Taking Hydrocortisone with NDT - Timing of Hydrocortisone doses

[BreifneKing]

Currently taking 3 grains of Armour Thyroid at 7am along with 5mg Hydrocortisone. I then take another 5mg Hydrocortisone at 11am.

My GP has now increased my daily Hydrocortisone from 10mg to 15mg but has written on the prescription to take 10mg in the morning and 5mg at night.

Does anyone else take Hydrocortisone morning and night only or can someone advise on the best times to take Hydrocortisone?

24 hour cortisol test confirmed (Phase 2) HPA axis (adrenal gland) dysfunction as low cortisol all day.

[Teresamarie]

Hi!

I too take hydrocortisone for adrenal insufficiency. I take 25 mg/day, 15 am 5 noon 5 4:00. Since I’m not a doc please take my advice only from the side of a person with both adrenal insufficiency and hypothyroidism.

I would suggest that you take the last dose around 4:00 pm as it will provide you the energy to get through the supper and bedtime without keeping you awake at night.

A suggestion: since levothyroxine needs to be taken away from food and other meds you might want to move the levothyroxine to bedtime or 3:00 am. This is how I manage the constraints of these two meds. Just a thought...

Good luck to you.

Teresamarie

[BreifneKing in reply to Teresamarie]

Not sure it’s a good idea to move my NDT to bedtime, particularly as I haven’t had a night when I didn’t wake throughout the night in over 3 years?

Also, my endo said not to take HC after 1.00pm as I don’t have Addison’s and he doesn’t want to shut down natural production. Do you have what is often labelled as ‘adrenal fatigue’?

[Teresamarie in reply to BreifneKing]

Not fatigue but adrenal insufficiency. My cortisol is missing so I replace with hydrocortisone. Do you have fatigue? I guess I would support your day with taking your hydrocortisone during the day, last dose around 3 to 4 pm.

[greygoose in reply to BreifneKing]

Your endo is right. If you don't want to shut your adrenals down, don't take after 1 pm. Your GP must have had a 'senior moment' when he wrote that.

Taking your NDT at night could help you sleep better. It does some people. Worth a try, anyway.

[BreifneKing in reply to greygoose]

I have to say I really cannot fault the way my GP has been since I was diagnosed so I do tend to overlook his ‘senior moments’.

For the last 3 nights I have taken half a grain at bedtime and the remainder at 7am and it has definitely had an impact on my sleep. I sleep deeper and have started having dreams again, but I still wake up 3 or 4 times during the night and feel very ‘heavy headed’ in the morning.

Would you suggest more NDT at night or is it too early to say?

[greygoose in reply to BreifneKing]

Do you take you morning dose two hours away from your hydrocortisone? You can't take them together.

I think waking up in the night has more to do with your adrenals than anything else. And, you really do need to take that HC when you first get up, which might help with the heavy headedness. So, you could try taking all your NDT at night, which could also help with your adrenals - natural T3 production occurs mainly at night.

[BreifneKing in reply to greygoose]

No, my endo told me to take NDT at same time as HC as he said the NDT was using up my natural production of HC, causing a crash, and the only way to counter it was to ensure the extra HC was still available by taking it at the same time as NDT.

Do you think he might be talking doodoo?

[greygoose in reply to BreifneKing]

I think he might. But, I'm not an expert. I just know what my doctor told me when I was taking NDT and HC.

[BreifneKing in reply to greygoose]

Experts are great at fixing cars but when it comes to health there's nothing quite like the experience of someone who's walked in similar shoes and fell down the same holes but has managed to find the ladder you're struggling to find!

Did you find the HC helped straightaway?

Would you suggest trying all the NDT at night and HC the moment I wake up in the morning?

Any advice would be gladly received as I think NDT and HC may be the answer but I don't know how best to take them.

[greygoose in reply to BreifneKing]

HC helped within a couple of days, yes. I felt great. But, after the first flush, it didn't make me feel as good anymore.

I would suggest trying all the NDT at night - or, splitting it between the night and the afternoon - and taking the HC first thing.

[BreifneKing in reply to greygoose]

So did you just stop taking the HC?

Ok will try the night timing first.

How long should it take to notice a difference with the timing and whether it’s the way to go?

[greygoose in reply to BreifneKing]

No, I weaned off it after two + years of taking it - very slowly. But, I was taking a lot more than you.

I really can't say how long it would take to notice a difference. That's such an individual thing.

[BreifneKing in reply to greygoose]

Sorry, what I meant was whether there was a typical timescale for symptom relief similar to the 6-8 weeks after a dose increase in thyroid meds?

Is the issue of taking NDT with HC purely to do with thyroid meds needing to be taken alone or is there a more ‘scientific’ reason?

[greygoose in reply to BreifneKing]

I don't think there is any sort of time scale, because I doubt many people have found themselves in that sort of position.

It's about taking thyroid hormone on its own for maximum absorption.

[threenme86]

I know it's been a while since you last posted, but I'm currently on 15mg of Hydrocortisone and I take my throughout the day. This may alter my adrenal's ability to produce but I'm hoping it'll only be temporary for me. I found out the cause of my adrenal and thyroid dysfunction is from Severe Mold Poisoning. I take 2.5mg before I go to bed. It helps me absorb my NDT medication (the cells need cortisol to absorb the T3). Hope to hear all is well.