Thyroid UK
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adrenal fatigue and how to treat it

I was on Medrol (4-6 mg daily) for four years, after being diagnosed with adrenal fatigue by a Hertoghe doctor in Belgium. I weaned off it more or less by mistake; one day, about two months ago, I was going to the lab, and was not supposed to take any meds before that, and then I just decided to wait and see how long I could last without it...until then, I started feeling worse within 24 hours off Medrol. Now, I felt ok, even after two days. Time went by, and now it's been more than two months off Medrol...and I guess I am doing ok.

Since going off Medrol, I have been reading a lot about adrenal fatigue. My hormone doctor says I will need to be on adrenal support (Medrol) for the rest of my life. However, most of the articles I have read about adrenal fatigue claim that is wrong, and that you should only be on adrenal support (be it hydrocortisone, prednisone, or methylprednisone) for a maximum of six weeks or six months (depending on source). Most if not all sources seem to agree that if you need to stay on adrenal support longer than that, you don't suffer from adrenal FATIGUE, but adrenal INSUFFICIENCY.

The reason the doctor put me on Medrol, rather on HC, in the first place, was because I tended to retain fluid (which, of course, could also be because I was hypothyroid as long as I remained on T4 meds only). Anyway, I think Medrol is very convenient, as it only has to be taken once daily, unlike HC which has to be multi dosed.

There are several things I have been wondering lately. First, given the long half-life of Medrol, should it be taken at bedtime rather than in the morning; I would imagine that, if you take it at bedtime, cortisol levels will peak in the morning?  I never even thought about taking it at night but, on second thought, maybe I should I understand Medrol is pretty slow-acting compared to HC.

Secondly, I'd be interested to know if anyone here has had to stay on adrenal support (for adrenal fatigue) longer than the recommended six weeks or six months (depending on source)? I guess what I mean is: is it possible to end up depending on adrenal support for the rest of your life, even if you don't suffer from adrenal insufficiency?

14 Replies

Yes I was in same position as you.

can I text you later or pm you later as I am very unwell at this moment and my concentration is very poor at moment.



Of course, please pm me and do it whenever you feel up to it:-)


Anna... I take the herb Holy Basil to reduce cortisol in my body. Works excellent for me. My panic attacks have lessened considerably, and hot flashes have gotten better. I take one a day. Have been doing for about a month. I dont know that i will need forever, but i imagine if i stop, the panic attacks will return. I think there is something off in my brain physically. 


What dose of holy basil do you take please?


Thank you, interesting!  The fact is that I have been having those very symptoms you describe, so I think I'll try holy basil and see if it helps. I'd appreciate info on which brand you're on.


I've been on HC for two and a half years.  Initially I was on 25mg plus 4 Nutri Adrenal Extra.  In the last six months I've reduced gradually to 12.5mg HC and 2 NAX.  But that's because it turned out that my thyroid and adrenal issues were caused by Lyme Disease (and possible co-infections).  Treating the infections has made a huge difference.


I took HC for about 7 years, 17.5mg at first then got down to 7.5mg, got it on prescription to start with but then the doctor refused any more so I bought it online. Eventually I decided to stop it and went to a Western Medical Herbalist for help. He weaned me off with the use of various herbs, and also treated old viruses such as EBV, chicken pox etc. which helped get my energy back. I've been off the HC for 5 years now and don't take anything for my adrenals and my last two adrenal salivary tests have been good, so I don't think that taking it long term necessarily means you need it for ever, as long as you don't take so much that your own adrenal function is suppressed. 


Thanks! For the first year, I was on 6 mg of Medrol daily, then managed to go down to 4 mg daily where I stayed...I think that counts as a physiological dose (I was told by my doctor up to 6 mg of Medrol, which equals 30 mg of HC) is considered a safe and physiological dose.


Try mixing 5 teaspoons of raw honey with one of Himalayan salt (find ground). Put this in a small container and keep by your bedside.  A small amount (size of half your little fingernail) should be placed under the tongue just before settling down to sleep. This mixture has proved to be helpful in promoting good sleep and is particu larly beneficial in perking up the Adrenals.  Look it up for yourself -

I hope you find this intersting and of some help.

1 like

Interesting, thanks for the tip!:-)


The only reason for long term cortisol replacement treatment would be if your adrenal glands really had given up and were no longer capable of functioning, that is if you have Addison's disease. In other cases you should be aiming to wean off and let them do what they should.

The term 'Adrenal Fatigue' is a bit of a misnomer. Its only in very rare cases that the adrenal glands are damaged and no longer working. Mostly what happens is that the delicate control mechanisms are disturbed, and the patient either over or under produces cortisol (or sometimes both, at different times of the day). So the aim is to restore a normal rhythm of cortisol production.

There is a book called 'The Adrnal Reset Diet' by Alan Christianson. Its the best I have read, with lots of tips and tricks other than diet - although his argument for carb cycling is quite compelling. His newletter has also had a lot to say about thyroid matters. The two are closely linked in any case.

My 'adrenal fatigue' was picked up by a holistic doctor when I told him about my sugar addiction, and the fact that sugar was my go-to drug of choice whenever I was stressed.  The 24 hour cortisol test showed that my cortisol was consistently elevated throughout the day. This is almost certainly due to long periods of no, or under thyroid treatment before I took my care into my own hands, plus some very stressful life experiences in both childhood and more recently (and the sugar thing started when my mother died when I was 12). 

But in fact the sugar addiction may also be to do with brain chemistry (well, isn't everything?) and after reading Dr Julia Ross (The Diet Cure, The Mood Cure) I have been experimenting with amino acids with considerable success. So that's another possible route.

'Adrenal Fatigue' is very much not a single illness. As a result my experience is that you need to experiment to find the things that work for you, and they may or may not work for anyone else. 


Thank you, Ruthi, very interesting and useful information!!!!



Very interesting information. I dont recommend taking an herb just because. I have been reading and experimenting . I am not an authorized naturopath. I try to read what is bothering me, and find a natural solution. I only know that i have always been over emotional, over reactive and have hormonal imbalances. I have always craved sugar as a child and cakes  - all things bad for me. As i got sick, i started eating better (although i still have a bit of chocolate), And taking vit d that i have been deficient in my entire life, and feeling better. I also take other vitamins and herbs. 

I have scarred kidneys from a sono i had done. Adrenals are on top of the kidneys. Protein in my urine. Etc....I have a lot more to learn, but really believe there is something wrong with my pituitary or hypothalamus. Could be genetics since my mom had inflammtory disease and died at 48 from colitis, her liver going. 

I sometimes think it is a physical abnormality rather than just poor diet and a traumatic childhood.

I was having panic attacks and lack of sleep for awhile now.  Meditation and yoga doesnt help because I believe it is something inside my brain that i cannot control with just being calm. (I also have mitral valve prolapse which i have been reading about as well that can cause physical changes).

I looked for an answer because it was awful and intolerable. I started with calming herbs, and found holy basil through taking an adrenal fatigue herb which had many different herbs in it. I felt like it was too much and singled out one herb, holy basil. I dont know if there are side effects with others, but it works for me. The need to talk to a doctor if other medication is being taken is important to do as they might not be compatible. Herbs are as powerful as medicine. They both come from nature and should be treated with care. 


The problem is that these doctors are only covering up your symptoms and  you don't know why you have low cortisol.   It can be treated naturally, by addressing food sensitivities, nutrient deficiencies and immune system, inflammation etc..

My functional medicine doctor thinks mine can be cleared up by healing my leaky gut.  But what she doesn't understand is that since i have low acth, it will not work for me, but for many it will.  Damaged adrenal glands of pituitary, forget it.  


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