Will hydrocortisone cream work as well as hydrocortisone tablets in allowing your adrenals rest to recuperate?

[cc120]

Thought that if the cream works in allowing the adrenals to rest, I would try it before the hydrocortisone tablets as is cheaper.

Any good sources of either appreciated?

[milupa]

Hi cc120 -

do you know that your cortisol is low i. e. did you do a saliva test?

If so, have you tried liquorice (to prolong the life of cortisol) or adrenal cortex?

Theoretically cream can be used. In some countried 1% cream can be bought over the counter, usually it's 0,5%. The usual advice is to put the cream in a syringe, then you have control over the amount you apply.

I tried this and found it too messy and inaccurate, even with a prescription 5% cream. I take 20 mg a day (10-5-5) and carry cream in case I need to stressdose.

[cc120 in reply to milupa]

Hi milupa

Thank you for your response. I did have a low cortisol reading but had the dexamatose test which proved I was producing cortisol but I feel that it is low during the day and high in the evening/night.

I requested a 24 hour cortisol saliva test but was denied.

I haven't tried liquorice.

When did you start the hydrocortisone tablets, what was your cortisol reading before you started and what has been the effect on you?

[milupa in reply to cc120]

Hi cc120 -

gosh, where to start? I have a pituitary adenoma with subsequent low ACTH. I have never been able to 'do it all' like my friends, for me it was always 'either or' because I was too exhausted. Then even an animated gossip session with my friend became too much. Door bells shocked me. Noises debilitated me.

I organized my own saliva test. No surprise: low from morning to evening. Then I found a lab that did nighttime cortisol test: Very high at 2 am. No wonder I was always a night owl!

At the time I could not function if I had to get up at eight, had a few goodish hours after midday, was extremely exhausted late afternoon and finally came to life after 8 pm.

I worked to bring my circadian rhythm back to normal. I had my blood cortisol measured at the worst times, which confirmed low and very low cortisol at those moments.

I used T3 circadian method to raise the morning cortisol. Then added liquorice to extend and cortisol at lunchtime and 16:00 to help the afternoon awfulness. I added melatonin and herbal nytol to improve sleep (I subsisted on three hours a night). Added 5htp and gaba and progesterone. Worked on neurotransmitters. Now, with better sleep I was ready to tackle the daytime cortisol problems.

I finally felt ready: I dropped cortex and liquorice but started taking hydrocortisone. It is often said that 35 mg is the right replacement dose for women (because we replace, not supplement). Too much for me. I am fine in the morning now, so take 10 mg at noon, and then twice 5 mg at three to four hour intervals, the timing depends a bit on activity and stress levels, as would the natural cortisol output.

I always have the pills with me, also the cream in case of a major stressor.

You would have to inform doctors and dentists, ideally wear a bracelet.

You probably know that you shouldn't stop suddenly but wean off slowly.

I am in my fifth month now. I feel so so much better. There's still a full supplement regime, careful exercise only, active stress avoidance, sleep whenever I can, autoimmune diet..

I go through the day with a lightness I haven't known in years. I am kinder to myself and others because I am not forcing myself to be active against my body's clear demands for R&R.

And: I did not put on any weight, which I was very worried about.

Apologies for writing a novel, I hope that I could answer just one of your questions?!

Good luck

[cc120 in reply to milupa]

Thank you milupa, very interesting and I'm sure will give some tips to many.

I had a pituitary scan which was negative. Had 7.5 to 8.5 TSH for over 10 years, which my GP chose to ignore despite my complaints of extreme fatigue. Don't know if she even read the results as the lab only red flags 10>, which they are concerned about even without symptoms. As my GP, she should have put the symptoms and the reading together to help me rather than allow me to deteriorate over the years.

But in any case, self medicating with NDT helped a lot, though still a lot less energy than a regular person. Wanted to try T3 alone but endo (well her side kick registrar) insisted I had to start with Levythyroxine before they would consider T3. I do have a good source for uni pharma, cytomel who also sell hydrocortisone tablets, so if I can't get T3 from NHS, or / and if cortisol cream doesn't do the trick I will go that route.

Awhile back did try progesterone cream but didn't seem to make a difference. I can't remember if this was pre / post NDT.