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Should I try low dose cortisol?

Messages
73
I have had moderate CFS for almost ten years now. I say CFS because I dont seem to have the stronger immune elements that I believe ME has perhaps on top of the CFS symptoms...however I of course have the debilitating fatigue and pain symptoms that means I had to give up work etc...

I recently went to a best friends wedding and was pleased I could make it. I had to push myself very hard tho and ended up drinking a lot to get though it - and could feel my symptoms getting worse all the way through. However I pushed through it. Its interesting that as I push its as if I can feel my body producing more adrenaline (or hormones) to get me through as I have to keep myself calm but can end up feeling quite skittish and talking fast on account of what I suspect is a sort of adrenalised exhaustion...I even get pain in my lower back which I wondered if it was in the position of the adrenal glands - but who knows...

Hence a month and a half after - Im still completely exhausted in the midst of a big kickback...I knew I would have to pay-but this is miserable and Im wondering if I could make it better rather than waiting the 3 months it might take to heal...

I have investigated low dose cortisol treatment before and research appears to show around 10mg per day is safe. But I am scared to be honest - to try it - in case of side effects. Im not really expecting anyone to tell me yes or no - but any thoughts - advice or experiences of others might help...I think I could just find somewhere that sells the cream?

Thanks in advance...
 

Valentijn

Senior Member
Messages
15,786
@cfsStevew - Have you been checked out properly for orthostatic intolerance? Some forms feature a significant delay and don't hit at the moment you stand up, but rather the effect slowly builds over minutes or hours.
 

Ema

Senior Member
Messages
4,729
Location
Midwest USA
If you've ever had a few bug bites and used HC cream on them, you've likely been exposed to 10 mg of hydrocortisone. 1/4 teaspoon of 1% cream contains about 10 mg of hydrocortisone.

If you suspect low cortisol, you should do a saliva test, in my opinion. You can order it yourself without a doctor's order for about $100 from Canary Club.

http://www.canaryclub.org/specializ...-zrt-stress-hormone-test-kit-c1-c2-c3-c4.html

The symptoms of high and low cortisol can overlap and it is hard to tell what is going on with the adrenals by symptoms alone.

Also, it is almost impossible to add to your own cortisol production by taking smaller amounts of hydrocortisone due to the feedback mechanism. At 10 mg/day, I would actually have less cortisol (and less energy) than I would taking no supplemental HC.

Hydrocortisone is one area where starting low and slow doesn't seem to work very well at all. Most people need to start on a full replacement dose and go from there to find their optimal dose. Most people start on 25 mg HC and end up in the 30-40 mg range if they are more than moderately active.

Some people find that tiny amounts (less than 5 mg) can help (especially first thing in the AM) but those people are rare and usually do not have low cortisol all day long. Rather they are only low at one specific point. This is also where testing can help figure out the best course of action.

Good luck!
 
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Mary

Moderator Resource
Messages
17,365
Location
Southern California
cfsSteve Weak adrenals can cause the exhaustion you're talking about. My chiropractor who does muscle testing discovered my adrenals were wiped out many years ago. He gave me Drenatrophin PMG by Standard Process - an adrenal glandular product - I had to take 3 to 4 times the recommended dose for a week or two, as I was so weak, but within couple of days my energy started to come back. It was amazing I had to take it for quite awhile and also learn about adrenal health - the basics - how stress, sugar, alcohol and caffeine are all very hard on the adrenals. I also found I needed extra pantothenic acid - one of the Bs - which is crucial for adrenal health. My adrenals are one of my Achilles heels (I seem to have more than one), and off and on over the years have to supplement with an adrenal glandular, but nowhere near the doses I needed many years go. I highly recommend both muscle testing and adrenal glandulars - many chiropractors do this -

The chiro told me that taking cortisol would stimulate my adrenals to work even harder, thus in the long run exhausting them further, but that the glandular product would allow them to rest.

Mary
 
Messages
73
thanks ema - your post outlined why Im not sure about taking cortisol - it seems like a minefeild really...and I am very aware that the body is constantly correcting the levels in the moment - so it seem rather crude to try to interfere...only in the most extreme situations perhaps...

I had these same symptoms following a crash last year after overdoing it - and did a salivary test. It didnt show my cortisol lower than the guidelines. It really frustrated me because it really felt like it was...I got a ATCH challenge test (synacten) from my GP but that again came back normal (although I understand that is not accurate enough)... I couldnt rule out that perhaps Im wrong - my adrenals were ok and its something else further upstream or something...
For that reason Im a bit reluctant to pay for yet another test which comes back negative...

I wonder if it is weak adrenals which is somehow subclinical-or testing is not accurate enough to catch it...

Im tempted to try a glandular as described by Mary - thanks Mary. When you say muscle testing you mean kinesiology? Perhaps something less clinical might give a more useful indication...Im open to that stuff tbh...
 
Messages
73
@cfsStevew - Have you been checked out properly for orthostatic intolerance? Some forms feature a significant delay and don't hit at the moment you stand up, but rather the effect slowly builds over minutes or hours.

no I havent tried this - I didnt have any POTS symptoms so didnt consider it...is that a tile table test?
 

Ema

Senior Member
Messages
4,729
Location
Midwest USA
Taking cortisol does not under any circumstances make your adrenals work harder. It actually does the exact opposite by suppressing them temporarily.

Adrenal glandulars are hit or miss for most. They usually contain adrenaline which can be a disaster if you are already low all day. I became even weak and shakier and turned bright red from all the adrenaline yet still had not enough cortisol to function. However, they may be an option for a mild adrenal issues along with the diet and lifestyle modifications mentioned.

I'd be more apt to try something like licorice provided your BP is not high. It prolongs your own cortisol by preventing it from being broken down so quickly. It also has mineralocorticoid benefits which can improve OI symptoms. I use a supplement called Licorice Plus from Metagenics and I like it a lot. It also contains some other adrenal adaptogens.

A tilt table test is the gold standard for diagnosing OI but you can do a poor man's version with a blood pressure monitor by comparing laying, sitting and standing measurements. If you google, you can find more detailed instructions.
 
Messages
73
yes Ema I did try glandualrs once and I ended up feeling very wired and anxious...it was Dr Wilsons I believe...

Perhaps Ill try some licorice thanks...maybe I can find a cheaper UK alternative as thats £24 here...I will look for the home OI test...thanks