Thyroid UK

HC always best for treating adrenal fatigue?

I hope it's ok to ask questions about adrenal fatigue here.

I have been on Medrol for the past three years for adrenal fatigue (prescribed by a Hertoghe doctor). I was told the reason I could not take hydrocortisone (HC) was because I tended to retain fluid (this was when I was still on T4 drugs only). However, now I have read that HC will not cause fluid retention if dosed properly, and that HC is always preferable to Medrol or Prednisone.

Since I could not get my doctor to prescribe HC for me, I ordered it myself and had such high hopes for it...but I just cannot seem to make it work. I seem to feel much more stable on Medrol. I feel best on 6 mg of Medrol daily, although I have gone back to 4 mg in recent months with the aim of eventually weaning off it completely. 30 mg of HC do not have the same effect on me at all.

The HC brand I've been trying is called Hisone.

The way I feel on HC, I am not sure I will ever be able to feel as well on it as I have on Medrol. I think Medrol has to be converted into cortisol by the body?

Since I've been on Medrol more than three years, and am unable to stop all adrenal support, I guess adrenal fatigue is not so easily cured as is sometimes said...?

I have also tried a lot of OTC products for adrenal support (chisandra, rhodiola rosea, licorice root etc), but so far without any results.

22 Replies

It is difficult to follow natural fluctuations of cortisol so with HC it is about finding the right way to take it. Some people do better by taking more in the morning.

Some people never find a perfect time to take it. Sorry I cannot help more.


You're not supposed to follow the natural fluctuations of cortisol with HC unless you have Addisons. Someone with adrenal fatigue should just take it first thing in the morning and again at lunchtime. But never after 1.0 pm.


Thank you so much!!! I have been multi-dosing, taking it four times a day, the last time around 5 pm...I have been careful never to take more than 10 mg at any time.

Then, I gave up for lack of results, and am now back to Medrol (currently 6 mg daily, all taken in the morning).

No, I don't have Addison's, I "only" have adrenal fatigue caused by long-term hypothyroidism.

Greygoose, in your opinion, is HC better than Medrol (prednisone was never an option as my doctor does not like it)?

Is it true that you should never take more than 10 mg of HC at any time? I took 6 mg of Medrol for a while and did great on it. I decreased it to 4 mg daily because 1. I thought I could eventually wean off it and 2. because I was afraid of complete adrenal suppression (my doctor said I could safely go as high as 6 mg daily as that equals 30 mg of HC).

I recently raised it back to 6 mg daily again because I was having symptoms like fatigue, depression, and moodiness...and they all went away within 48 hours after raising Medrol again. So, in my case, it's clear that I cannot go too low on the adrenal support.

Let's say, just for the sake of argument, that I need 30 mg of HC daily (provided I do as well on it as on Medrol)? How should I then dose it?


20 first thing in the morning, and 10 at lunchtime. But that's not really a high dose. My doctor put me on 40 in the morning and 20 at lunchtime - and he said I could take more if I felt I needed it, but never after 1.0 pm.

HC isn't the same as T3, or NDT. Taking 10 four times a day isn't likely to do anything. You have to understand why you're taking it : you taking it to give the adrenals a helping hand - taking the load off a bit - at their busiest time - i.e. the morning, when they've got to get you out of bed and doing. Then they can cope by themselves for the rest of the day. That way, there is no risk of your adrenals shutting down permenantly, because they have to cope by themselves for the rest of the day. If you try to follow 'natural fluctuations', they are going to shut down, because they have nothing to do. And once they shut down, that's it!

I've never tried Medrol, or any other kind of treatment, so I can't make a comparison, I'm afraid.


Thank you SO MUCH, Grey Goose!!! You gave me just the information I needed! I can NEVER thank you enough!!!


You're more than welcome, thecat. :)


Over here it is prescribed based on your needs. And people do take it after 1pm as well if they feel it fits.

Like divide the dose to three and stress dosing if necessary. Some do better that way. Same with taking t3 4 am and then back to sleep.

And no addisons just adrenal fatigue.


Well, that's the way I was taught to do it by a Hertogh-trained doctor, and it makes sense to me.

But the test of the method is whether or not you're able to come off the HC, or are you stuck on it for life?


Well people have weaned off hc successfully what I know. They are on it for short period mostly especially when on lio. Some might have has back up hc in case they need it for example after stressful event or illness.

But naturally they are also recommend to follow daily rhythm with eating to support adrenal glands.

Like that is why we have that rhythm at school and in many work places to follow the natural ups and downs.

Breakfast before 8. ( even tho sleeping until 10 is best for people with adrenal fatigue as then you don't use up cortisol produced in the morning)

Coffee break 9.30 am , lunch 11.30 am. Coffee break 2 pm, dinner 6 pm , snack 9.30 pm and be in bed before 10.30 pm.

But since people are individuals and have different type of daily schedules and times to work they have had to adjust the dosage a bit. Like taking it in the morning and around lunch and then third tiny dose around 2 or 6 when cortisol levels can dramatically dip.

But like I said these are people I know that are on lio are put on hc for short period of time. I don't follow local forums a lot as they are quite quiet and getting support is sometimes hard.

Naturally there can be people who aren't able to wean off as they have been guided /treated wrongly.


Well, we do not have that rhythm in France. Anywhere. I dread to think the reaction you'd get from your boss if you said you wanted a coffee break at 9.30. Most people Don't start work til 9.0.


Oh I see. Then it is only finnish system that is build on that rhythm.

Of course not all jobs star at 8 but school day, office work etc does.

7.5 hrs day you get 2x10 min coffee break and 20-30 min lunch.

When people have a job that does not follow those hours they are recommended to eat a snack those hours if possible so adrenal glands cab rest any not forced to push out extra cortisone to compensate drop of blood sugar as that usually is the issue with poor adrenal glands.


That's helpful, thanks! However, if you take HC at lunch, and then again at 2 pm, is there really enough time between doses?

So how should HC be spread out throughout the day? 10-10-5 if you take 25 mg daily, and 10-10-5-5, or 10-10-10 if you take 30 mg?


Sorry Greygoose, this question was for Justina! The second part of my question is not relevant, anyway, as you have already replied to it above! Sorry, I'm kind of confused right now...!


That's OK. lol I can imagine you must be confused. :)


It has either been split as you suggest or 12.5 -7.5 -5 or so. But there seem to be as many variations as there are people suffering from adrenal issues.

What greygoose suggests might as well be the right way to do it, as I think her doctor actually is one of those good doctors. But then again it might all depend on the severity and other health issues what works for each person. Naturally other medication might affect one as well. Like I have read that SSRI's causes adrenal fatigue and so on.

People I know , like I said , have been following proper diet to give adrenal glands the needed rest. They also been doing mild exercise that supports adrenal glands and fixing their personal issues, for example getting rid of negative people in their life and so on. There are so many variables in ones life that there might not be one correct way to do it.

Like some of these people have been eating liver/kidneys and say it has worked with HC. Bone broth is also recommended.

Altogether I think it comes down to severity of adrenal fatigue as there are many stages of it.

I have no experience of HC as I did not want to use it. Took 2 years to "fix" the issue. For two years I had steady low level from the morning when I took the cortisol saliva test twice. Third test finally showed normalized levels, but it was bumpy road and I am still not healthy, but at least I know proper diet and life style was actually the answer for me. It proved what I had learned about the importance of eating well and find peace in mind.

I used to end up arguing quite easily feeling the adrenal shots, heart pounding, sweating etc. I gave up on that, if somebody tried to piss me off I walked away. I refused to argue that way. I looked for possibilities to laugh, I watched tons of funny videos on youtube just to laugh, I laughed with friends even to things and jokes I used to think were stupid.

I am fortunate person living close to the most beautiful nature. I used it, I walked in the forests and enjoy picking berries. Alone (with some lurking bears :P) . They say walking in the nature for 15 minutes works better than antidepressants, lowers your blood pressure and stress levels.

Sorry for long response and rambling lol.


How did you fix your adrenals? What I would like to ask you and others is if there are really good OTC products out there; adrenal cortex or whole adrenal?


I was told to take hydrocortisone 6am and 6pm


Can't see the point of that. You Don't need it at 6 pm, your adrenals are slowing down ready for you to go to sleep. They need help in the early morning, when they have to get you up and ready for the day. Has it helped taking it like that?


Hi grey goose, I am only on day 3 of hydrocortisone. Not a clue yet. Getting a whole host of symptoms too early to say what is what yet. Got to give it at least 28 days.

Hydrocortisone is all new for me bit too new.


When I started HC, I felt wonderfully well that very day, didn't have to wait 28 days to know it was helping. Be interested to hear how you get on, and how you're sleeping. :)


I will keep you upto date with how I do. My main symptom so far is very easily panicked.


Know it well! lol

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