Licorice root/cortisol-raising drugs (hydrocortisone)?

[Mikee5]

So I've been suffering with adrenal fatigue for over 28 months now, and recovered by only about 60% to my pre-adrenal crisis state. A saliva cortisol test taken a few months ago indicated only slightly disturbed (low) cortisol levels, with optimal levels in the morning but dipping too low throughout the day. It also indicated borderline-low DHEA levels, which caused me to suspect poor cholesterol-pregnenolone conversion compromising adequate hormonal production. I'm also suffering from mild secondary hypothyroidism, possibly as a result of HPA axis dysfunction, a weakened endocrine system or just poor overall adrenal output. Here's brief a breakdown:

Symptoms​

Adrenal crisis (2013-2014):

- Severe blood sugar fluctuations and reactive hypoglycemia
- Debilitating cognitive impairment and performance
- Neurological issues
- Chronically low body temperature
- Bedridden, eventually completely regained ability to walk a few months post-adrenal crisis
- Breathing difficulties
- Frequent urination
- Low libido, erectile dysfunction
- Pale, anemic-looking skin
- Excessive sleep, possibly chronically low cortisol levels
- Steady weight gain

Evidently I experienced a critical adrenal crisis, which I didn't quite comprehend at the time. I never sought any medical treatment and eventually most of these symptoms improved. This was probably Stage 3 of adrenal fatigue, possibly bordering Stage 4. There were moments when I felt like I was dying, I was physically present yet emotionally and mentally incredibly detached and confused. I can't remember much of this period, my memory was severely impaired and I struggled to enjoy simple conversation and social interaction. I toyed with the idea of adrenal fatigue, or even possibly a stroke, but I wasn't aware of saliva cortisol tests or even the term 'cortisol' for that matter.

Today:

- Mild hypoglycemia, there are periods when it isn't noticeable
- Moderate cognitive issues, still somewhat debilitating
- Rapid weight gain, almost 70 lbs gained since my adrenal crisis
- Inability to exercise without being depleted or experiencing acute adrenal fatigue symptoms
- Social anxiety
- Inability to cope with stress, typically followed by a crash
- Depression
- Poor stamina and sex drive
- Poor dental health; cavities, weak enamel etc.

As you can see, it's still pretty dismal. I did not recover as quickly as I expected, considering a period of almost two and half years of rest, nutritional balancing/nourishment and minimising stress.

Complexity
​

Even during the early stages of my adrenal crisis, I attempted supplementing with desiccated adrenal and thyroid glands, several minerals and vitamins and even hormone replacement. I reacted more severely to hormonal replacement supplements and glandulars, but even magnesium and vitamin D aggravate many of my symptoms. I have even recently reattempted to supplement with pregnenolone, DHEA, adrenal cortex, magnesium, B complex and B5, with the same results. There really isn't much research regarding paradoxical reactions. Dr. Lam acknowledges such reactions but doesn't provide any explanation for them, and why many people recovering from such critical states of fatigue experience them later in their recovery. Perhaps it's insufficient cortisol, or underactive receptors/neurotransmitters. The only thing I have not experimented with is adaptogens/herbs.

Any experiences with increasing cortisol levels? What has worked for you?

 

[JaimeS]

Hi, Mike! Welcome.

I reacted more severely to hormonal replacement supplements and glandulars, but even magnesium and vitamin D aggravate many of my symptoms.

You will find that is unfortunately somewhat typical of this patient subset.

There really isn't much research regarding paradoxical reactions.

Maybe not officially, but there is a LOT of anecdotal information here. Search practically any medication and you will find a thread entitled, "overreaction to X?"

The only thing I have not experimented with is adaptogens/herbs.

If you overreact to supplements, you may find that generally, you will overreact to herbal medications, too. Or perhaps you won't; but again, this is the experience I've noted in myself and in others here. There are a few that have worked out for me. No matter what, you are going to want to start with doses so low you do not believe that they could possibly be effective, and gradually increase until you experience improvement. "Start low and go slow" is the motto, here.

Regarding cortisol, you will find it is a somewhat contentious topic, here, and is nearly guaranteed to start an argument. Some swear by it. Others, myself included, crash when taking a small dose (or small according to my endocrinologist at the time - NOT small according to our somewhat ridiculous over-reactions to medications.)

I would not recommend Glycerrhiza glabra (Chinese licorice) if you have aldosterone issues (frequent urination). Though I was taught at one point that licorice contained glucocorticoids, it apparently blocks them actually. (We had this conversation on the boards quite recently.)

I have a post here which includes a discussion of what I take now, which includes some comments about adaptogens.

Welcome again!

-J

 

[heapsreal]

I found when first supplementing with pregnenolone and dhea its best to start with one of them and low doses which i slowly increased over several weeks. Than introduced the other hormone the same way.

with pregnenolone 5mg was enough and sometimes i could only tolerate it every second day. Now i can tolerate full doses of dhea (25m)and pregnenolone (50mg).

 

[minkeygirl]

Sorry I can't read your entire post. My NP put me on Licorice Solid extract, start with 1/8 tsp and go up to 1/4. 500 mgs Pantothenic acid.

I can't say it's helping much.

I felt a boost from pregnenolone then crashed hard a few hours later. No matter what dose i was on.

 

[Mikee5]

If you overreact to supplements, you may find that generally, you will overreact to herbal medications, too. Or perhaps you won't; but again, this is the experience I've noted in myself and in others here. There are a few that have worked out for me. No matter what, you are going to want to start with doses so low you do not believe that they could possibly be effective, and gradually increase until you experience improvement. "Start low and go slow" is the motto, here.-J

I found when first supplementing with pregnenolone and dhea its best to start with one of them and low doses which i slowly increased over several weeks. Than introduced the other hormone the same way.

with pregnenolone 5mg was enough and sometimes i could only tolerate it every second day. Now i can tolerate full doses of dhea (25m)and pregnenolone (50mg).

Since my DHEA is low, I have experimented with oral and transdermal pregnenolone and oral DHEA at the smallest doses, around 2.5mg (1/4 of a pill!). It definitely aggravates my symptoms, I start developing acne, become irritable, fatigued etc. It also induced insomnia, which makes me suspect that the pregnenolone is perhaps increasing my cortisol levels too much. I tried to stick to the lowest possible doses for at least a week, but experienced continued decline in my symptoms. I also took pregnenolone upon waking, which is generally advised, and at different times of the day with the same effects. Perhaps my adrenals are so weak that I just can't respond to treatment (despite having an adrenal crisis more than two years ago).

At times I reflect on these dismal, miserable and dark two years that have robbed me of my youth and I wish euthanasia was legal in my country.

 

[drob31]

Pregenolone turned my brain back on, but I had to go pretty high 100 mg/day. Eventually I felt better when I stopped using it after a few months. Now I feel like I may need it again.

What's wrong with using small doses of cortisol to assess you reaction? My doctor remarked that when people have severe cealiac symptoms, doctors give 60 mg/ prednisone for 6 months without batting an eye. So what's the harm in trying 2.5-5 mg 2x a day as a trial to see if it helps.

The question is, why do you have adrenal fatigue? The answer is that it has nothing to do with the adrenal glands not working, unless you truly have addison's disease. It's likely that you have a reactivated/newly acquired virus/secondary opportunist bacteria/ and or parasite that's the root of the problems. Your immune system may be immunocompromised allowing the pathogens to exert just enough of an effect to alter your hpa-axis, and cause fatigue related symptoms.

Have you had the following labs?

Free t3
Free Testosterone
Vitamin D
Vitamin B12
Iron/Ferritin
CBC (WBC important)
CD57
Any autoimmune tests?

One way this happens is via hypercoagulation. The pathogen(s) trigger a coagulation cascade, your blood becomes thick, it's a runaway reaction and stays thick, trapping the pathogen in a layer of fibrin. Until you can get rid of the pathogen your body continues to malfunction, and you have symptoms.

 

[JaimeS]

Since my DHEA is low, I have experimented with oral and transdermal pregnenolone and oral DHEA at the smallest doses, around 2.5mg (1/4 of a pill!). It definitely aggravates my symptoms, I start developing acne, become irritable, fatigued etc. It also induced insomnia, which makes me suspect that the pregnenolone is perhaps increasing my cortisol levels too much. I tried to stick to the lowest possible doses for at least a week, but experienced continued decline in my symptoms. I also took pregnenolone upon waking, which is generally advised, and at different times of the day with the same effects. Perhaps my adrenals are so weak that I just can't respond to treatment (despite having an adrenal crisis more than two years ago).

At times I reflect on these dismal, miserable and dark two years that have robbed me of my youth and I wish euthanasia was legal in my country.

I can't tolerate anything that increases my cortisol, @Mikee5 ... you're not alone in not responding 'typically' to replacement therapies.

-J

 

[JaimeS]

One way this happens is via hypercoagulation. The pathogen(s) trigger a coagulation cascade, your blood becomes thick, it's a runaway reaction and stays thick, trapping the pathogen in a layer of fibrin. Until you can get rid of the pathogen your body continues to malfunction, and you have symptoms.

Never heard this explanation for low ESR in PWME before, drob31! That's very interesting! Do you have a citation?

-J

 

[Mikee5]

Pregenolone turned my brain back on, but I had to go pretty high 100 mg/day. Eventually I felt better when I stopped using it after a few months. Now I feel like I may need it again.

Great. Sounds like you can tolerate pregnenolone, and it benefited you at much higher doses. I struggled with 5mg, so I can't begin to imagine how much 100mg would effect me physiologically. I would have probably reverted back into my pre-recovery-adrenal-crisis state with the overwhelming amount of hormones flooding my endocrine system.

The question is, why do you have adrenal fatigue? The answer is that it has nothing to do with the adrenal glands not working, unless you truly have addison's disease. It's likely that you have a reactivated/newly acquired virus/secondary opportunist bacteria/ and or parasite that's the root of the problems. Your immune system may be immunocompromised allowing the pathogens to exert just enough of an effect to alter your hpa-axis, and cause fatigue related symptoms.

Candida, poor gut flora or parasites are not the root causes of all disease and illness. I'm pretty sure that I had developed borderline Addison's Disease back in 2013, as my adrenal crisis had made my body so fragile and weak and it was so sudden. My body was deprived of glucose and I was running 5 miles every night for an entire week. The ketogenic diet I embarked on theoretically induces starvation mode within the body, and eventually relies on fat as a source of fuel, or fat adaption (a coined hypothesis with no real scientific credibility and is a dangerous parroted marketing term within the low carb community). My vulnerable, malnourished body at the time obviously could not cope with the increased demands in cortisol and adrenal hormones during a period of physiological stress, so my adrenals were profoundly effected and impaired, and it made me acutely symptomatic.

Bad bacteria, poor digestion and spontaneous 'viruses' clearly had no role in this event. It was a combination of a history of anorexia and fluctuating weight gain that had impaired my metabolism and made me more vulnerable to adrenal fatigue, and consequently accelerated this adrenal crisis.

I took probiotics about a year ago to address some digestion issues and acne. Both cleared up immediately with a high dose, but it barely had an impact on my weak adrenals or my symptoms. During this period I had probably successfully restored some of my gut flora, and it evidently didn't help.

Have you had the following labs?

Free t3
Free Testosterone
Vitamin D
Vitamin B12
Iron/Ferritin
CBC (WBC important)
CD57
Any autoimmune tests?

I took full thyroid panel test around this time last year. My T4 was borderline low, indicating hypothyroidism. However, supplementing with T4 induced (yet again) a paradoxical reaction (once that lasted for at least two months). Everything else was fine.

All other tests indicated optimal levels, like a conventional blood test that included iron levels, B vitamins, minerals etc.

 

[Grigor]

Very interesting. I'm the same as the OP. Wish I could find something that helps.
It's driving me nuts... Tried HC but also was exhausted with it. And at the end of the week panic attacks.