have avoided HC other than 1% topical on a very few occasions, even though I think I would have been better off to take it for a few days a few years back.

Probably 20 years ago, and anesthesiologist physician friend once commented that surgical sedation procedures were often modified if a person had ever taken HC, even if only for a short term acute problem. Why is that?

#28

Yes I can explain that, but I’d say the anesthesiologist was overstating the situation.

It’s an important point, however. When you get an infection, an injury, a major stressor, your adrenal gland can often elevate your cortisol level to 300% of normal levels. However, if you have been taking corticosteroids, your adrenal gland shrivels over time, because it hasn’t been doing anything. But then when you have a serious issue occur that requires a big dump of cortisol, those shriveled adrenals can’t do anything.

This is a common issue we get in the ER with trauma and infection. Those patients get a stress dose or steroid that has both anti-inflammatory and mineralocorticoid activity, and HC is pretty good in that mix. I usually give 2-4 mg/kg body weight IV when I have these patients on chronic steroids and unable to mount a physiologic response.

If you are disabled and can’t tell a doctor that history - it’s a massive health risk - get a medalert band saying “on chronic steroids”

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#29

You might want to pick up this book which was written by an MD who advocated just that: Safe Uses of Cortisol: 8580000993172: Medicine & Health Science Books @ Amazon.com

#31

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)75738-X/fulltext

“ Anthony Cleare and co-workers1 report that the use of low-dose hydrocortisone (5 or 10 mg daily) is associated with substantial reductions in self-rated fatigue and disability in patients with CFS. Their regimen was not complicated by suppression of endogenous adrenal glucocorticoid secretion. McKenzie et al,2 however, obtained less impressive results with daily doses of 25–35 mg of hydrocortisone in CFS, and their doses led to endogenous adrenal glucocorticoid hyposecretion.”

Dosage makes the poison

#32

I started taking HC again 3x daily last week. 7.5mg morning, then 5mg and 2.5mg 5 hours apart. I take it with my T3 thyroid hormone each time (I’m also on T4 but take that middle of the night).

I definitely notice a significant effect on my brain and cognitive health, along with energy and well being. It seems like it’s improving my impaired thyroid conversion, which is probably why I feel better. I think I’ll stick with it forever. I had absolutely no issues getting off last time, which I shouldn’t have done in hindsight. A few years ago, my saliva test showed low cortisol all four times of the day. 15mg daily shouldn’t be hard to come off for a decently large guy like myself. I’m glad I re-watched Dr. Hertoghe’s lecture and read Dr. Jefferies book again.

#33

This is not complete. It only goes to page 29.

#34

Your experience mirrors mine, though I was taking generally larger doses. I experienced reduce irritability, more mental flexibility/stress management and energy with 15/10/5 dosing schedule. I did this for years under the guidance of my prescriber. Over that time period 15/10/5 was the typical dose, but I also did periods of upwards of 50mg/day for months at a time during high stress (eg long covid type issues). My cortisol curve pre-hydrocortisone was right at the bottom of the normal range, and relatively flat.

We used regular measurements of ACTH and 24hr urinary cortisol to track potential adrenal suppression. Over time, 24hr urinary cortisol AND ACTH increased, which is the opposite of what you’d expect with exogenous cortisol. This led to the decision to try to discontinue hydrocortisone. After discontinuing my ACTH, 24 hour urinary cortisol, and cortisol curve returned to what it was before taking hydrocortisone. I also don’t notice any difference in symptoms without it. Despite my best efforts, I have yet to find any case reports or otherwise of someone having the opposite of adrenal suppression occur with hydrocortisone usage.

I still take generous amounts of hydrocortisone when I’m sick because no amount of over the counter medications makes it tolerable.

#35

I ended that experiment that I mentioned earlier. I noticed absolutely nothing from it.