Adrenal Thread

What are the caveats to hydrocortisone supplementation? It was my understanding that a dependency starts to develop with usage, and stopping usage can be life threatening. Doesn't the feedback system in the body basically shut down its own adrenal cortex when you supplement with cortef?
 
chap said:
What are the caveats to hydrocortisone supplementation? It was my understanding that a dependency starts to develop with usage, and stopping usage can be life threatening. Doesn't the feedback system in the body basically shut down its own adrenal cortex when you supplement with cortef?
Chap, I think Marianco answered this in his reply to one of my questions on the page before this one.. his answer was titled Adrenal fatigue vs. Adrenal Insufficiency.
 
T man

i have exact same feelings as u.... shaky in mornings... tight sac when i use toilet (spasms etc).... if u find ANYTHING that helps please post as ive been this way nearly 3 years and until 3pm im unable to function
 
oki said:
T man

i have exact same feelings as u.... shaky in mornings... tight sac when i use toilet (spasms etc).... if u find ANYTHING that helps please post as ive been this way nearly 3 years and until 3pm im unable to function
I think adrenal fatigue usually works the other way. One can feel ok in morning, but when afternoon around, espcially around 3-5, comes around you have no energy. I feel this way and I most likely have some sort of adrenal fatigue.
 
LiquidGib said:
I think adrenal fatigue usually works the other way. One can feel ok in morning, but when afternoon around, espcially around 3-5, comes around you have no energy. I feel this way and I most likely have some sort of adrenal fatigue.

I think everyone is different. NO ONE should ever have an exact time of day when they feel like crap. My worst time of the day used to be mornings. Would start the day feeling hung over, including severe nausea and no I do not drink. In fact, alcohol really disagrees with me. Having an adrenal supplement really makes a difference in my wellbeing for the entire day.

There are many here who are worried about adrenal shutdown. That link posted by SPE is very good reading. Also, the degree of shutdown is dependent on dose. The worse cases com from over 10mg prednisone per day or asthma inhalers. Although I wonder how many cases of asthma are actually hypoadrenal or hypopituitary.
 
Stress Signals, Testosterone, and Adrenal Fatigue

Stress Signals, Testosterone, and Adrenal Fatigue

When the brain experiences stress, there is a very complex set of reactions to handle the stress involving the brain's nerves, the brains protective cells (called the glia), the peripheral nervous system (parasympathetic and sympathetic), the motor nervous system, the enteric nervous system, the endocrine system, and the immune system. These systems have a large overlap. For example, the hypothalamus is both part of the brain and part of the endocrine system. The adrenals are part of the nervous system, part of the endocrine system, and part of the immune system. The glia are part of the nervous system and part of the immune system. These systems for one large information processing system which I would call "the mind". It uses chemical messengers to carry data - compared to electrical energy as computers do. What we use to conceptualize as the mind = the brain is a gross and incorrect oversimplification of what is actually occurring.

Here is a very simplified version of the stress reaction:
1. In response to stress, the brain has increased production of NOREPINEPHRINE - a primary signal for stress - in the sympathetic nervous system component of the brain (the controller of the flight or fight reaction). This causes the person to experience anxiety, tension, insomnia, impaired sex drive.
2. NOREPINEPHRINE increases the production of CORTICOTROPIN RELEASEING HORMONE (CRH) from the hypothalamus.
3. NOREPINEPHRINE also triggers the sympathetic nerves that travel to the adrenal gland core (called the adrenal medulla).
4. CRH from the hypothalamus triggers the production of ADRENOCORTICOTROPIC HORMONE (ACTH).
5. CRH also increase the production of NOREPINEPHRINE in the brain. This causes a viscious circle where the stress reaction is magnified (norepinephrine increases CRH, CRH increase norepinephrine, etc.). In some cases, this can trigger a panic attack.
6. ACTH travels through the blood stream to the adrenal cortex (the outer later of the adrenal gland), where it stimulates the production of CORTISOL, DHEA, and other steroid hormones. ACTH also stimulates the growth of the adrenal cortex so it can respond to higher stress levels with higher production of hormones (similar to muscle hypertrophy in weight training).
7. CORTISOL performs its functions including: increasing the production of glucose from the liver, triggering the release of fatty acids from fat cells. This leads to an increase in one's energy level and energy on demand. CORTISOL also has actions in the immune system including reducing inflammation.
8. CORTISOL also goes back to the hypothalamus, where it reduces the hypothalamus production of CRH. The reduction in CRH then reduces the production of NOREPINEPHRINE, which then helps reduce the stress response, allowing return of sex drive, etc.
9. In response to the sympathetic nerves, the adrenal medulla produces NOREPINEPHRINE and EPINEPRHINE and releases them into the blood stream to reach the rest of the body.
10. NOREPINEPHRINE and EPINEPHRINE in the blood stream triggers the rest of the stress reaction in the body including: increasing heart rate, increasing blood pressure, dilation of bronchioles in the lungs to assist in breathing, increasing metabolic rate, inhibition of the enteric nervous system (the nervous system of the gastrointestinal system), impaired blood flow to the penis (deflating the penis).
11. NOREPINEPHRINE produced in the brain also triggers other sympathetic nerves that travel to other organs in the body and sympathetic ganglia (collections of sympathetic nerves), which also then trigger the other stress reactions in the body (e.g. increased heart rate, etc.).
12. NOREPINEPHRINE itself triggers ejaculation.
13. TESTOSTERONE goes to the hypothalamus and pituitary gland where it reduces the production of ACTH. This then results in a reducted production of CORTISOL and other adrenal hormones.
14. TESTOSTERONE also goes directly to the adrenal glands and reduces activity of the adrenal glands. It particularly reduces the production of CORTISOL. TESTOSTERONE essentially acts as a governor, reducing the stress response and preventing the adrenal gland from becoming too active. If the adrenals are like a car engine, testosterone prevents the engine from overheating.
15. TESTOSTERONE goes to the brain where it increase the production of DOPAMINE.
16. TESTOSTERONE increase activity of the vagal nerve (the main nerve of the parasympathetic nervous system).
17. The parasympathetic nervous system counteracts the fight and flight response of the sympathetic nervous system (including reducing blood pressure, slowing down the heart, etc.), and promoting resting activities such as digestion and penile erections.
18. DOPAMINE in the brain reduces the production of NOREPINEPHRINE. This helps end the stress response and calms a person down.
19. DOPAMINE also directly increases sex drive and increases the production of TESTOSTERONE.
20. DOPAMINE, via the reward circuit, elevates mood and reduces anxiety.
21. Also in the brain, certain neurons produce SEROTONIN which helps block the perception of stress and reduces anxiety.
22. SEROTONIN, itself, can reduce the production of DOPAMINE. If this reduction in DOPAMINE PRODUCTION is large enough, there may be a reduction in TESTOSTERONE PRODUCTION.
23. SEROTONIN also directly inhibits sex drive and inhibits orgasm/ejaculation.
24. PROGESTERONE from the adrenal glands also has a calming, mood stabilizing effect in the brain (by increasing the production of SEROTONIN, DOPAMINE, and GABA (gamma amino butyric acid - the primary calming neurotransmitter of the brain) and by blocking GLUTAMATE (the primary stimulant neurotransmitter).
25. PROGESTERONE can also be used by the adrenal glands to make CORTISOL in response to stress.
26. PROGESTERONE can also be used by the testes to make TESTOSTERONE.
27. PROGESTERONE increases the potency of THYROID HORMONE, which increases activity of the adrenal glands.

There are numerous other neurotransmitters involved in the stress response - which were left out of this simplified picture.

When exposed to chronic severe stress or overwhelming traumatic stress, things can break down. This is analogous to what happens when a muscle is overtrained. For example, the adrenal gland can itself fatigue. This results in an inability to produce its hormones in response to stress. The outer adrenal cortex (as opposed to the inner adrenal medula) is the part to fatigue the most leading to impaired production in response to stress of hormones such as CORTISOL, DHEA, PROGESTERONE, and ALDOSTERONE. This can lead to reduction of sex drive.

In the brain itself, in response to chronic severe stress or overwhelming traumatic stress, there is a system breakdown including a reduction in GABA receptors and atrophy (with loss of brain mass) in certain areas (such as the hippocampus) - which leads to impaired ability to adapt to and reduce the stress response.
 
griffinannie said:
I need help interpreting the recent results and am looking for the name of neuroendocrine expert. I'll get on a plane and go anywhere.

43 years old 6 feet 200 lbs 17.0% body fat. Feel crappy, ED, cant shed last few pounds around waist, "depresed", easily fatigued

My GP readily admits this is out of his expertise but he is extremely open minded He feels and I agree I need someone who does Neuroendocrine works cause I have more than regular T/E issues happening. He is concerned about adrenal fatigue and is self described as inexperienced on neurotransmitters

Testosterone 332 241-827
Estradiol 14 3-70
Dheas AM 27 95-530
Dheas PM 29 95-530
Cortisol AM 11.1 4.3-22.4
Cortisol PM 6.3 3.1-16.7
Progesterone 0.2 0.3-1.2
IGF 1 229 101-267
TSH 3.28 0.35-5.5
DHT 34 30-85
T4 7.9 4.5-12
T3 191 85-205
PSA 0.5 0.0-4.0
Vitamin D 25 Hydroxy 18.1 32-100
Prolactin 3.7 2.1-17.7
SHBG 11 13-71
Neurotransmitter test - all tested (dopamine,serotonin,epinepherine, norepinepherine) came back low- except GABA which was normal

1. MISSING DATA: Comprehensive metabolic panel - with a fasting glucose, Hemoglobin A1c, Free T4, Free T3, CBC, sitting and standing blood pressure and pulse, body temperature, pupillary light reflex, past and present stresses in life, etc.

2. SEXUAL DYSFUNCTION: Contributing factors include: low to low normal testosterone for age, low to low normal dihydrotestosterone, low estrogen, low progesterone, low to low normal cortisol, diabetes or insulin resistance (which impairs nerve signal transmission), hypothyroidism, low dopamine, low norepinephrine, etc.

3. ADRENAL FATIGUE: lab test findings giving clues to its presence include: low normal cortisol, low DHEA-s, low progesterone, low dopamine, low epinephrine, low norepinephrine, low to low normal glucose, high albumin, etc.

4. HYPOTHYROIDISM: lab test findings giving clues to its presence include: TSH > 2.0, low Free T3, low Free T4, low serotonin, etc.

5. INSULIN RESISTANCE OR DIABETES: lab test findings giving clues to its presence include: fasting glucose > 102, high hemoglobin A1c, calculated mean blood glucose > 110, low to low normal testosterone for age, low sex hormone binding globulin, etc.

6. DEPRESSION: depression can have multiple factors including: environmental and psychological stresses, one's ability to adapt to stress, functioning of the behavioral neuroendocrine and immune system (including brain functioning, reproductive system function, thyroid function, adrenal function, insulin resistance, etc.).

For best results, there is a sequence for treating each area of dysfunction, that has to be customized for the patient (depending on factors including the person's level of stress, ability to adapt to stress, severity of illness, etc.), particularly when treating a multisystemic problem. If the sequence is not followed, then the person may feel worse instead of better. For example, treating low testosterone prior to treating adrenal fatigue may make may people feel worse rather than better - e.g. blood pressure may worsen, anxiety or depression worsening, etc. Treating thyroid problems prior to treating adrenal fatigue may cause a person to get worse - fatigue worsening, depression and anxiety worsening, etc.
 
Adrenal fatigue = OVERTRAINING

eliteballa3 "Why is my DHEA so low" said:
im relooking over my lab rsults and my dhea is 212 range is 180-1250 why is it so low and what can i do about it i do have a ton of dhea at my house.

Lab findings consistent with adrenal fatigue include:
1. low normal cortisol
2. low DHEA
3. low to low normal progesterone
4. low sodium
5. low potassium
6. high albumin
7. etc.

Bodybuilding is a severe nervous system, endocrine system, immune system stress.

The bodybuilding literature has numerous articles about the need for rest to allow muscles to recover from the damage induced by weight training, to grow in adaptation to the progressively higher stress levels due to progressively higher weights used. It is important to avoid OVERTRAINING - since overtrained muscles may fail to adapt to the stress and shrink rather than grow. Some of the top bodybuilders give each muscle about a week of rest between intense weightlifting exercises.

What is not often realized is that the nervous system, endocrine system, and immune system also have to rest and recover from the stress of weight lifting. Central to this are the adrenal glands - which is a component of all three systems. Just as one's muscles fatigue, the adrenals fatigue in response to weight lifting.

One symptom of adrenal fatigue is hunger or a sensation of low blood sugar - since one's body has more difficulty during adrenal fatigue in producing blood sugar and in burning fat and protein for energy. Many people get the munchies after weight traning and gain a lot of fat rather than muscle.

Other symptoms include the sensation of being "burned out", lack of sex drive, impaired attention, depression or anxiety, insomnia, etc.

Adrenal fatigue is a sign of OVERTRAINING.

Adrenal fatigue indicates one has not recovered their neuroendocrine and immune system well enough before embarking on another round of weight lifting stress.

Each person has a unique time for recovery of the adrenal glands.

One cannot goad or force the adrenal glands to recover faster. The elements of treatment are time and stress reduction.

The treatments of adrenal fatigue essentially reduce the adrenal glands' workload/stress, thus allowing them to rest while one is still active and stressed in life. But the adrenal glands will still need time to recover.

Often, a common time frame for recovery from moderate adrenal fatigue is about 6 months of rest.

More severe adrenal fatigue (e.g. where one cannot exercise or at worse, where one is essentially nonfunctional and bedridden) may take up to two or more years of total rest without stress to fully recover.

Reducing one's stress during the recovery period is highly important to improve the rate at which the adrenal glands recover from fatigue. Some bodybuilders take periodic time off from bodybuilding (e.g. some take at least 6 weeks off) to recover from signs of overtraining (e.g. hitting a wall or plateau, feeling burned out, etc.).

It is interesting how many bodybuilding products contain stimulants (such as caffeine). These not only work in the brain, but they also goad the adrenal glands to work harder against the stress of weight lifting. These stimulants, however, are a significant stress, to the adrenal glands. Eventually, adrenal fatigue may occur. One adrenal fatigue occurs, the stimulants stop working or don't work well at all.
 
Yes Marianco, all of what you stated makes alot of sense and is very applicable to myself! I can totally understand now how my body is not coping with the stress I have been placing on it with weight training and all the other stress I have been under in the past years.

I have read in some excerpts from the book "Stop the Thyroid madness",
"Since cortisol is needed to distribute thyroid hormones from the blood to the cells, low cortisol results in high amounts of thyroid hormones to build in the blood"
Do you agree with this? My blood test results for T3 and T4 were at the upper limit, could this be another pointer for Adrenal fatigue?
 
Matt Muscle said:
Yes Marianco, all of what you stated makes alot of sense and is very applicable to myself! I can totally understand now how my body is not coping with the stress I have been placing on it with weight training and all the other stress I have been under in the past years.

I have read in some excerpts from the book "Stop the Thyroid madness",
"Since cortisol is needed to distribute thyroid hormones from the blood to the cells, low cortisol results in high amounts of thyroid hormones to build in the blood"
Do you agree with this? My blood test results for T3 and T4 were at the upper limit, could this be another pointer for Adrenal fatigue?
Hi Matt Muscle here is a link to a post that Chris from "Stop the Thyroid Madness" said to us here at the Men's Heath Forum.
https://thinksteroids.com/community/threads/134239555
 
Confused.

My morning cortisol was 19. The range says that is the upper limit but here you all say it is low.

Does taking something like isocort give your adrenals a chance to heal? Or is it a maintenance dose.

Progesterone here was .3, dhea in the 200's and testosterone was in the low 400's.
 
painman said:
Confused.

My morning cortisol was 19. The range says that is the upper limit but here you all say it is low.

Blood cortisol is not reliable. Saliva is best for testing cortisol. Read the following.
 
Thank you!

I really appreciate the follow up and read the thread you gave. Thanks again.

Their does seem to be some controversy with salvia tests. MD's or at least the average MD appears to not be on the bandwagon yet. The one I go to has suggested to followup with a ACTH stim test and 24-hour urine if I wish to explore further.

I do wonder if hydrocortisone and other steroid creams I have used consistantly has suppressed things. As well as some major surgeries, long term 4 year androderm therapy I didn't need, etc.

Thanks again....


1cc said:
Blood cortisol is not reliable. Saliva is best for testing cortisol. Read the following.
 
Painman,

At this link are some tests you can do to see if you do have low Cortisol.
http://www.stopthethyroidmadness.com/adrenal-info/
And if you fail this do a 24 hr saliva test and read this link.
http://www.stopthethyroidmadness.com/adrenal-info/how-to-treat/
My morning Cortisol blood test came back at 9.04 range is 7.0 to 25 ug/dL. My Dr. is not up on this and I am waiting for my wife who is seeing a new Dr. tomorrow for her Thyroid and this Dr. is up on Adrenal Fatuge. So I am just in a wait and see mode.

I did the tests my temp is ok my bp does not go down when I stand yet my eyes failed this test.
 
Pmgamer18, thanks!

Great links and things to read up on.

Much appreciated.

-J

P.S. I did a blood test where it showed that phosphytlserine(sp?) was slightly low. I have started to supplement but will that lower my cortisol further? Seems the masses want to lower cortisol associating it with belly fat and stress. Now I am considering trying to take cortisol, might as well be different I guess.
 
painman said:
Pmgamer18, thanks!

Great links and things to read up on.

Much appreciated.

-J

P.S. I did a blood test where it showed that phosphytlserine(sp?) was slightly low. I have started to supplement but will that lower my cortisol further? Seems the masses want to lower cortisol associating it with belly fat and stress. Now I am considering trying to take cortisol, might as well be different I guess.
I can't say are you treating under a Dr.
 
painman said:
Thank you!

I really appreciate the follow up and read the thread you gave. Thanks again.

Their does seem to be some controversy with salvia tests. MD's or at least the average MD appears to not be on the bandwagon yet. The one I go to has suggested to followup with a ACTH stim test and 24-hour urine if I wish to explore further.

I do wonder if hydrocortisone and other steroid creams I have used consistantly has suppressed things. As well as some major surgeries, long term 4 year androderm therapy I didn't need, etc.

Thanks again....

An ACTH stim test is only as good as its interpretation. The AACE and mainstream medical interpretation is based on the two extremes of total adrenal failure or gross excess. Subclinical adrenal insufficiency or adrenal fatigue is not even considered. If you read the past posts on this thread, that point is well illustrated. The reference ranges for serum cortisol are skewed very low by the test subjects they are derrived from. AM cortisol for a male should be upper 20's-lower 30's. An ACTH stim should go to 50+. Test results that do not meet those standards AND symptoms matching those of adrenal insufficiency should be suspicious to a thinking doctor.

Those advertisments touting weight loss via supression of cortisol horrify me. Thank goodness they are just horse-shit supplements that do not really work. A person with severe adrenal insufficiency does lose weight. He is unable to retain nutrition and hydration because of the violent digestive upset characteristic of adrenal insufficiency. Unfortunately, many people have been near death because the attending physician assumes it is the flu or food poisoning. I have read many accounts of Addison's patients not being correctly diagnosed. The doctor rehydrates them and maybe treats the nausea, then sends them back home. It is my experience that one must beg for a cortisol test, much less an ACTH stim test. Low cortisol is not on the radar of most doctors.
 
Marianco,

Do you agree with what many are saying in this thread in regard to the lab ranges for Cortisol being incorrect? That a healthy AM Cortisol level for males, should be around the high 20's low 30's, not within the specified range of 5-22?
I believe this information has come from the book "Safe uses of Cortisol" by Dr Jeffries.
 
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