1) Never assume a pill is going to absorb in your stomach completely or even remotely completely. Always opt for a pill that is not enteric coated that can be dissolved sublingually when possible. I found out I absorb very little of any med orally and I do not even think I have real bad stomach issues. There was a study done on celiac patients and it took 2-3x the thyroxine to achieve equal lab values as in non celiac patients with oral thyroxine pills. With some degree of intestinal inflammation this could very well be your case too. 2) Some pills may only absorb well in one form obviously...ask the pharmacist and read the labels that come with your script. 3) You will never feel good if you are hypovolemic. Partial diabetes insipidus is real and according to the master of it on this forum a dose of .4mg-.8mg which is 4-8x the starting dose my endocrinologist gave me is an optimum dose. I must dissolve desmopressin sublingually. I received no benefit from lower doses of .1mg twice per day, only mild side effects. My endo told me I was not hypovolemic based upon my blood pressure rising upon standing but this is the exact opposite of the truth as verified by experts in the field. 4) transdermal dhea in me at least absorbs far better than oral dhea. 5) Endocrinologists and doctors are often very ignorant of their own profession. 6) Run labs to verify everything. 7) Florinef alone will not increase blood volume like AVP/desmopressin will (not to the strong degree desmo does). 8) My blood pressure dropped after fixing the hypovolemia with high dose desmopressin twice per day. It was extremely high and nothing would bring it down. 9) If you have frequent and or excessive urination you probably will never feel good until you fix this because electrolytes will be leaking out at abnormal rates and you will probably become hypovolemic. 10) drink electrolyte drinks especially if you are just starting out on desmopressin to restore what is lost. 11) In hypovolemia cortisol need is increased. This alone could be a factor for cortisol depletion. "Stressful conditions, including pain, fever, and hypovolemia require an increase in ACTH and cortisol." http://ajrccm.atsjournals.org/content/163/7/1520.full I find it interesting how most of us with fatigue have OI and how hypovolemia can manifest in many different blood pressure readings and test results. There is no hard and fast rule for one reading meaning one thing when it comes to OI. They appear to have treatments for all of them though. The most shocking part of all of this to me was the dose of desmopressin required to elevate blood volume significantly and stop frequent high volume urination (.4mg twice per day sublingual desmopressin). Don't assume that because you are not thirsty that you don't have partial DI. That other member posted a study showing that most CFS patients had partial DI when they measured their blood volume in relation to their serum AVP levels. If you think about it, the body may not crave water if it is low on electrolytes because that could further dilute the existing electrolytes.Whenever I tried to increase florinef my blood pressure would just skyrocket. Maybe now I can add it since there is more fluid volume from higher doses of desmopressin. I think fluid dynamics have a lot to do with a lot of cases of CFS, particularly because they are hard to measure. Another member I mentioned earlier even passed the water deprivation test (which tests for diabetes insipidus) once and he was peeing 7 gallons per day. I don't believe that test is worth a damn. If you wake up a lot peeing or pee a lot it is worth investigating this.