If you give hydrocortisone to an ME/CFS patient whose cortisol is normal, then you have supraphysiological levels. So it depends on whether you are giving hydrocortisone to correct hypocortisolism, or as a corticosteroid treatment for ME/CFS.
Interestingly enough, Dr John Chia has observed that patients who were given glucocorticoids like hydrocortisone or prednisone by a doctor during the acute phase of an infection — because doctor thought the symptoms were suggestive of asthma — have a high risk of developing ME/CFS later. This combination of glucocorticoids during acute infection is a recipe for precipitating ME/CFS, Chia has found.
To quote Dr Chia:
So one etiology for ME/CFS that Dr Chia says he has observed hundreds of times is the incorrect prescription of glucocorticoids when a patient has initially come down with a viral infection. One might guess that the immunosuppression caused by these glucocorticoids during the acute infection stage prevents the immune system from dealing with the virus, so that perhaps the virus is able to insinuate itself more into the body, leading to ME/CFS.
Of course, giving glucocorticoids like hydrocortisone once the patient already has ME/CFS is not associated with any known risk. It is only during the acute phase of infection that glucocorticoids appear to be able to precipitate ME/CFS.
Chia says he now tells every doctor to only prescribe glucocorticoids to a patient if their life depends on it, due to the significant risk he has uncovered connecting glucocorticoids during acute infections to the later development of ME/CFS.
I wish more research would be undertaken on this connection that Chia seems to have found.
I also think that this data from Dr Chia is extremely important in terms of understanding ME/CFS viral etiologies in general. It suggests that the enterovirus itself is not the main etiological determinant; rather, it is the state of your immune health when you caught the infection that may play a major role in whether that infection leads to ME/CFS or not.
Thanks Hip. I tried the link that you posted to the quotation from Dr. Chia but couldn´t find it. Would you please direct me to it? Would be of great help as this was how ME/CFS started for me. I didn´t know that hydrocortisone in pharmacological/supraphysiological doses could be involved.