I did extensive research on adrenal insufficiency over 20 years ago now, relying primarily on a book written by William Jeffries, M.D. He made a career out of researching low-dose hydrocortisone supplementation, and was able to show how it improved a wide variety of health issues. I still take 20-25 mg/day of Cortef after all these years, and am not aware of any adverse effects.
Here's a quick review of some of my baseline understanding:
The body normally makes approximately 40 mg of cortisol/day. Most steroid medications such as Prednisone are altered and revved up versions of the body's own cortisol molecular structure. Every mg. of those medications is roughly equivalent to about 4x the body's natural cortisol. So if you're given a dose of lets say 50 mg. prednisone, that would be equivalent to 200 mg. of natural cortisol. That's a lot, roughly 5x more than your body produces in a day.
If you continue taking that for too long, the body's adrenal glands will quit producing cortisol altogether. However, if you take less than 40 mg.of bioidentical hydrocortisone, (called low-dose hydrocortisone therapy), the adrenal glands will not shut down, but "may" reduce cortisol output depending on the needs of the body. I myself have been doing low-dose hydrocortisone (10-20 mg/day) for many years, with no problems.
The body normally responds to any kind of injury by increasing its normal levels of cortisol to facilitate the healing process. My best guess is it's rarely the equivalent of 200 mg, but I could be wrong. The point I'm getting to however, is that I believe it's safer to do relatively low-dose bioidentical cortisol than to do the artificially created revved up versions. BTW, each of those steroidal medications has a different molecular structure, not because they're superior, but because it allows pharma companies to have their own particular patent.
How much bioidentical cortisol to take? Based on my experiences, if I feel my body needs some extra oomph, I will increase my normal low-dose hydrocortisone. I've experimented a lot, and can easily take a total of 30-40 mg with good results. On a few occasions, I've taken 70-80 mg. for 3-5 days, again with good results (and no ill effects). It's a fair amount, but it appears to be less than normal prednisone prescriptions, and almost assuredly much safer. It also feels like it's in line with what the body might do naturally to help a healing process.
I have my own prescription of hydrocortisone (called Cortef). However, it's a relatively benign "drug" that can be purchased from online pharmacies without a prescription (at least it used to be available). If I was in a position where I was seriously contemplating temporarily increasing my cortisol levels, I would opt for the bioidentical cortisol over the souped up pharmaceutical versions. It would give me a lot more control, and the risks of side effects would be much less.
One indication that I've reached my limit on how much to take is when my face starts to look flushed. Once I've reached that point, I always stop taking any more for the day. I rarely do more than 25 mg in a single day, and it is extremely rare that I take over 50 mg. But I know that if I absolutely positively have to get through a day of intense activity, I can do it. Taking this much for a few days is not going to be problematic. Only if it starts running into weeks and more does it cause significant imbalances.
You might find the following post interesting. In the lengthy post, Dr. Thomas Levy describes how he discovered while recovering from COVID that he had adrenal insufficiency, and how supplementation did wonders for his health. To the point where he felt healthier after COVID than he had for many years prior to getting COVID.
-- Since you're exploring Mary's butterfly hug, I suspect you'd be open to an interesting video. The young woman has some pretty fascinating things to say about brain function, and demonstrates a simple technique that she says can improve brain function significantly within a matter of weeks. (I often notice subtle and relaxing shifts while I'm doing them).
Personal Recovery Stories Involving Qigong
Insights on Qigong for ME/CFS
