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Adrenal Fatigue & Glucocorticoid Use

theres lots of cases of low dose hydrocortisone/corticoids helping recover adrenal function.
and i know of personal experience.
low dose hydrocortisone/prednisone/adrenal glandular can help...no, will help your adrenals bounce back.

as for me...i personally had to go over the recommended 40mg hc dosage to get my adrenals back up and running.
i had to go on 60-80mg daily for a year to recover my adrenals. 20-40mg a day did nothing to resolve my hypoadrenalism. my hypoadrenal was stage 3. which means they were so weak they couldnt even handle dhea hormone. dhea would cause adrenal fatigue. if your hypoadrenalism is stage 3. mine were. very close to failing permanently.

also.
fun fact.
JFK, the president...was a sufferer of addisons.
he had hypoadrenalism, hypothyroidism and hypogonadism.
just like me. i have all three.

Kennedy was diagnosed with Addison's in the 1940s. In 1955 he was diagnosed with hypothyroidism, an insufficient output of thyroid hormones. Symptoms can include many of those associated with Addison's, as well as paleness, intolerance to cold, depression and a low heart rate.
he was on,
500 milligrams of vitamin C twice daily; 10 milligrams of hydrocortisone daily; 2.5 milligrams of prednisone twice daily; 10 milligrams of methyltestosterone daily; 25 micrograms of liothyronine twice daily; 0.1 milligrams fludrocortisone daily; and diphenoxylate hydrochloride and atropine sulfate, two tablets as needed.

see...docs wanna bullshit and say there's no such thing as hypoadrenalism.
that is...until they find out you are the guy with his thumb on the red button and has the nucleur launch codes.
then all of a sudden they make damn sure that the guy with with his thumb on the red button gets ALL THE HORMONE REPLACEMENT he needs or wants.
last thing you want...
is the guy with the launch codes to be a foggy headed, low energy, depressed cause he cant get a hard on while with Marilyn Monroe, fumbling bumbling because he cant concentrate mess.

they made damn sure his hormone levels...ALL of his hormone levels were optimal.
thats if you dont want him nuking you and your world because he couldnt perform his job from being.........


underdosed.
or his obvious hypoadrenalism being ignored or scoffed at.
 
larkasaur said:
I can't order cortisol tests on my own because I live in NY State and there's a law against it here.
Click to expand...
then break it.
i too live in ny state.
it is your duty as a citizen to oppose irrational illogical laws.
all i do is break the law.
i break the law every time i import hydrocortisone from thailand and androgens from overseas.
if i obeyed the laws. id be dead.
cause the only thing that kept my blood pressure up to sustain my life, from one day to the next throughout the 10 months i was experiencing an adrenal crisis was the old bottle of hydrocortisone from years and years ago when i first switched from snake oil synthroid to desiccated thyroid.
if i wasnt extremely lucky in having that. in happening to have that at my disposal i'd be dead.
because from the 1st moment i 1st walked into the ER complaining of low blood pressure causing breathing to become so shallow that my lungs would cease functioning to the day i received my saliva and blood cortisol tests was 10 months.
and 10 months is 10 months overdue regarding adrenal tests.
when adrenal function is suspect....time is of the essence. you cant make someone wait x & o amount of time.

and keep in mind we live in a country with a broken corrupt health care system that puts the patient last instead of first in terms of priority.
we live in a country where laws are passed to protect the industry of health care instead of the patient.
its your duty as a citizen to ignore a health care industrialist lobbied law.

if you fear breaking the law. then obey it.
and watch your health slide into the pooper.
i dont know what else to tell you.

you can also go to a out of pocket doctor. whether here or in new jersey. but if cortisol saliva tests are an issue, go to a out of pocket endo in jersey.
but if i were you, i'd break the law.
fuck it.
if anyone gives you lip.
ask them how a country that is the number 1 country in the world in health care spending having a lower ranking than Slovenia and El Salvador in terms of quality of medicine, ie America.
if they can give you a logical reasonable answer other than disgusting uncivilized barbaric corruption between the government and the health care industry,...then you can tell them you accept any court ruling against you and your actions.
 
there are online saliva cortisol test kits. i cant tell you which one to get since i've never used one that way.
i got my saliva test kit from my out of pocket endo that works in jersey.

but there must be at least one willing to send/receive the kit for you in ny state.
 
if you have relatives that live in jersey or a neighboring state...just ask your relative to allow you to use their home address to send/receive the lab kit and results.
 
@larkasaur i found that endo because i got sick and tired of waiting for a doc thats "in the system" system being that works with health insurance.
i got tired of getting the ridiculous run-a-round by the endos and docs that work in the system who were all avoiding and refusing to run adrenal tests.
so i went to a out of pocket endo working in jersey.
who works for an association of out of pocket endos called BodyLogic.
she was okay.
not fully satisfied.
i do NOT go to a doctor anymore. not in years. pointless.
i self treat/medicate.
i cut the useless middle man(doctor) out of the equation.
i dont really go by blood tests anymore. just by how i feel. i know when i'm getting too much or little of what i need hormone-wise.
As for going to the doctor ever again, i do plan to go back but only after i immigrate to western europe. i'll go there. but here in the states? no way. never again if it can be avoided.

just type in 'out of pocket endocrinologists' or 'cortisol test endocrinologist' or 'testosterone endocrinologist' into google maps with your area in mind. see what comes up.
 
and to answer your "how are they different" question...
an out of pocket endocrinologist is far more likely to run all the tests you need, both saliva and blood...and far more likely to prescribe HRT hormone replacement therapy medication.
as for getting adrenal tests or testosterone replacement drugs from a endo that works within "the system" of health insurance....good fucking luck cause you are gonna need it.
you've got a better chance of finding a needle in a haystack.
 
@IndigoSunset Thanks! I might be able to get treated by an endocrinologist in-network, because my ACTH stimulation test was ambiguous. According to some published criteria I have adrenal insufficiency, according to others I don't.
The endo who gave me the ACTH stimulation test used the level that rules in adrenal insufficiency as his threshold. Because my 60-minute cortisol was above that level he said I don't have an adrenal problem.
But, the level that rules out adrenal insufficiency is higher, and my 60-minute cortisol was below that level.
So my test is actually inconclusive AFAIK, and further testing would be needed.
I called a couple other endocrinologists and tried to find out over the phone what their criterion is for pass/fail on the ACTH stimulation test. But the person I talked to wouldn't tell me, I would have to have an appointment to find out :(
*Something* is making me sick, causing low blood pressure, etc., and it's been getting worse.
So if it's adrenal insufficiency, maybe it will get unambiguously bad and the local endo's will help.
But just 10 mg of hydrocortisone/day seems to have fixed my low blood pressure problem. I haven't had any very low readings in the past few days. That makes it look like I do have adrenal insufficiency.
I live in upstate NY so if I'm going out of state Pennsylvania is closer.
 
Last edited:
This is interesting.
https://ils.unc.edu/bmh/neoref/nrschizophrenia/jsp/review/tmp/177.pdf
They gave 3 people with PTSD 10 mg/day of hydrocortisone in a double-blind, placebo-controlled, crossover study, and it helped.
Cortisol levels tend to be lower than average in people with PTSD:
Urinary free-cortisol levels in posttraumatic stress disorder patients. - PubMed - NCBI
So this is another situation where people have somewhat low cortisol, but not low enough to be considered adrenal insufficiency, and low-dose hydrocortisone may help them.
 
Michael Scally MD said:
ChemMan, thank you for the invaluable posts that are helping move this thread discussion forward. It will be important to determine a definition for "adrenal fatigue." Whether this is an acceptable definition will be critical to any form of treatment. It is not possible to have a treatment for an undefined or ill-defined disorder. However, since many do receive treatments for "adrenal fatigue," please post on the glucocorticoid treatment.


The following is the post from the Mayo Clinic link above. Since this is one person's opinion not found in peer-reviewed literature, maybe someone can find a link to a similar sort of evidence for "adrenal fatigue."

Question: Adrenal fatigue: What causes it?
Is there such a thing as adrenal fatigue?

Answer from Todd B. Nippoldt, M.D.

Adrenal fatigue is a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. The term often shows up in popular health books and on alternative medicine Web sites, but it isn't an accepted medical diagnosis.

Your adrenal glands produce a variety of hormones that are essential to life. The medical term "adrenal insufficiency," or Addison's disease, refers to inadequate production of one or more of these hormones as a result of an underlying disease. Signs and symptoms of adrenal insufficiency include fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness and loss of body hair. Adrenal insufficiency can be diagnosed by blood tests and special stimulation tests that show inadequate levels of adrenal hormones.

Proponents of the adrenal fatigue diagnosis claim this is a mild form of adrenal insufficiency caused by chronic stress. The unproven theory behind adrenal fatigue is that your adrenal glands are unable to keep pace with the demands of perpetual fight-or-flight arousal. As a result, they can't produce quite enough of the hormones you need to feel good. Existing blood tests, according to this theory, aren't sensitive enough to detect such a small decline in adrenal function — but your body is. That's why you feel tired, weak and depressed.

It's frustrating to have persistent symptoms your doctor can't readily explain. But accepting a medically unrecognized diagnosis from an unqualified practitioner could be worse. Unproven remedies for so-called "adrenal fatigue" may leave you feeling sicker, while the real cause — such as depression or fibromyalgia — continues to take its toll.
Click to expand...

Ok, old man, let´s see. @Michael Scally MD

The bottom line to me is: There are many stressors that stand in the shadows, censored.

A systematic view is a DUTY. Thinking in part terms is the same way that the old scientists had in the sixties regarding the concept "living beings". Then Maturana and Varela make the AUTOPOIESIS concept and voilâ. Since then we have phenomenological readings about living beings, who explain and ask about the structure that makes living beings, precisely that structure, that is the living being and nothing else. And we no longer have to read the ridiculous discussions about descriptions of characteristics of living beings; In the past it was a competition of definitions and characteristics.
In the present is a question of phenomenology, that is, of observing the dynamic structure of an object in the various moments that exist, it is not a matter of seeking an ideal model.

With the adrenal fatigue happens exactly the same, from my humble point of view.
There are phenomena, beyond odious descriptions (masturbations for idiot physicians) and emotional phenomena (currently and formally characterized as hormone axis stressors) that due to their complexity of treatment and due to the reductionist laziness of orthodox medicine are concealed in descriptions reductionist but not for that unreal.

And of course with steroids the same thing happens. That is why the idiosyncrasy of Dr. Jim does not allow exploring uses focused on well-being. And if you think I exaggerate because it's an excuse not to train with a decent weight, you're wrong. There are studies, as you know, I imagine, that show that the weight lifted is not proportional to the burning of fat, I mean that if I weigh less than 100 kilos I can do the work, why raise a hundred kilos? Your homework jim @Dr JIM


Rethinking ‘Adrenal Fatigue’ Although the term ‘adrenal fatigue’ has been beneficial insomuch as it has promoted an increased awareness of the relationship between stress and disease, the simplistic nature of this label truly underestimates the complexity of the stress-response system and completely disregards the vital roles that other bodily organs and systems, hormones, and enzymes play in the overall stress response. There is always an underlying etiology behind states of low cortisol, and clinicians who understand the complexity of the HPA axis and discover the underlying root cause of a patient’s hypocortisolism will succeed where others may fail. For a full, referenced review of this topic with treatment suggestions see: Chronic Stress and the HPA Axis, The Standard Volume 9 No. 2 on the web at www.pointinstitute.org

http://www.pointinstitute.org/wp-content/uploads/2012/10/standard_v_9.2_hpa_axis.pdf

Cheers
 
[OA] Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC Endocrine Disorders. 2016;16(1):48. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997656/

Background - The term “adrenal fatigue” (“AF”) has been used by some doctors, healthcare providers, and the general media to describe an alleged condition caused by chronic exposure to stressful situations. Despite this, “AF” has not been recognized by any Endocrinology society, who claim there is no hard evidence for the existence. The aim of this systematic review is to verify whether there is substantiation for “AF”.

Methods - A systematic search was performed at PUBMED, MEDLINE (Ebsco) and Cochrane databases, from the beginning of the data until April 22nd, 2016. Searched key words were: “adrenal” + “fatigue”, “adrenal” + “burnout”, “adrenal” + “exhaustion”, “hypoadrenia”, “burnout” + “cortisol”, “fatigue” + “cortisol”, “clinical” + “burnout”, “cortisol” + “vitalility”, “adrenal” + “vitality”, and “cortisol” + “exhaustion”.

Eligibility criteria were:
(1) articles written in English,
(2) cortisol profile and fatigue or energy status as the primary outcome,
(3) performed tests for evaluating the adrenal axis,
(4) absence of influence of corticosteroid therapy, and
(5) absence of confounding diseases.

Type of questionnaire to distinct fatigued subjects, population studied, tests performed of selected studies were analyzed.

Results - From 3,470 articles found, 58 studies fulfilled the criteria: 33 were carried in healthy individuals, and 25 in symptomatic patients. The most assessed exams were “Direct Awakening Cortisol” (n = 29), “Cortisol Awakening Response” (n = 27) and “Salivary Cortisol Rhythm” (n = 26).

Discussion - We found an almost systematic finding of conflicting results derived from most of the studies methods utilized, regardless of the validation and the quality of performed tests.

Some limitations of the review include:
(1) heterogeneity of the study design;
(2) the descriptive nature of most studies;
(3) the poor quality assessment of fatigue;
(4) the use of an unsubstantiated methodology in terms of cortisol assessment (not endorsed by endocrinologists);
(5) false premises leading to an incorrect sequence of research direction; and,
(6) inappropriate/invalid conclusions regarding causality and association between different information.

Conclusion - This systematic review proves that there is no substantiation that “adrenal fatigue” is an actual medical condition. Therefore, adrenal fatigue is still a myth.
 
The Myth of Adrenal Fatigue
Treating The Symptoms that are believed to be Adrenal Fatigue

When patients present claiming that stress has worn out their adrenal glands, it can be easy to discount their belief in “adrenal fatigue” — but they often have real symptoms that require treatment.

If more proof is needed that the Internet provides a wealth of information and misinformation, endocrinologists need to look no further than the increasing number of patients who claim a diagnosis of “adrenal fatigue.”

Although current medical science recognizes no such condition, physicians need to take the complaints and symptoms of these patients seriously, according to Endocrine Society President Lynnette Nieman, MD, who is a senior investigator at the National Institute of Diabetes and Digestive and Kidney Diseases: “Our role is to be good active listeners to determine if there is a true medical disorder lurking among the complaints. It is very important to take the person seriously, not to brush them off and say there is no [such thing as] adrenal fatigue. These people are suffering from something, so we need to take the suffering seriously.”

The patient may have already been to see a naturopath who promotes the condition, so may be taking supplements of unknown formulations to treat it.
 
Was given a 6 day medrol taper for a back spasm recently. Overall made me feel like shit and halfway in to it started coughing up blood. Was told to stop taking it immediately even tho instructions say not to. Wouldn't recommend it. Chilled the back out tho so take it for what its worth. Taking stress hormones known to cause bone loss and muscle wasting seems to be counter productive to what a lot of us are her for. From what I understand everything in the glucocortisoid family basically attacks the immune system in the hopes that it will also attack your ailment. Effective, but seems to duck you up in the process.. Kind of like chemotherapy. Not for me. Maybe has a more practical application if you are already suffering from adrenal insufficiency but if you are taking it for pain/inflammation then it only seems to cause it instead.
 
Adrenal Fatigue

Adrenal insufficiency is a well-defined endocrine disorder with characteristic symptoms, signs, and serum hormone abnormalities on static and dynamic testing.

Adrenal fatigue is a fabricated condition that has been promoted by popular websites despite the lack of scientific evidence that the condition exists.

It is proposed that the condition can be diagnosed by symptom scoring systems alone or by assessment of daytime salivary cortisol profiles that have never been validated as a testing tool.

Treatments can be purchased online from these websites and consist of “adrenal support” supplements, many of which contain actual bovine adrenal extracts.

Propagation of this false information about adrenal fatigue endangers the public by diverting their attention away from legitimate evaluations to identify the real causes of their symptoms and by promoting the use of unregulated steroid-containing supplements that can lead to serious suppression of endogenous adrenal function and cause the many known toxicities of steroid hormone excess.

McDermott MT. Adrenal Fatigue. In: McDermott MT, ed. Management of Patients with Pseudo-Endocrine Disorders: A Case-Based Pocket Guide. Cham: Springer International Publishing; 2019:127-37. Adrenal Fatigue
 
Glad i have found this thread. I have to take dexmethasone since last juli...so almost a year now. I have s condition called "syringomyelie" and there was a good tumor in my HWS which could completly removed in 2017! As a leftover i have a "syrinx" in my HWS...that is why i must take the dex...keeps me function...saves my ass i would say...my doc wants me to skip it and i tried it 3,4 Times...dont worked...after a few days i can barely walk...everything hurts...feels Like a hole body Arthritis...since last month i must take take Insulin lantus and novorapid due my bloodsugar was skyhigh...and...i take steroids...test e and proviron...call me an idiot, but i Take steroids for years now. Cant Imagine to be off at the Moment. Dexmethason dose is Just 1.5mg in the morning. With this is feel "okay"...the "arthritis" Like Feeling is there...but i can handle it. Feeling nearly normal with 2.5-5mg dex.
My question would be if and how i should go Forward now. Next try to skip Cortison? Change to another Cortison Like Prednisolon?
 
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