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My understanding of treating adrenal fatigue

Discussion in 'Adrenal Dysfunction' started by heapsreal, Apr 17, 2012.

  1. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    If u look there are studies for and against both, so i would say one way is right and the other wrong, i think it should be an edicated choice to try it, if it works wekk cool.

    cheers!!!
     
  2. adreno

    adreno 3% neanderthal

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    Heapsreal, the study you quoted show that HC has anti-inflammatory effects, not that it helps fight viral infections. I never denied that cortisol has anti-inflammatory effects, or that it is effective in autoimmune disorders.

    But having an autoimmune disorder is very different from having, say a retroviral infection. Since we are not aware of the cause of ME/CFS, I believe it is prudent to be careful not to take anything that might worsen long term outcome.

    I agree that patients with Addisons have impaired immune function, but all studies show that the hypocortisolism seen in ME is mild. And the truth is that even healthy people would feel improvement on corticosteriods, including less pain and fatigue, more energy and clearer thinking.
     
  3. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Those other studies i put in there as they said it had no impact on immune function
    , maybe anti-inflam effect is way it may help immune function???
    Cortisol also supplies the extra energy needed for the fight against infections by increasing blood sugar levels etc
    I just think it can help some in many different ways.

    cheers!!!
     
  4. adreno

    adreno 3% neanderthal

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    Heapsreal, if you value doctor's opinions, you might be interested in what Cheney has to say in this article:

    "Viruses, especially herpes viruses like EBV, CMV and HHV6, make proteins that mimic IL-10. The virus deceives the immune system into thinking that the threat is coming from the opposite side! So the immune system shifts from the Th1 mode that attacks viruses to the Th2 mode that does not. The virus increases its chances of survival by diverting the immune system.

    Researchers have demonstrated that most CFIDS patients end up stuck in Th2 mode. This has several consequences. When the Th2 system activates, it blocks the Th1 system. This suppresses the Th1 weapons, particularly NK function. Accordingly, there is also an increase in the Th2 weapons - the white cells and antibodies. Most notable is increased antibody production. Dr. Cheney said that if you measure antibodies to anything a CFIDS patient has ever been exposed to, they will very likely be elevated. (At this point he drew small arrows beside the "weapons": They pointed down on the left side to indicated suppression / lower levels; and they pointed up on the right side to indicate activation / higher levels.)

    Cheney notes that other problems ensue. Patients get into trouble on both sides: they overreact to things on the right side and under-react to those on the left. When they are Th2 activated, they no longer have the defense mechanisms to keep dormant all the things they caught in the past. They cannot suppress or control them anymore, and the EBV, chlamydia pneumonia, CMV, etc. reactivate. The yeast also begins to appear."

    http://www.anapsid.org/cnd/diagnosis/cheneyis.html

    And this is exactly what cortisol does, it shifts balance to Th2 cytokines, making the whole problem a lot worse.
     
  5. adreno

    adreno 3% neanderthal

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    Here is an example of how cortisol shifts cytokine balance in HIV/AIDS:


    Glucocorticoids and the immune system in AIDS.

    Vago T, et al.

    Baillieres Clin Endocrinol Metab. 1994 Oct;8(4):789-802.

    Department of Endocrinology, Luigi Sacco Hospital, Milan, Italy.

    Abstract

    Data reported in the literature show in the majority of cases an increased basal cortisol level in HIV-positive patients compared with controls, although the plasma concentration of cortisol in HIV-positive patients is generally within the physiological range. It is well known that pharmacological doses of glucocorticoids are immunosuppressive, but little is known about the effects of physiological concentrations of cortisol on the immune system. If a dialogue really exists between the HPA axis and the immune system, immune responses should be modulated by physiological concentrations of cortisol, as well as pathological levels of cortisol (high as in Cushing's syndrome or low as in Addison's disease), which are known to be associated with impaired immune system responses. We suggest that in HIV-positive patients, a chronic increase in the basal endogenous cortisol levels may provoke an imbalance in cytokine production, with a decrease in the production of type 1 and an increase in that of type 2. The type 1 to type 2 shift might be synergic with the increased cortisol levels in enhancing viral replication and apoptotic phenomena, and finally in causing the progression of HIV infection.

    PMID 7811222
     
  6. adreno

    adreno 3% neanderthal

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    Here is another example of how HC shifts balance to Th2:


    Effects of hydrocortisone on the differentiation of human T helper 2 cells.

    Sun L, et al.

    Scand J Immunol. 2011 Mar;73(3):208-14.

    Departments of Neurology Medical Examination Center Intensive Care Unit, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

    Abstract

    We investigated the effects of the neuroendocrine modulator hydrocortisone (HC) on Th2 differentiation of human naive CD4+ T cells with and without CD28 co-stimulation. Human naive CD4+ T cells were isolated and purified from umbilical cord blood mononuclear cells from full-term newborn infants. CD4+ T cells were treated with different concentrations of HC under Th0 or Th2 culture conditions. Th0 conditions included stimulation by immobilized monoclonal antibodies (mAbs) against CD3 and CD28; Th2 conditions were the same + rhIL-4. Parallel cultures excluded the CD28 mAb. Th1 (IL-2, INF-?)- and Th2 (IL-4, IL-5)-type cytokines were quantified in culture supernatants by ELISA and within cells by flow cytometry. For both Th0 and Th2 culture conditions, HC significantly inhibited Th1 cytokines' release (IL-2 and INF-?). For Th0 culture conditions, HC slightly increased IL-4 expression (Th2 cytokine). However, for Th2 culture conditions, HC inhibited the IL4-induced production of IL-4. Although the absolute cytokine amounts were decreased, absence of CD28 co-stimulation did not alter these 'trends'. Our findings indicate that HC can alter the Th1/Th2 balance by inhibiting the production of Th1-type cytokines. HC can also diminish the extensive Th2 differentiation induced by IL-4.

    PMID 21204899
     
  7. garcia

    garcia Aristocrat Extraordinaire

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    Heaps I am pretty open minded. I went along with the hormonal people. I bought many books. I even bought Jefferies "Safe Uses of Cortisol", read it cover to cover. However for me personally almost all the effects were immunosuppressive exactly in line with the research adreno has linked to, and that was at both low and high doses.

    I accept that others may have different experiences, and that it may even increase immunity in some people.

    However I would urge any patient with ME to exercise caution.

    Actually strangely one of the few good things cortisol did was to kill of a fungal toe infection I had. The infection was beneath the big toenail so I could not get anything to work topically. When I took h/c the entire toenail fell off! I kid you not. The toenail infection went, never to return.

    But other than that it was a horrible horrible ride for me.
     
  8. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Personally i think if one wants to raise cortisol, try other methods like pregnenolone etc first. Im sitting on the fence only because others have been helped with hydrocort. WHen it does come to finding studies etc, we can always find something to back each arguement or a doctors opinion to back their arguement.
    Im just saying it can help some people, low doses(5-15mg) arent suppressive for most for short term trial and one needs to work with a doctor who knows what they are doing with testing etc. My personal experience is with pregnenolone not hydrocort. Plus other stuff i have mentioned which is also important and may make increasing low cortisol levels more effective ie dhea as well as lowering viral load with av's or bacterial load with abx.

    cheers!!!
     
    SaraM likes this.
  9. SaraM

    SaraM Senior Member

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    100% agree with heaps. DHEA, Preg, Progesterone, and many amino acids are helping tremendously. One year of HC stopped palpitations , but had no effect on low energy, brain fog, OI, or muscle pain.
     
  10. Ema

    Ema Senior Member

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    That is not surprising. Cortisol is necessary for proper thyroid function and those symptoms would not have eased until subclinical hypothyroidism was treated along with the low cortisol. All of the symptoms you mention are more indicative of low thyroid as opposed to low cortisol.

    OI is most commonly an aldosterone deficiency which may have been helped some by HC (which does have some mineralocorticoid properties) but probably was not sufficient alone. Many people take Florinef for this reason which can help significantly. Of course, proper aldosterone testing is necessary prior to starting Florinef.
     
  11. SaraM

    SaraM Senior Member

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    Ema,
    My thryoid panel , not just tsh or t4, have always been perfect, so my case has nothing to do with thyroid.I took different forms of thyroid hormone for a long time, and never felt a thing. Aldosterone level is high and out of range . Dhea,and progesterone were also really really low . I never take hormones without proper testing.

    Best
     
  12. adreno

    adreno 3% neanderthal

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    Here's a study that shows exactly how cortisol affect the immune system. You will notice that cortisol suppresses TH1 cytokines, including INF alpha/gamma and TNF alpha, which are cytokines involved in fighting viruses.


    Glucocorticoids and the Th1/Th2 balance.

    Elenkov IJ.

    Ann N Y Acad Sci. 2004 Jun;1024:138-46.

    Clinical Neuroendocrinology Branch, National Institute of Mental Health, National Institutes of Health, Building 10, Room 2D46, 10 Center Drive, Bethesda, MD 20892, USA. Elenkovi@mail.nih.gov

    Abstract

    Evidence accumulated over the last 5-10 years indicates that glucocorticoids (GCs) inhibit the production of interleukin (IL)-12, interferon (IFN)-gamma, IFN-alpha, and tumor necrosis factor (TNF)-alpha by antigen-presenting cells (APCs) and T helper (Th)1 cells, but upregulate the production of IL-4, IL-10, and IL-13 by Th2 cells. Through this mechanism increased levels of GCs may systemically cause a selective suppression of the Th1-cellular immunity axis, and a shift toward Th2-mediated humoral immunity, rather than generalized immunosuppression. During an immune response and inflammation, the activation of the stress system, and thus increased levels of systemic GCs through induction of a Th2 shift, may actually protect the organism from systemic "overshooting" with Th1/pro-inflammatory cytokines and other products of activated macrophages with tissue-damaging potential. However, conditions associated with significant changes of GCs levels, such as acute or chronic stress or cessation of chronic stress, severe exercise, and pregnancy and postpartum, through modulation of the Th1/Th2 balance may affect the susceptibility to or the course of infections as well as autoimmune and atopic/allergic diseases.

    PMID 15265778
     
  13. adreno

    adreno 3% neanderthal

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    From wikipedia, about the function of interferons:


    'In addition, interferons induce production of hundreds of other proteinsknown collectively as interferon-stimulated genes (ISGs)that have roles in combating viruses.[4][5] They also limit viral spread by increasing p53 activity, which kills virus-infected cells by promoting apoptosis.[6][7] The effect of IFN on p53 is also linked to its protective role against certain cancers.[6]

    Another function of interferons is to upregulate major histocompatibility complex molecules, MHC I and MHC II, and increase immunoproteasome activity. Higher MHC I expression increases presentation of viral peptides to cytotoxic T cells and natural killer cells, while the immunoproteasome processes viral peptides for loading onto the MHC I molecule, thereby increasing the recognition and killing of infected cells. Higher MHC II expression increases presentation of viral peptides to helper T cells; these cells release cytokines (such as more interferons and interleukins, among others) that signal to and co-ordinate the activity of other immune cells.

    Interferons, such as interferon gamma, directly activate other immune cells, such as macrophages and natural killer cells."

    http://en.m.wikipedia.org/wiki/Interferon
     
    garcia likes this.
  14. hixxy

    hixxy Woof woof

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    I've just received my salivary adrenal test results. They're attached.

    Adrenal.jpg

    Show's high DHEA, which has been a feature of mine for a long time. If it's not high, it's usually high normal.

    Low at 8PM, and right on the border low at 12PM.

    Opinions?? I'm pretty clueless with adrenal issues.
     
  15. taniaaust1

    taniaaust1 Senior Member

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    Thanks adreno for posting those cortisol TH1/Th2 studies. Very interesting.

    Due to having low cortisol, I have tried taking low doses of hydrocortisone in the past for a while (cant remember the dose I was taking now, it may of been 10 mg, maybe 15mg per day) but it didnt didnt do a thing for me.. it didnt make me any worst nor did it make me anything any better.

    I do have cortisol issues thou (24hr results low.. and it also dont increase on pain or stress)
     
  16. Ema

    Ema Senior Member

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    Here's my take:

    DHEA 2.0H (0.3 - 1.8) High, yes.
    CORTISOL 8AM 10.8 (6.0 - 16.0) This result is 48% of the range and is commonly thought to be best at least 75-100%. I would consider this result low.
    CORTISOL 12PM 4.0 (4.0 - 6.0) This result is at 0% of the range and is usually best in the top half at least. I would consider this result low.
    CORTISOL 4PM 2.4 (2.0 - 3.5) This result is at 27% of the range. I would consider this low normal.
    CORTISOL 8PM 0.9L (1.5 - 2.0) This result is below range and low.

    Overall, I would consider your results low. You are still getting somewhat of a peak surge in the AM though so that is good. I would not be surprised if there was some unrefreshing sleep though due to blood sugar swings/adrenaline and some tiredness in the morning which may start to lift towards mid-afternoon.

    If it were me with these results, I would probably look into taking some herbal adrenal support like rhodiola or ashwagandha. I would avoid the formulas that contain many multiple herbs as often they have contradictory actions and may or may not actually work well together. I would also make sure to have some basic nutritional support in place like adequate Vitamins C, B, and D as well as consider supplementing Celtic sea salt. These measures may be enough to help support flagging adrenals but if you continue to have symptoms, I would suggest investigating a trial of low-dose HC (usually 25-35 mg a day for women; slightly more for men in divided doses to mimic the natural production rhythm).

    It's also possible that an adrenal CORTEX product only (not whole glandular which can contain adrenaline and be overly stimulating for many) taken in the morning and at noon could help bolster flagging levels.

    Another way to measure the function of adrenals (particularly after beginning adrenal support), is by taking daily average temperatures with a mercury thermometer. This involves taking the temp three hours after waking, then three hours later and three hours later and then averaging the temps to get one value for the day. The average values from day to day should be no more than 0.1 degree centigrade to indicate strong adrenals. As long as there is greater variation than this in the averages (not the individual temps!), one may assume that the adrenals are perhaps not performing up to par.

    Hope that helps!
     
  17. hixxy

    hixxy Woof woof

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    Thanks Ema. I'd really love to figure out that high DHEA too. That's been like that for years now. Very strange. Especially considering all my other hormones are low (sex hormones).
     
  18. Ema

    Ema Senior Member

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    According to Dr Lam, it isn't uncommon for DHEA to go high to try to compensate for reduced cortisol output in the early stages of dysfunction. I would hazard a guess that is at least playing a part in your levels but it is a bit odd that it would go on for years. At some point, I would assume it would fall if your adrenals really started to tank but I would not suggest that route at all!

    Hixxy, are you male or female?
     
  19. adreno

    adreno 3% neanderthal

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    What is your prolactin level?
     
  20. hixxy

    hixxy Woof woof

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    Male, very low testosterone too.
     

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