Thyroid UK
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Does anyone take hydrocortisone?

Hey guys,

sorry to ask two questions in one day. But I have incredibly low cortisol, and mild hypothyroidism. I want to start on a thyroid supplement, but am terrified of making my adrenal situation worse (it's really, really critical. I can barely function and don't want to end up in Addison's territory, though I suspect I'm already there.) Do you guys have any advice for me? Do you think supplementing cortisol might be a good idea?

Thank you,


4 Replies

I do. In fact I am just beginning. My cortisol is low and I decided to do it and take hidrocortisone as nothing else worked. I heard that without proper adrenal function thyroid hormones I am taking can't work either.

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If your cortisol level is so low you risk an adrenal crash if you start treating your low thyroid function.

In fact it is very possible that your low thyroid function is a result of the low adrenal function, as the body tries to slow you down in order to give your adrenals a possibility to heal.

Addison is an autoimmune disease and not the same as low cortisol because of adrenal exhaustion/stress.

You could try and read (Google) the articles from dr. Lam about adrenal fatigue. Very enlightening.

I too had critically low cortisol a couple of years ago 129nmol/l. (Addison <99nmol/l) I took for a period dessicated adrenal cortex, but didn't want to continue, because of potential side effect by long term use, even though the risk of side effects are low when it's given as a substitute for your own.

I now have been on LDN ( for two month and have improved in energy, sleep and mood.

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Hi Emma,

I too have low cortisol (daily profile is as flat as a pancake), and thyroid is not 100%. I take bioidentical hydrocortisone from Regenerative Nutrition - was on 20mg/day, now down to 5mg. It's best to keep your dose in the physiological range - ie close to what the body might produce itself - so avoid exceeding 20mg/day. High doses can suppress your adrenals' own natural hormone production. Start low and see how you feel after a week or two before adjusting. I also take adrenal cortex (Dr Wilson's Adreno Max) which has the constituents to help rebuild the glands (and maybe some hormones too). You can get this online. Don't expect instant miracles. My adrenals were in a very poor state after a major "crash" and it's taken 2 years to crawl into the very bottom of the normal range. There is excellent practical advice in Dr James Wilson's book "Adrenal Fatigue - the 21st Century Stress Syndrome".

Goods luck!



Thanks for this reply, Xanthe. I'm very encouraged by your story - from what people keep telling me taking corticosteroids is like a downward spirall that i'll never be able to get off of. That you've lowered your dose makes me think that there is hope! Did anything else help to heal you? Everyone says sleep but that's the problem...I cant! I wake up at 4am almost every night.


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