1. Patients launch $1.27 million crowdfunding campaign for ME/CFS gut microbiome study.
    Check out the website, Facebook and Twitter. Join in donate and spread the word!
Dr. Kerr, I presume?
Clark Ellis brings us a rare interview with British researcher Dr. Jonathan Kerr who is now living in Colombia.
Discuss the article on the Forums.

My understanding of treating adrenal fatigue

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

  1. hixxy

    hixxy Woof woof

    Messages:
    724
    Likes:
    107
    Russell Island, Australia
    I can't find any prolactin in my history of pathology tests. I have a huge pdf full of pathology. 'prolactin' doesn't come up when searching.
  2. adreno

    adreno 3% neanderthal

    Messages:
    2,313
    Likes:
    1,449
    Tundras of Europa
    Well, elevated prolactin is a cause of elevated DHEA. I'd get it checked.
  3. nanonug

    nanonug Senior Member

    Messages:
    1,248
    Likes:
    384
    Virginia, USA
    Is that DHEA or DHEA-S being measured?
  4. hixxy

    hixxy Woof woof

    Messages:
    724
    Likes:
    107
    Russell Island, Australia


    That's salivary DHEA, but I also tend to have elevated DHEA-S on bloodwork too!

    My doc seems to think it's a HPA Axis problem impairing conversion of DHEA -> sex hormones.
  5. taniaaust1

    taniaaust1 Senior Member

    Messages:
    7,938
    Likes:
    4,912
    Sth Australia
    That could mislead.

    In women.. ones temperature can be quite affected by the female hormones and hence it can do different thing at ovulation and also is much different before and after ovulation and right shift before menstation starts. Temp changes depending on where a women is in her cycle is completely normal (there is actually a birth control method based around the shifts).

    mine shifts from .3 to .5 depending on where I are in my cycle which is a normal thing.
  6. taniaaust1

    taniaaust1 Senior Member

    Messages:
    7,938
    Likes:
    4,912
    Sth Australia
    35mg dose isnt all that low. Such doses can put someone at risk of ending up with worst adrenal issues such as addisons disease as adrenals can stop putting out as much cortisol due to shifting output due to the drug.
  7. madietodd

    madietodd Senior Member

    Messages:
    2,455
    Likes:
    1,686
    East Coast, USA
    From Dr. Teitelbaum's SHINE protocol:

    54.** Cortef (Rx): 5 mg tablets - to 2 tablet(s) at breakfast, to 1 tablets at
    lunch and 0 to tablets at 4 PM. Use the lowest dose that feels the best. Most patients find
    that 1 to 1 tablets in the morning and to 1 tablet at noon is optimal. Take it with food if it
    causes an acid stomach. Do not take over 4 tablets a day without discussing the risks with
    your physician. Take Calcium (see #3) if on Cortef. If taken too late in the day, Cortef can
    keep you up at night. You can double the dose for up to 1 to 3 weeks (to maximum 7 tablets
    a day), during periods of severe stress (e.g. infections - see or call your doctor for the
    infection and let him/her know you're raising the dose). If routinely taking over 4 tablets a
    day(at your doctors direction), wear a "Med-Alert bracelet" that says "on chronic Cortisol
    treatment." After 9-18 months, you can try to wean off the Cortef (decrease by tablet a
    day each 2 weeks) if you feel OK (or no worse) without it.

    I took 5mg am and 7.5mg at noon. It worked great, I was on it for about 2 years, and when I weaned off, everything got worse again. I don't think this dose did me any harm, but it certainly didn't heal anything either.
  8. nanonug

    nanonug Senior Member

    Messages:
    1,248
    Likes:
    384
    Virginia, USA
    Do you have simultaneous values for other hormones such as estrogen, testosterone and DHT?

    Having simultaneous values for a bunch of these hormones could point to potential conversion problems between them. Wikipedia provides a good illustration of steroidogenesis and involved enzymes.

    You may also want to look at 17-beta-hydroxysteroid dehydrogenase deficiency.
  9. Ema

    Ema Senior Member

    Messages:
    3,318
    Likes:
    3,553
    Midwest USA
    You are absolutely right. Temp for women can change quite a lot over the course of the menstrual cycle.

    However, these changes become absolutely predictable after a few months of temp charting and the rise in temp after ovulation should not be considered as "unstable" temps for this purpose. Simply note the rise and fall and temps should stabilize around the new point quickly. If you graph the temps as shown on Dr Rind's website, it is easy to see cyclical variations.

    I actually found that I had much less of a range in temps overall though as my cortisol levels improved through supplementation. I think the large cyclical variation may be due to a combination of progesterone and cortisol (and likely other hormones) but overall this method of average temps works the best of anything to track progress with adrenals and supplementation.
  10. Ema

    Ema Senior Member

    Messages:
    3,318
    Likes:
    3,553
    Midwest USA
    Recent studies have shown even those with confirmed Addison's for many years still have the possibility of regaining adrenal function even after years at a full replacement dose.

    Fear of steroids based on outdated and incomplete information has kept way too many people sick for way too long. I'm not suggesting it is the only answer but hormonal balance and proper cortisol levels are absolutely a crucial piece of the puzzle that are too often ignored out of fear and ignorance.

    A full replacement dose varies considerably based on many factors including one's own personal absorption capabilities, the amount and type of fillers, and other factors that are individual. Most doctors that I've worked with that sensibly use steroids as a part of the protocol consider up to 40 mg a physiological dose. Yes, it is controversial and yes, some would not agree but I trust the doctors that are using low dose steroid replacement in their practice daily as opposed to those who have just read about the dangers of steroids in some book.

    If one uses the daily average temperature method described by Dr Rind, one is able to find the minimum effective dose of steroid quite easily. That way the majority of any ill side effects can be avoided while reaping all the benefits of properly supported adrenals. Blood pressure is also a great way for many to help avoid overdosing on steroid.
  11. brenda

    brenda Senior Member

    Messages:
    1,258
    Likes:
    613
    UK
    Thiose who suspect Lyme or have been diagnosed, would be wise to be cautious about using HC even in small doses as many with Lyme have been made worse even though people say that a very small dose will not suppress the immune system. Lyme forums show a different story.
    garcia likes this.
  12. Ema

    Ema Senior Member

    Messages:
    3,318
    Likes:
    3,553
    Midwest USA

    This is exactly opposite of what most of the best LLMD's are currently saying and practicing. These doctors know that Lyme disrupts the endocrine system, specifically the HPA axis, and they work to treat those dysfunctions along with the bacterial infection for best results.
  13. hixxy

    hixxy Woof woof

    Messages:
    724
    Likes:
    107
    Russell Island, Australia
    I mentioned earlier on that testosterone and estrogen are low so there's a likely conversion problem.
  14. nanonug

    nanonug Senior Member

    Messages:
    1,248
    Likes:
    384
    Virginia, USA
    Are you 'GG' for rs28939085? Varview also has a bunch more SNP's you can look: HSD17B3 Variation Viewer.

    By the way, why aren't you taking replacement testosterone?
  15. taniaaust1

    taniaaust1 Senior Member

    Messages:
    7,938
    Likes:
    4,912
    Sth Australia
    There is actual ME/CFS people who have actually ended up with Addison's disease (which is life threatening) after being on a well known CFS specialists advice for cortisol what some are saying are low dose (I cant remember if it was throu Holtolf or Dr. Teitelbaum's .. it was throu those "fatigue" clinics). Ive come across one or two of those people online in the past who now have Addison's after this "low dose" treatment!!! (low dose cortisol given can suppress the adrenal glands more), so there are people out there who have been harmed.

    Hence my warnings it isnt without any risk and no one should take it without considering possible risk.

    That CFS low dose cortisol study being refered too, was less then taking 35mg.. I cant remember but it was something like only 15-25mg being studied if my memory is being correct.. maybe someone can provide a link to the actual study)

    Im not against people trying cortisol if their levels are actually low.. but Im just saying.. take care. That there is a risk there, even with low dose just being given, should be aknowledged.
    garcia likes this.
  16. adreno

    adreno 3% neanderthal

    Messages:
    2,313
    Likes:
    1,449
    Tundras of Europa
    I believe those conversion problems are rare. I would look for high prolactin levels first. If prolactin is high, it could explain your high DHEA and low testosterone. High prolactin can be caused by a tumor in the pituitary, so it's important to rule that out.
    garcia likes this.
  17. garcia

    garcia Aristocrat Extraordinaire

    Messages:
    933
    Likes:
    102
    London, UK
    I agree 100% tania.
  18. Ema

    Ema Senior Member

    Messages:
    3,318
    Likes:
    3,553
    Midwest USA
    I think the far greater risk is people NOT treating their endocrine abnormalities properly due to overstated risks of steroid treatment based in incomplete and outdated information.

    Nothing is without risk and many people have done worse on HC, it's true. But this is usually due to improper dosing and timing rather than an inherent flaw in the therapy. Go to a doctor that is using low dose treatment successfully NOT the one that warns you of pharmacological side effects from taking a physiological dose.
  19. adreno

    adreno 3% neanderthal

    Messages:
    2,313
    Likes:
    1,449
    Tundras of Europa
    Cortisol supplementation is very unlikely to treat any endocrine abnormalities, but it might treat some of the symptoms of it. It's not going to "heal your adrenals". Let's make that clear.

    The thing is, the mild hypocortisolism seen in most cases of ME/CFS simply isn't worth going on a lifetime of steroids for. I've never heard of a PWME who got anything but very minor improvements from HC, and the studies support what I'm saying.

    Studies also show that anything in the range of 15-25mg HC will suppress endogenous production. This will atrophy your adrenal glands, and make it even harder for the endocrine system to adjust levels of cortisol as needed (mount an adequate stress response). This is why patients are told to "stress dose". But the thing is that the endogenous control of cortisol release is orders of magnitude more finely tuned, than anything you can hope to achieve manually. You're essentially moving control of the endocrine system from automatic to manual, which is a bad thing in my book, and will only make you worse in the long run.

    The biggest issue with having relatively low levels of cortisol is increased inflammation, but this can be treated with much safer drugs and supplements.
    brenda and garcia like this.
  20. garcia

    garcia Aristocrat Extraordinaire

    Messages:
    933
    Likes:
    102
    London, UK
    How do you know this?

    There seems to be a pattern amongst proponents of hormone therapy to blame the patients when their one-size-fits-all hormone protocols fail to work.

See more popular forum discussions.

Share This Page