My understanding of treating adrenal fatigue

Ema

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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.
I know it from speaking to hundreds of people who have worked through many of these issues. It makes me feel really sad when someone with demonstrably low cortisol on a saliva test is given a tiny dose of HC and fails to improve or feels worse when a full replacement dose could help that person start living life again. Time and time again these same issues come up and a change in form to a longer acting steroid (common issue for those of us with concurrent viral/bacterial infections) or a change in dosing makes all the difference in the world.

I would never advocate for one-size-fits-all treatment but there are common places to start based on experience and judgment. I would also never blame anyone (except possibly ignorant doctors who don't know enough about hormone replacement to help guide their patients through it). The only point of any of this is to feel better by properly supporting the endocrine system dysfunctions.
 

Ema

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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.
Let's not argue over semantics. Taking a full replacement dose of HC (if warranted by testing) can allow for a re-set of the HPA axis and I would call that healing.

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.
Well, here I am (though I had low cortisol and not mild)! I've suffered from ME for over 10 years and taking HC, thyroid hormone, and other sex hormones has changed my life dramatically. It was what allowed me to start making progress on the methylation protocol and antibiotic/antiviral therapy and not suffer from "die-off" that was intolerable.

I would agree that those who only have mild hypocortisolism likely do not need HC and could be better served by adaptogens and basic nutritional vitamins (such as B, C, D, etc).

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.
Only if you assume that the endocrine system dysfunctions are for life...are the research on those with Addison's simply doesn't support that thought. Many people successfully wean from HC, especially once methylation defects and infections are addressed. If the other "legs of the table" remain weak however, I can see where one might have trouble weaning from steroids.

The biggest issue with having relatively low levels of cortisol is increased inflammation, but this can be treated with much safer drugs and supplements.
Well, obviously I disagree that inflammation is the biggest issue when low levels of cortisol can actually cause a crisis and kill you. That's how important cortisol is...but yes, inflammation is an issue for many and taking hormonal support does not preclude using other measures to address it (like turmeric, krill oil, and other anti-inflammatory agents).
 

heapsreal

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All i can say is having balanced hormones can only be helpful or why would they bother testing them.
some people dont react well to HC and others do, but your not going to know unless you have a go.
There are alternatives before trying HC like adaptogens which has been mentioned but also other hormones like pregenolone and progesterone can help will low cortisol levels too. I wouldnt close the book on HC unless i have been tested as having optimal levels and tried it first. Everyone reacts differently to drugs and supps.
 
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I never had much luck with adrenal "fatigue" protocols. The Wilson's programme caused me to crash badly, most of his supplements felt like stimulants. DHEA makes me feel slightly better but gives me heart flutters after a while.

And I don;t seem to be alone http://www.raysahelian.com/dhea.html



In my case inflammation is directly linked to the problem. Anti-inflammatory herbs have the best effect on my hormones and sense of well-being without the uncomfortable side-effects of adrenal stimulants.
I've had bad luck with Adrenal supplements in the past as well. Licorice supplements make me feel horrible, as did the 'Adrenal Stress End' by Dr Jacob Teitelbaum. Taking these gave me the worst CFS crashes, they type of feeling/symptoms I'm always trying to avoid.

This may be a clue for me. Maybe my problem is over-reactive adrenals. I need to find out a way to moderate their output.
 

xks201

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If you truly have adrenal fatigue of any degree that is clinically measured on a lab test, nothing is going to help except maybe licorice in minor cases because it lessens the decay of cortisol. If someone has true adrenal fatigue most of the time they will be deficient in more than one adrenal hormone. And most people who are deficient in more than one hormone are deficient in several.

Most people who develop these spontaneous endocrine problems probably have autoimmune polyglandular syndrome, or have infection which is exhausting the endocrine system.
 

alice111

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@heapsreal given this original post was a while back do you still find that these things work for you? Have you had any other changes in thoughts? I ask because I had some positive improvements in energy with cortisol but had to come off it due to severe anxiety which outweighed the energy improvements... I feel like it is something I need, but that it needs to be balanced, or I have to go about it another way?
 

heapsreal

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@heapsreal given this original post was a while back do you still find that these things work for you? Have you had any other changes in thoughts? I ask because I had some positive improvements in energy with cortisol but had to come off it due to severe anxiety which outweighed the energy improvements... I feel like it is something I need, but that it needs to be balanced, or I have to go about it another way?
What I use currently is transdermal pregnenolone and testosterone every morning. Dhea pills 25mg morning and night. I think they help as I feel a lul when not on them. Not a cure but every little thing helps.

occasionally I can tell pregnenolone is causing sleep problems. Almost feels like its building up in the system. So if this happens I take a night or two off.

hope that helps.
 

drob31

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I think HPA-axis dysfunction is a co-morbid consequence of another medical issue. Something is causing dysfunction, which can be high cortisol or low cortisol, or even a maladapted rhythm

I think if this underlying issue is addressed, normal levels and this rhythm can be restored. For example, it could be high levels of TNF-a, IL1 beta, and IL6 cytokines that are causing inflammation leading to high cortisol. It could be SIBO releasing high amounts of ammonia which are converted to NO and eventually downstream oxidants thus causing the high cortisol response.
 
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I currently take low dose Hydrocortisone daily along with Fludrocortisone, Sea Salt, SRPotassium and Naturthroid Thyroid.
I recently did 23andMe and discovered I have CBS mutations, MTHFR, and a list of others. I would like to treat these but wonder if I need to stop the meds I'm doing now to do that. I believe these mutations are what is causing me to have problems with my thyroid med not working to its full extent.
Does anyone here have any experience with this?
I'm sorry if I'm intruding on the conversation, I'm new here and have been reading and kind of lurking (I guess) trying to find a solution to my problem.
These meds have given me my life back......to a certain extent........I would just like to improve and hopefully try to get off the meds if at all possible.
Thanks to any and all.
 

Valentijn

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I recently did 23andMe and discovered I have CBS mutations, MTHFR, and a list of others.
The CBS mutations listed by Yasko and GeneticGenie are not capable of causing problems. MTHFR mutations for C677T and A1298C are extremely common, and usually do not cause problem except during pregnancy when not getting enough dietary or supplemented folate.
I believe these mutations are what is causing me to have problems with my thyroid med not working to its full extent.
I don't think there's any scientific evidence showing that methylation SNPs impact thyroid function, nor even a rigorous theory for how that might happen biochemically.
 

bertiedog

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Having just joined Livewello.com and having received my report I have just looked through the Chronic Fatigue Syndrome section and find I am homozygeous for many of the listed genes. One thing in particular caught my eye and that is I am homozygeous for 2 SNPS on NR3C1 which is the glucocorticoid receptor.

Does anybody know if this could partly explain my need the 6mg Prednisolone from the age of 52? In an explanation that I have read it mentions glucocorticoid receptor resistance but I still am not sure what this would entail.

If there is a link I would find it fascinating.

Pam