Hydrocortisone question

[Rand56]

Does anyone know if I can order hydrocortisone tabs from an online pharmacy without a script? If that is possible, also if anyone knows of a reliable source? I live in the US, so Canada would be preferable, but would go elsewhere if I needed to. I'm looking to do physiological doses only, based on the "Safe Uses of Cortisol" book. I sent off a question to an online company and got no reply back. I wanted to find out for sure it can be ordered without a script or if its just a teaser to get you on their site. Also, I'm leary of sending my money to a company who can't even spend a minute to respond back.

 

[Tito]

I would personally never take hormones just based on a book. The ultra minimum is to check at what level YOUR cortisol is and then go from there with medical advice.

 

[Rand56]

hi Tito

I appreciate your reply. First off, I have no health insurance, secondly I know I'm low cortisol from a 24 hour saliva test I had awhile back, thirdly, from what I understand, even if I saw a doc, docs are hesitant to prescribe unless you are out of their range on a test. It's my guess there are probably a lot of people who have adrenal insufficiency who are in range on their stinkin tests. Apparently, you have to be close to being on a death bed before they give you a script.

I've read many of Ema's posts on how it has helped her. I've read plenty of Heapsreal's posts on balancing cortisol and DHEA levels. More than likely me not being able to handle DHEA, which I have tried many times in the past, was because my cortisol levels were not up to par. I've tried Pregnenalone before but who knows if it was going down the right pathways.

I swear, my last dentist appt. I had screwed me up more. I was not feeling to bad before that. Shortly after I got worse. I've read and heard that some dental procedures can wreak havoc with the adrenals. Quite possible it happened to me.

 

[Wayne]

Hi

Does anyone know if I can order hydrocortisone tabs from an online pharmacy without a script? If that is possible, also if anyone knows of a reliable source? I live in the US, so Canada would be preferable, but would go elsewhere if I needed to. I'm looking to do physiological doses only, based on the "Safe Uses of Cortisol" book. I sent off a question to an online company and got no reply back. I wanted to find out for sure it can be ordered without a script or if its just a teaser to get you on their site. Also, I'm leary of sending my money to a company who can't even spend a minute to respond back.

Hi Rand,

Both my brother and I take low-dose hydrocortisone (also based primarily on Jeffries' book "Safe Uses of Cortisol"). I ordered some Cortef (brand name hydrocortisone) from an online pharmacy out of Britain a few years ago, but they sent me the generic hydrocortisone instead (which doesn't work for me).

I believe my brother just recently ordered some online without a prescription, and even though it was generic, it sounds like he's doing very well with it. If you can't get any good answers in the coming days, I would be happy to try to call my brother and find out where he's getting his from.

BTW, reading Jeffries' book was way more valuable and insightful than any discussions I've had with doctors, including my ND, who I have a lot of respect for. I also agree with Jeffries' that a trial of low-dose HC is far more valuable than ANY of the tests available, including the saliva tests. In short, try it, and if it helps and makes a difference, then it's pretty safe to assume you need it. I think you're on the right track.

Best Regards, Wayne

 

[GracieJ]

There is a wonderful book called Adrenal Fatigue: The 21st Century Stress Syndrome. It is written to a general audience so does not go into specifics with CFS and does not go into the HPA axis issue, which was a disappointment, but otherwise is an excellent resource. I kissed PEM good-bye after being on the herbal protocol listed for several months, and am now back at work as a massage therapist. That was a major event in my life. The book lists several things holistically that one can do for the adrenal glands as well as the usual medications. Good luck!

I had cortisol levels so low it was a miracle I was still alive (2004). The doctor could not get me back into her office fast enough to get started on cortisol treatment. Apparently, I was about an inch away from collapse and a trip to the ER with who knows what kind of outcome.

After several years on both cortisol and thyroid therapy, I came to the conclusion that both were keeping me in a loop of management but not healing, and did a lot of research on how to break that loop. Currently, I am on no prescription medications for any CFS symptoms. I have gone the natural route all the way, and it is working well. Not cured, not by a long shot, still have to manage and do this. It could be this is all a remedy and will not fully restore my health. I still keep looking and working, though. This is the best management level after 22 years, and I see gradual improvement all the time, setbacks and challenges aside. The freedom I enjoy from no medication side-effects is a huge bonus.

Edit: Forgot to add one other thing -- this book has some cool self-tests to indicate adrenal function, including one where you sit in a dark room with a flashlight and a mirror and watch how the pupils of the eyes react to light. Good stuff.

 

[Ema]

I'll send you a PM.

 

[Dreambirdie]

HC was very damaging to me, and caused the beginning of my current 4 year crash.

I read the Jefferies book, and tested low on my all my 4X saliva tests, so it made perfect sense that HC was right for me. But then it ended up overstimulating my adrenals so badly that I ended up with a six week long SEVERE ongoing anxiety attack, followed by a severe 6 month crash. It was hell. I have not gotten back to where I was before I took the HC.

Based on my absolutely horrible experience I would never recommend HC to anyone.

 

[Ema]

But then it ended up overstimulating my adrenals so badly that I ended up with a six week long SEVERE ongoing anxiety attack, followed by a severe 6 month crash. It was hell. I have not gotten back to where I was before I took the HC.

I'm so sorry that you had such a bad experience with HC.

I'm not sure I understand how it could overstimulate your adrenals though. Supplementing HC turns down ACTH production which would suppress hormonal production from your adrenals - the opposite of stimulating them.

It sounds like your dose may actually have been too low which can suppress more than you are replacing exogenously. That situation can lead to adrenaline surges and terrible anxiety. But the solution for that is to slightly increase the dose and/or perhaps change to a longer acting steroid for a short time to saturate the cortisol binding globulin.

It's also possible that toxins were blocking your cortisol receptors (Lyme in particular is known to do this and I'm sure that there are others) and the release of those toxins caused a flare in symptoms. These type of reactions are not uncommon either unfortunately but usually do not go on for as long as 6 weeks.

I'm not certain if either of these situations is correct in your case but are possible explanations for what might have gone wrong.

 

[Tito]

Rand, it might be useful to collect as much info as you can on the characteristics of patients who benefited from HC and of those who had terrible effect from it, such as severity, xmrv status, etc. in order to have a better idea if you might belong to the + group or to the - group.
Good luck.

 

[Rand56]

hi Wayne

Yes I'm also finding the book quite insightful. Also, have done some research on it first before I even decided to get the book, including reading on STTM site about physiological dosages and such. I've tried a bunch of other supps, but I could be just beating a dead horse. I'm willing to atleast give myself a trial with the real deal. I'm also aware of the precautions to take..ie...making sure to stay under a particular dose each day, taking it 4 times per day, and weaning off of it slowly after a certain amount of time on it.

Yes, I'll see if anyone else on here can give me a source. If not, I'll let you know and would greatly appreciate if you could ask your brother. Generic would be fine to start to see if I'm a responder to it, plus no doubt it would be easier on my wallet.

I even considered doing the hydrocortisone cream if I can't order it without a script. Only problem is, how does one know how much they are actually absorbing? I know the equivalent measurements on the cream but would not want to be slabbing more of it on me if I had no effect, and mistakenly maybe going too high on the physiological doses per day which could be detrimental for the long run.

 

[Rand56]

HC was very damaging to me, and caused the beginning of my current 4 year crash.

I read the Jefferies book, and tested low on my all my 4X saliva tests, so it made perfect sense that HC was right for me. But then it ended up overstimulating my adrenals so badly that I ended up with a six week long SEVERE ongoing anxiety attack, followed by a severe 6 month crash. It was hell. I have not gotten back to where I was before I took the HC.

Based on my absolutely horrible experience I would never recommend HC to anyone.

Hi Dreambirdie.

Thanks for your response and I'm sorry about your experiences with it. I knew I would be getting some negative responses to my post, and that is fine. I was counting on it. Good to hear the good and bad, and so sorry about your bad experience with HC.

 

[Dreambirdie]

I'm not sure I understand how it could overstimulate your adrenals though. Supplementing HC turns down ACTH production which would suppress hormonal production from your adrenals - the opposite of stimulating them.

It sounds like your dose may actually have been too low which can suppress more than you are replacing exogenously. That situation can lead to adrenaline surges and terrible anxiety. But the solution for that is to slightly increase the dose and/or perhaps change to a longer acting steroid for a short time to saturate the cortisol binding globulin.

It's also possible that toxins were blocking your cortisol receptors (Lyme in particular is known to do this and I'm sure that there are others) and the release of those toxins caused a flare in symptoms. These type of reactions are not uncommon either unfortunately but usually do not go on for as long as 6 weeks.

Ema, the HC was EXTREEEEMELY overstimulating. The worst stimulant I have ever taken. Having a non-stop anxiety attack for 6 weeks was unbelievably stressful and terrifying. I had to take 6 caps of Holy Basil every 2 hours and loads of magnesium just to make it slightly bearable.

I had taken a low dose of HC initially and then moved it up from 5 mg to about 25 mg, slowly and incrementally. It got worse with the higher doses.

I do not have Lymes, but I do have a lot of heavy metal toxicity, so maybe that skewed my readings. Maybe I was not low in cortisol after all, and the heavy metals had blocked the receptors... Who knows.

One thing for sure, I will NEVER go near the HC ever again. It was horrible for me. And I am still paying the price.

 

[Ema]

Ema, the HC was EXTREEEEMELY overstimulating. The worst stimulant I have ever taken. Having a non-stop anxiety attack for 6 weeks was unbelievably stressful and terrifying. I had to take 6 caps of Holy Basil every 2 hours and loads of magnesium just to make it slightly bearable.

I had taken a low dose of HC initially and then moved it up from 5 mg to about 25 mg, slowly and incrementally. It got worse with the higher doses.

But it likely wasn't the HC that was overstimulating, it was the adrenaline produced in response to a too-low dose of HC that was more likely the issue. This is a really common scenario for people because there are so few doctors that understand how to educate their patients and work with them through this period. Instead everyone gets a knee jerk "steroids are the devil and now this proves it" response to what is in fact a dosing error.

A full replacement dose is generally considered to be 20-25 mg/day. This number goes up quite a bit and still remains within physiological dosing if one has infections when starting. Infections can burn through cortisol like nobody's business.

Also, if one has been low in cortisol for a long time, it's pretty typical to start on a loading dose of 30-40 mg for a period of a few weeks to get stable.

Ramping up on HC never works well for people. It sounds like you were getting a lot of adrenaline from suppressing more HC than you were replacing and by the time you got up to a possibly full replacement dose there were complicating factors from the roller coaster ride and adding adaptogens like Holy Basil which can lower cortisol even further (and may have actually made the adrenaline worse). It sounds like you were really lucky to come through that experience without going into crisis.

It's really difficult when we have bad reactions to meds - was it the med itself, the wrong timing, the wrong form, or something else entirely? Would it happen again the same way? There's no way to know but cortisol is crucial for the functioning of the immune system and HPA dysfunction causes so many nasty symptoms that it only seems worthwhile to me to try to get it right. Sure do wish it were easier though...

 

[Dreambirdie]

Ema--the higher dose of 25 mg of HC made me SIGNIFICANTLY WORSE and more over-stimulated, to the point that I had cardiac arrhythmia. It was horrible. If I would have cont. the HC, I think I would have had a heart attack.

The Holy Basil and magnesium saved my life, by calming down the excessive over-stimulation.

I know what the theories say. I educated myself thoroughly on the topic before I began the HC. In this case (as is often the case with hyper-sensitive people who are prone to paradoxical reactions--like me) reality speaks a lot louder than theory.

That's all I have to say about it. Peace out.

 

[Ema]

But you didn't start the typical starting dose from the beginning and by the time you got there it was nowhere near enough for the near crisis situation you had inadvertently created with the addition of the adrenaline, Holy Basil etc. This isn't theory - it's reality for any number of people. I've seen it happen countless times. And seen it corrected by the appropriate amount of HC.

This wasn't your fault and wasn't a result of not enough education because the "education" is just beginning to emerge on how to adequately and correctly dose HC in illnesses like ours where there isn't a structural gland failure. Lord knows there aren't any high quality "research" studies out there because there is no financial incentive to do one so we are more dependent than any would like on patient experiences in this matter.

I really feel for you and others that have gone through this type of situation. I'm just trying to offer some perspective on why it may have gone wrong so that others don't have to go through it as well. I have had enough terrifying experiences on this journey to know exactly where you are coming from. Mine just happens to be spelled C-Y-M-B-A-L-T-A.

 

[Sherlock]

Infections can burn through cortisol like nobody's business.

Hi, Ema: why would that be? What's the mechanism?

 

[Ema]

Hi, Ema: why would that be? What's the mechanism?

It probably is because infection raises inflammation so the body releases additional cortisol to combat that inflammation. There could be other reasons as well though.

Most doctors will recommend that you double your daily HC dose for infectious illnesses for as long as the illness lasts when you have adrenal insufficiency. Generally this is a short term increase but it seems like those with chronic infections need more HC on an ongoing basis as well. It's a real balancing act to find the "Goldilocks" dose.

 

[caledonia]

I've tried about 8 different things for my adrenals - various forms of adrenal cortex extract, various forms of DHEA, pregnenolone, some homeopathic things, etc. They were all EXTREMELY overstimulating.

I don't have Lyme that I know of and had chelated out metals prior to trying the adrenal stuff. I had very disconcerting heart symptoms when I tried to increase beyond 1/8 of an adrenal cortex extract after a year on it. I had heart pain and a numb left arm after one dose of 1/4 which lasted for a week. I've tried higher "normal" doses years prior to that and had to discontinue because of anxiety and nervousness.

The pregnenolone was the worst - weeks and weeks of non-stop 24/7 anxiety and agitation.

On saliva testing, my adrenals are flatlined throughout the day and night. My naturopath said they were the worst adrenals he had ever seen.

I've also been through SSRI withdrawal where my cortisol was 5 times higher than normal! I had horrible 24/7 anxiety, agitation, acid reflux, insomnia, thoughts of death, you name it, I had it. I thought I was going to die. This went on for 5 months until I found the right treatment to bring my cortisol back down and got back on the SSRI. Then months of PEM so bad I had to have my family feed me and bring me my pills.

Based on this, I don't think there is anything wrong with my adrenals, per se, and that I don't have adrenal fatigue, even though this is how it reads on tests. Rich Vank says there can be a problem upstream with the signaling from the hypothalamus and pituitary. This is due to lack of glutathione in these organs, due to methylation cycle problems. I believe this applies in my case, as I do have documented methylation problems.

I also have autoimmune thyroiditis (commonly co-current with adrenal problems). According to Rich Vank, a similar signaling mechanism may be present. Some people have had their thyroids come back online after starting methylation supps and had to discontinue thyroid meds.

The best thing I have done for my adrenals is replace the salt and magnesium that is being massively lost with a homemade electrolyte drink four times a day. (I don't seem to have a problem with potassium, so don't need to replace that.) If you have adrenal problems you will be losing electrolytes, as the adrenals regulate those levels.

I feel better since doing that. But the ultimate solution is likely going to be restarting methylation.

 

[Ema]

Furthermore, adrenal hormone is necessary to maintain adequate blood sugar. People with low adrenal reserve experience rapid drops in blood sugar (hypoglycemia) during stress because there is not enough cortisol to maintain sugar levels. In response, the body starts producing and secreting adrenaline, which raises blood sugar but also causes anxiety. Therefore, people with low adrenal cortisol are more prone to flare-ups of temper, nervousness or shaking, palpitations, irritability, difficulty concentrating, salt cravings, sleep disturbances, fear of situations that are even moderately stressful, and can have panic attacks, fatigue, feel cold, and may have depression.

During infections, the adrenal glands normally increase their output to double or triple the amount of cortisol in the blood to help fight the infection. During a viral infection, adrenal hormone is necessary to suppress inflammation—people with low reserves are more prone to higher fever and body aches. Therefore, people with low adrenal reserve may have increased susceptibility to colds and infections, more prolonged infections, and are more prone to allergies and arthritis.

http://www.jockdoctors.com/page.asp?id=32&name=Cortisol + DHEA

 

[Wayne]

I kissed PEM good-bye after being on the herbal protocol listed for several months, and am now back at work as a massage therapist. That was a major event in my life. ...... Currently, I am on no prescription medications for any CFS symptoms. I have gone the natural route all the way, and it is working well. ...... This is the best management level after 22 years, and I see gradual improvement all the time, setbacks and challenges aside. The freedom I enjoy from no medication side-effects is a huge bonus.

Wow GracieJ, I'm so pleased to hear about your success story. Even though it sounds like it's still somewhat "relative", it sounds very profound as well (and inspirational!). Congratulations on having all your hard work pay off so well!