Thyroid UK
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Responding poorly to cortisol therapy/hydrocortisone

An adrenal test taken a few months ago indicated moderately low cortisol output throughout the day, however my symptoms have been relatively bad. I wake up groggy and tired, get hypoglycemic reactions after a high protein breakfast, cannot exercise, I have rapidly gained weight and my cognition is impaired.

Recently I took a 5mg dose of Cortef in the morning. I reacted badly, and it definitely aggravated a lot of my adrenal fatigue symptoms. I noticed the effect almost immediately. I upped the dose to 10mg with no success. It also makes me bloated and very sleepy, and induces blurry vision, head pressure, breathing difficulties etc. I'm not sure if these are symptoms of adversely high cortisol.

Does my body need more cortisol? I'm scared to increase the dose and experience more adverse, debilitating symptoms. I'm self-navigating and it's puzzling why my adrenals are not responding to cortisol therapy. I've attempted different natural treatments from vitamin B5, vitamin c, glandulars and licorice root with no success.

4 Replies

Hi Mikee, that is puzzling. Are you also on thyroid medication and if you are, perhaps you should hold off until your adrenals catch up. Did you previously try adrenal cortex without other ingredients. I've read that the adrenals can heal rather quickly.

This man is excellent.


Hi Mike...i was looking into adrenal fatigue and found an herbal supplement that had 3 ingredients. I got some pain in my right side and stopped. Decided to take one ingredient out of the 3, holy basil. I have been on for 2 months. No side effects. Believed to keep cortisol production in balance. I have thyroid nodules. I noticed my panic attacks have subsided and feel a lot better. Hope you can find some answers that work for you. Take care!

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I don't know about medicating cortisol and am sorry to hear you are still so unwell.

I have read that we can have a higher FT3 than FT4 when the body over-converts after sensing a low T4 storage level. T4 is converted into the more active T3 by the deiodinase system (D1, D2, D3) in various organs and tissue, and (D3) converts T3 into an inactive form called Reverse T3. Usually the body converts excess//unused T4 to Reverse T3 during (emotional, psychological or physiological) stress as a means of conserving energy for healing and repair, possibly why your T4 is so low ? ? ... As your results are unusual it might be beneficial to have RT3 measured as a large amount could inactivate the availability of T3.

Your adequate T3 levels are not working and the HPA axis has a central role in regulating homeostasis in the body. Your adrenal crisis could easily have impacted thyroid performance and progressively skewed other sex hormones .

For instance if there is too much TBG (thyroid binding globulin) caused by elevated oestrogen (both men and women) thyroid hormone becomes bound and unable to get into the cell even though thyroid function//results are good. With elevated testosterone TBG becomes deficient, leaving too much thyroid hormone available which can shut down receptor sites.

Excessive or diminished cortisol can effect the workings of the HPA axis, causing receptor site defects, as can high homocysteine (caused by malabsorption or conversion problems of B Vits seen in gut dysbiosis. Thyroid hormone not produced & used properly can lead to a build up and oxidative stress.

When you have supplemented have you given enough time for the benefits to be seen ? ? .. . Adrenals glandulars might take up to a year for adrenals health to improve any..

When you supplemented (various) thyroid hormone replacement did you ensure of optimal iron//nutrient levels. It is not enough to just eat a balanced diet as good thyroid function for many people requires a very wide margin of basic fundamentals that must all be met for meds to work efficiently.

Addressing gut & liver issues will encourage thyroid meds to work better because T4 is converted in many tissues in the body but primarily the liver (kidneys) and gut. Insulin resistance will effect how your hormones are working.

I think in order to supplement cortisol you should have all sex hormones evaluated as one imbalance usually transfers up the line.


Thyroid Deiodinase Activity

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Hi. I have recently been given hydrocortisone and to take 20 + 10 daily. Each time I take a tablet I feel worse. My energy/ strength lowers considerably. I do take levothyroxine also for under active thyroid. I can’t seem to get away from this viscous cycle. I get up from bed 8am. I feel sort of alright but not brilliant. I can do a few things like water the garden and make my breakfast. I take it easy. I take 20 hydrocortisone then within 45 mins I want to go to sleep or have little strength left.

Have you experienced something similar. What other meds could a take. It’s nit working. It’s naking me worse. Is there an underlying reason for the hydro having adverse effects. Many thanks. Pam.


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