Prescription cortisone for adrenal fatigue?

I'd really appreciate some feedback on this.

Diagnosed with adrenal fatigue by Hertoghe doctor in Belgium in 2011 (using 24 h urine analysis). Put on 4 mg of Medrol and told I could raise to 6 or even 8 mg daily if needed; apparently, 8 mg daily is the equivalent of 40 mg of bioidentical hydrocortisone and, if you take more than that, your own adrenal glands could stop producing cortisol).

Anyway, the Hertoghe doctors seem to think that you can remain on physiological (bioidentical) doses of HC/prednisolone/Medrol indefinitely. If you search the internet, you can find thousands of articles supporting or refuting that theory.

My problem is that I have tried to wean off Medrol more times than I can count in the last couple of years; not because of potential side effects, but because I worry about long-term use more generally. I guess that, somehow, I have come to believe that you should never take hormones unless your own body is unable to provide them and, after all, my adrenal glands are not dysfunctional, just tired...

But I have tried literally hundreds of supplements over the years, both adrenal glandular and cortex, and nothing makes me feel as good as Medrol (I have not tried hydrocortisone or prednisolone but have been told they are considered equivalent, but that Medrol is longer-lasting so could be preferable for that reason).

Has anyone else experienced this?

Is it a good idea to remain on prescription cortisone for the rest of your life if you don't suffer from Addison's disease? After all, adrenal fatigue is not an official diagnosis in most countries...and is considered curable even by most homeopathic doctors.

I wish I could find the magical supplement that would make me feel the same way but, for some reason, I find most OTC supplements, both adrenal glandular and cortex, rather weak, or maybe inconsistent is the right word.

Can you become addicted to drugs like Medrol if you only take physiological doses?

Can they mess your adrenals up long-term? After all, I've read about people not having thyroid disease using thyroid hormone for weight loss purposes and ending up suppressing their TSH and spending years getting their own body to produce enough thyroid hormone again after weaning off it.

Any advice would be greatly appreciated as I've read that long-term cortisone use can really mess you up, metabolically and otherwise.

[Framboise]

I don't know much about Medrol but have just read a short explanation. I was prescribed a low dose of hydrocortisone for a year or so for my adrenals by my private doctor at that time. After a while he wouldn't prescribe any more and asked me to stop taking it. I was worried about stopping so I started to buy it from abroad. I only took 7.5 mg a day, went down to 5 mgs a day and decided to wean off it after a couple of years but couldn't. In the end I went to a Western Medical Herbalist who made up herbal mixtures for me every couple of weeks. After about 5 months I was able to stop the hydrocortisone and a year later I stopped the herbs too, and have been fine since.

That was some years ago. However, I was already diagnosed with osteopenia and have now been diagnosed with osteoporosis in one area of my hip, which I think I would have had anyway but the hc won't have helped!

In retrospect I wouldn't take steroids again and should have tried herbs or glandulars first. It's probably worth it for you to try to wean off the Medrol, but you may need to find some other type of help to do so. If you try someone like the herbalist I went to, I suggest you make sure they are properly qualified as they are not all equal, and make sure that they actually mix and dispense the herbs themselves, and aren't just buying in herbs already mixed or reselling ready-made tablets or capsules.

Good luck!

[marigold22]

I have a similar story to Framboise . In 1995 I saw the well known private doctor (Dr.P), who diagnosed me with adrenal insufficiency (basically exhausted adrenals) due to very longterm & under medicated hypothyroid. I had been on T4 only for 14 years when I saw that private doctor & he told me that the T4 was not being converted into the usable thyroid hormone T3. Recently I have proved that I have a faulty thyroid gene from one parent so he was correct in his diagnosis. He prescribed me a 'pharmacological' dose of hydrocortisone - 5mg a day. He wanted me to only take them for about 6 months.

But when his prescription stopped, I still felt awful and bought from abroad. I even stupidly increased to 10mg a day but I felt semi human whilst taking them.

In hindsight and with my knowledge now from this forum, I consider that I should only have been taking them for a few months, one year max., until my adrenals had had time to recover, and at the same time, taking supplements to boost my thyroid conversion, eg selenium, folate, vitamin B12 etc. Nobody had told me about the importance of vitamins & minerals.

I find it interesting that the Hertoghe doctors say you can take Medrol up to 8mg daily and indefinitely. From my own personal experience I would say you will have problems.

There have been many posts on here about how to support the adrenals.

[Hidden in reply to marigold22]

Thanks to you both! I agree, taking steroids long-term is likely to cause problems.

The reason I was put on Medrol and not hydrocortisone (although the latter is bioidentical) was that Medrol is longer-acting and can be taken once a day in the morning.

Another problem with steroids is that I also have to take Omeprazol every day to protect my stomach, as well as calcium to prevent osteoporosis. I also worry about weight gain even on low doses of steroids; a few years ago, I had to take high doses of Betapred short-term for inflammation and, in that short period of time, I gained 10 kg and swelled up like a balloon. Back then, I was taking therapeutical doses of course, but still...I don't like the idea of taking steroids long-term if not necessary.

Can anyone recommend a good supplement, either adrenal cortex or glandular, that I could try? I think they will not affect the body the same way steroids do?

Some say the adrenaline in glandulars can be problematic and that adrenal cortex can be less stimulating, but I guess that's highly individual. I know many do well on Nutri Adrenal (isn't that the brand recommended by Dr. P?) so maybe that could be worth trying? There is also Nutri Adrenal Extra and I understand the difference is that the latter also contains vitamins and minerals?

[hendb]

hello Hidden i read your message with a lot of interest because my self i started taking hydrocortisone (what is the difference with medrol? i dont know) 1 month ago

my cortisol levels were super low (even though not addison disease neither)

and i also have thyroid issue (hypo) do you also?

i dont have an answer to your question,but what i would do if i were you is to ask dr hertogue himseld. after all you paid for consulatations and you can ask him this precise question. what do you think?

i totally agree with you saying that if we provide a hormone to a gland for too long there is a risk it stops working by itself... but may be this doctor would tell you other wise?

for me the situation is worse because hydrocortisone doesnt even seem to give me a super energy etc....as you seem tohave with medrol

another quetsion: how old are you?

[Hidden]

I'm 49.

Medrol is a synthetic version of hydrocortisone. As far as I know, only synthetic versions like Medrol and Prednisolone are used to treat inflammation.

I have hypothyrodism (Hashimoto's) diagnosed 19 years ago. I spent years on T4 only and did not feel any better (it seems I don't convert enough T4 to T3). The main reason I went to Hertoghe's clinic was because I wanted a prescription for NDT. Both Armour and Erfa have since reformulated and don't work as well, plus they cost a fortune and are not reimbursed by social security, so I now source my own meds (Thyroid-S) from Thailand for a fraction of the cost of Armour/Erfa. I actually find Thyroid-S to work better than prescription NDT...!

Although I think it's good that there are alternative health care practitioners such as the Hertoghe doctors, I also feel they are a bit too "pill happy" at times. For instance, when I went there for the first time, I was 41 years old and no way near menopausal. Still, they put me on both estrogen and progesterone. The reason they gave was that, if you suffer from adrenal fatigue, you need to replace all adrenal hormones, not just cortisone (however, they never mentioned aldosterone which I learned about much later by reading books about adrenal fatigue).

I later went off the estrogen as it can have lots of side effects (even bioidentical estrogen, it would seem), and should not be used for more than a few years anyway for problems related to menopause (some doctors say three years, others five, but if I had stayed on it I would have used it for eight years by now). On the other hand, I use progesterone cream (Biovea) and have for the last few years, as I read many women are estrogen dominant and that seems to apply to me as well (another reason to avoid estrogen as that will only make the problem worse). Progesterone cream helps create a better balance between estrogen and progesterone (we can make estrogen from many other things, including body fat it would seem, which tends to make us estrogen dominant and progesterone deficient).

So, I think you need to use some common sense, and not trust those doctors blindly even though they call themselves hormone experts and God knows what...I know that many mainstream doctors don't approve of what Hertoghe is doing (for instance, prescribing growth hormone injections for anti-aging purposes). What he is practising is actually anti-aging therapy more than anything. Of course, many of his patients have an endocrine disease such as hypothyroidism, and go to him because they don't feel well on T4 only and their doctors won't listen to them, but they end up not only on NDT but several other hormones as well. I was prescribed not only NDT, but also Medrol, estrogen, progesterone, testosterone (which I decided not to take after reading about the side effects of it in women, including hirsutism, weight gain and oversized muscles) and was offered growth hormone as well (which I was not interested in). And all of my hormone levels were in range to begin with, just not optimal according to him.

[endomad]

My cortisol is very low 95 (150-550) my endo prescribed 10mg hydrocortisone x 30 tablets only to be taken under extreme stress. They deff helped but he will not prescribe any in last year as he said my adrenals will stop working all together. I have tried every supplement herb glandulars and cortex recommended and none have made any difference, so I am stuck with very low cortisol meaning I get exhausted very easily, it disturbs my sleep and I cannot handle any stress. I am unable to find a Dr who can help. X

[Pop_pop20]

Hi there, I would say the best place to get advice is on the adrenal institute Facebook page. As members have been officially diagnosed through an endocrine consultant/specialist.

Adrenal fatigue I’m afraid is not a clinical diagnosis.

Before taking any steroid treatment for any kind of adrenal insufficiency a fasting 8am serum cortisol must be taken with an ACTH level to decipher whether the insufficiency is primary (adrenals) or secondary (pituitary). As u have started taking steroids without this this will effect all future blood test/investigation results into the condition and will inhibit you receiving an accurate diagnosis.

Urine levels are typically used to check for Cushings disease, as it gives u the amount of cortisol for the whole day - ur levels were low but were they high at one point and low at other points of the circadian rhythm throughout that day?? So ur diagnosis of ‘adrenal fatigue’ could be inaccurate. Certain medications can also interfere with the results. For adrenal insufficiency hydrocortisone is typically used and administered in divided doses over the course of the day - following the circadian rythm.

Addison’s disease is a serious illness and steroids should not be used lightly. It has been proven that even a short course of steroids on a person who does not require them can cause irreparable damage. If u ask some of the members of the adrenal insufficiency united site who have been diagnosed with this condition some will tell u they had only been on steroid treatment for their asthma for a year or less and their pituitary gland has now stopped producing enough ACTH to stimulate the adrenals - causing secondary adrenal insufficiency just as debilitating a condition as primary (addisons etc). If u take steroids for these purposes I urge u to inform ur GP and have an emergency bracelet, if u are in an accident or come into severe I’ll health it is detriment to your health that health professionals are aware of this, so if you go into an adrenal crisis due to such events they can treat u effectively.