Do I need adrenal supplements?

[ancientprune]

3 years ago I had a cerebral stroke but no residuals,thank God.My herbalist saw my bloodwork and said my adrenals were weak and put me on adrenal cortex 100 mg.2 years ago I was diagnosed with PMR and put on 15 mg pred.By Feb.,this year I was down to 4mg and had a magnificent flare which put me back to 8mg.Now I'm tapering again and am down to 6.5mg.When I had the flare I also stopped all supplements because of severe gastritis but have resumed the vitamins and adrenal cortex which I reduced to 50mg.All my docs know I'm taking this and haven;t remarked one way or another.After finding this forum and reading the wonderful information I'm wondering if I should continue or stop the adrenal supplement.My rheumatologist is not very keen on my questions and GP doesn't seem to know much about this condition.I've learned more here than at both their offices.Thank you all for the kind help

[SnazzyD]

Hello, so as I understand it the main ingredient of adrenal extract is hydrocortisone, something that is given to those who have very little ability to make their own cortisol. Take too much and it’ll help suppress function. Taking it while on doses above 8mg of Pred would be pointless because the adrenal function has shut down because the body is awash with artificial cortisol and doesn’t need to work. Taking adrenal extract would be just taking more steroid on top. If you keep taking it, your adrenal glands have no reason to make all their own cortisol because it is coming from the extract and they may not regain their proper function. So if you ever want to have your own adrenal function without relying on pills, you will have to taper off both. If you were to stop the extract now, I expect you might feel some effects of withdrawal as it is a weak steroid but you still have some backup from the Pred. It would be good if you had the advice of an endocrinologist and perhaps a Synacthen test to check if your adrenal glands are capable of working on their own after all the extract before PMR and a plan for reducing both at once or separately without having an adrenal crisis. The test can’t be done until you are 4mg or less of Pred but the extract will complicate the picture. Anyway, this is just my view and you’ll get others I’m sure.

[ancientprune in reply to SnazzyD]

I really want to be off the supplement by the time I get to 5mg in 4 months but i'm not sure how to do it.It's a 50mg capsule so I think I might have to decrease 1 dose a week or do i just stop alltogether?

[SnazzyD in reply to ancientprune]

You really need some qualified advice but it appears your docs are not wanting to think about it. Adrenal function is not PMR so really lack of knowledge about PMR isn’t really an excuse not to try. If I were to choose, I’d try to stop the weaker cortisone, the hydrocortisone, and see how you go. If you are ok with that, then think about the stronger one, the Pred afterwards because that has a greater effect. I hope your adrenal function hasn’t been encouraged to not bother because the supplement has been taking up the slack for so long. Really, if the herbalist thought your adrenal function was so poor that you needed supplemental hydrocortisone they should have tried to diagnose the cause.

[PMRpro Ambassador]

I agree with all that Snazzy has said already. The only thing that encourages the body to make its own cortisol is there not being enough present in the body - just like the factor that turns on a functioning central heating boiler is that the thermostat detects the room is too cold for where it is set. If you set the thermostat where you need it and then provide some other form of heating in the room the thermostat just say "warm enough" whether it is a wood burning stove or an electic fire. In the same way, taking artificial corticosteroids medically or supplements such as adrenal cortex also signal to the body it need not make any more.

There are no "supplements" that encourage adrenal function - a good diet and self-care with possibly lifestyle adjustments are what create a healthy body. Very concerning is that supplements are not subjected to the same monitoring, checks and controls that prescription drugs are so anyone who criticises Big Pharma but buys supplements as "better", even from apparently respectable companies does not necessarily know what they are putting in their bodies. "Adrenal cortex" supplements are based on a chemical that is made from the adrenal glands of slaughtered cows, pigs, and sheep and which contains a lot of things that probably don't appear on the label (see the second link).

It is one thing to be diagnosed with adrenal insufficiency, whether primary due to a medical condtion or secondary due to taking pred - but the way to deal with it is not with expensive supplements of doubtful provenance. The claimed diagnosis of adrenal fatigue is questionable - and usually used to make a profit at your expense.

healthline.com/health/why-y...

pubmed.ncbi.nlm.nih.gov/295...

hormone.org/diseases-and-co...

[ancientprune in reply to PMRpro]

Can I reduce the supplement one capsule a week or just stop it?

[PMRpro Ambassador in reply to ancientprune]

Really don't know - how many do you take? It will all depend on how much corticosteroid there is in them. That is the problem with supplements, you often can't tell.

[ancientprune in reply to PMRpro]

I 'm taking one 50mg capsule in the am and would like to just stop

[PMRpro Ambassador in reply to ancientprune]

If it were me I might take it on alternate days for a couple of weeks and see how you get on and then cut down the rest slowly.

[Thelmarina in reply to ancientprune]

I would ask a pharmacist in the first case, then try a different GP in your practice and explain your worry and that you want advice. It’s good that you are aware of what’s going on and that you can now get back on track. Nothing you’ve done is going to kill you so don’t be scared! 👍xx

[ancientprune in reply to Thelmarina]

Thank you for the advice.I have been scared but this forum has helped so much and I so appreciate it