Anyone here on hydrocortisone and thyroid meds? - Thyroid UK

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Anyone here on hydrocortisone and thyroid meds?

Incoguto profile image
39 Replies

Hey all,

Started hydrocortisone trial today as I'm having trouble tolerating thyroid meds and my morning saliva cortisol was 7% range, early afternoon was 9%, the rest was good.

Any success stories? How much hydro do you take and your thyroid dose?

I'm currently just trialling hydro, 10-7.5-5-2.5 mg (25 mg in 4 doses to replicate circadian rhytm) for 3 days, with 2.3 grains of Armour and 2.5 synth T3 (Thybon).

My ft4 was 28%, ft3 57% (24 hrs after dosing in the morn), TSH always below 0.01. Had iron IV, it didn't improve my symptoms at all. All vits as advised on here, are perfect and optimal so searching for the Holy Grail now!

Thank you!

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Incoguto profile image
Incoguto
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greygoose profile image
greygoose

Have you been diagnosed with adrenal insufficiency? Because if it's adrenal fatigue, it's not a good idea to try and replicate the circadian rythme by taking HC four times a day. The best idea is to take it early morning, to give the adrenals a helping-hand at their busiest time, but never after 1 pm. The adrenals need to be left to work by themselves for half the day or they will shut down completely. And, if they shut down, they won't start working again if you try to come off the HC.

I took it for a couple of years - can't remember the dose, it was a long time ago - but I took if first thing, and then just before lunch. Never after 1 pm. And, after a couple of years I was able to wean off it.

Is that how your endo told you to take it?

Incoguto profile image
Incoguto in reply to greygoose

I don't have insufficiency, it's adrenal fatigue. Do you think a three day trial could shut them down if taken 4 times a day?

It's a self-trial as no endo cared about my 7% salivary cortisol and meds intolerance, but I asked my doctor to prescribe it yesterday. There is another doctor I know of who does it too, I reached out to him.

I think from memory I remember you said it helped you a lot. It would be great to know what people are dosing, I certainly don't want to cause damage, but I also can't function this way anymore and I need to get back to work, right now on sick leave since July.

Thank you grey 😀

greygoose profile image
greygoose in reply to Incoguto

Yes, it did help a lot. But I can't see the point of doing a three day trial. It's not long enough. I would think a three month trial would be more like it, but just taking it in the morning, not the afternoon.

Incoguto profile image
Incoguto in reply to greygoose

I guess it was just to see if it does anything at all. So far I just feel more calmer. Okay, that's a good point, thank you.

Were you taking t3 at the time of taking HC?

greygoose profile image
greygoose in reply to Incoguto

I started taking HC at the point where I was transitioning between T4+T3 and NDT. Doctor said to come of the T4/T3, start the HC the next day, and then start the NDT when it arrived. So, I had about a week without thyroid hormone, just on HC.

Incoguto profile image
Incoguto in reply to greygoose

Ah I see, thank you grey 🤗 But eventually you ended up on t3 only despite taking HC with NDT, right?

I've been on T3 & T4, felt on it worse than on Armour or Nature Throid. Started transitioning to more Thybon t3 less Armour, but as I dropped Armour I get horrendous symptoms. Taking more Armour with t4 or just Armour also didn't work. My doctors think I'm hypo because my iron tanks despite an infusion, and estrogen tanks too. It makes sense to me, last year both were higher with higher thyroid, but I was unable to tolerate thyroid meds 🤷‍♀️it's exhausting

TiggerMe profile image
TiggerMe

I have been taking 5mg of HC around 9-10am as my morning cortisol was ok but dropped off quickly until back in range at bed time, this is alongside 100mcg T4 and 10mcg T3 4-6am and another 5mcg T3 at 6pm

Like greygoose says I wouldn't take it after 1pm as it can mess things up.... unless you want to pull an allnighter!

I'm going low and gentle for 6-8months and then dropping back to adrenal cortex in the hope my adrenals will have had an easier time of things and perked up 🤞 I tried adding another 5mcg but didn't feel any benefit

TiggerMe profile image
TiggerMe in reply to TiggerMe

If I have a busy afternoon ahead I do take an adrenal cortex around noon to prop things up!

Incoguto profile image
Incoguto in reply to TiggerMe

I'm pretty desperate. If you told me to eat a steel bridge or roll in the middle of a street to make me feel better, I totally would 😅

Incoguto profile image
Incoguto in reply to TiggerMe

Thanks Eeyore 😀 Is the 5mg making a difference?

My morning salivary cortisol was dire 7% of range, while it was 66% in 2015 when I started Armour.

I was just worried that once I take HC then ACTH will blunt like TSH when you take thyroid meds, so I'd sabotage the progress as I won't produce cortisol endogenous due to thar low ACTH...

TiggerMe profile image
TiggerMe in reply to Incoguto

Yes, I found the 5mcg gave good benefits and allows me to be keep up a decent level of activity during the day and I also have less of an adrenaline hit if shocked or stressed, so no more jitters... like I say I tried adding a second dose of 5mcg but didn't feel any benefits so dropped that.... I'd rather take the least possible and this allows me to bob along building my strength and stamina up during the hibernation season 🐻

Your fT4 at 28% is that your happy place? I feel totally 💩 if it drops below 50%

25mg of HC are you not totally wired and bouncing off the walls?

Incoguto profile image
Incoguto in reply to TiggerMe

Does it mean that you tolerate thyroid meds better? Today I feel no jitters or stress, it has made me really calm and it is the first day..don't wanna jinx it, but it looks promising...🙈 but I've said something like this before and you know, the good effects didn't last!

I am not sure about the ft4, when I have it at that level, I never feel well, but in fact, I haven't felt well on so many combos...I could add 6.25 Levo tomorrow and my levels of ft4 would go from 20% to 70%, same with t3, and that made think of cortisol and not properly utilising anything, stressing the system etc.

So today I took in total 22.5 and I feel very calm. No bouncing off walls, quite ready for bed in fact. I wonder if this is a sign I need it or maybe it will hit me tomorrow or Monday

TiggerMe profile image
TiggerMe in reply to Incoguto

I seem to tolerate everything better with it, worth heeding the none after lunch rule so as not to possibly risk shutting down your system 🤗

Steroids are powerful and not to be taken lightly

Incoguto profile image
Incoguto in reply to TiggerMe

Absolutely, definitely don't want to shut them down!

I am reading a book by Dr Jeffries, he was prescribing hydro 4x times daily to restore low adrenal reserve (not insufficiency), then Dr Myhill and Peatfield say only up to lunch. But what if you take it only in the morning, your ACTH gets blunted so you don't produce cortisol anyway. It's not easy, isn't it? My ACTH is low in range, quite worrying.It is just mad how in 2015 my cortisol was 66% range in the morning and it is now 7%, shocking.

Had no problems raising doses back then whatsoever, now it's impossible.

TiggerMe profile image
TiggerMe in reply to Incoguto

As with all things Thyroid related its down to trial and error 😟... I read the various suggested route and decided on feeling my way with least possible and only at the time my levels were deficient.... it may be I'll be following in your footsteps further down the line... you be the hare and I'll be tortoise 🤗

Incoguto profile image
Incoguto in reply to TiggerMe

Or I may be following yours 😀 the nighttime 2.5 mg dose disrupted my sleep early morning, so I'm dropping that. This morning I took 10, I'll take 5 at 12ish and then see what happens.

TiggerMe profile image
TiggerMe in reply to Incoguto

We'll work it out 🤗

Incoguto profile image
Incoguto in reply to TiggerMe

Oh I hope so! 🤗 Out of curiosity...have you ever done a saliva test or are you taking HC based on your cortisol blood serum?

TiggerMe profile image
TiggerMe in reply to Incoguto

I've done a couple of saliva tests, this was my August one before starting HC and dhea

Worse than my January where I had just had my first Endo appointment and my dose was lowered and put me back to bed for February 😕

healthunlocked.com/thyroidu...

Incoguto profile image
Incoguto in reply to TiggerMe

Oh dear..your morning cortisol is much better than mine, but then it drops.I know the feeling, I crashed after iron iV beginning in November, still haven't made it to a shop since, only walks around the block and so on...

Incoguto profile image
Incoguto in reply to TiggerMe

Oh dear...I'm taking it back. After the 3rd hydro dose today I felt dizzy, breathless, shaky and was getting cold sweats. Thank god for a little xanax I had stashed. Maybe 25 is too much, maybe I need to start with 5 or 10 in the morning 🤷‍♀️

TiggerMe profile image
TiggerMe in reply to Incoguto

That doesn't sound great! Perhaps back to baby steps and plot your journey... I didn't find 10mg any better than 5, I think it is as much down to the timing of the dose... I'm also thinking the lowest possible dose is going to be easier to wean off later 🤷‍♀️

Incoguto profile image
Incoguto in reply to TiggerMe

Thanks Eeyore 🤗 Yes, maybe a day or two break and starting with 5 mg in the morning since my cortisol is low first thing and around 2pm.

Yes, weaning off is also important..there was a graph I saw, which showed different hydro doses and how much they reduce our own output by. 25 mcg was a full replacement or 30 mcg. I think 5-10 mg was about 30%+.

TiggerMe profile image
TiggerMe in reply to Incoguto

HC is fast acting and fast leaving the scene so you'd probably be fine starting tomorrow rather than suddenly stopping and putting your system in another spin?

Incoguto profile image
Incoguto in reply to TiggerMe

You're right, I'll try 5 mg tomorrow morning. Do you take it before your meds or with your thyroid meds?Thank you Ee 🥰

Thankfully I only took for less than 2 days

TiggerMe profile image
TiggerMe in reply to Incoguto

I take T3&4 between 4-6am (pee time) generally up around 7am and HC 9-10am which is a bit fluid but seems to work for me 😏

Incoguto profile image
Incoguto in reply to TiggerMe

Thank you Ee😊took 5mg hydro this morning, will see what happens 🤗are you splitting your thyroid dose? Thanks again for responding and being so helpful!

TiggerMe profile image
TiggerMe in reply to Incoguto

🤞🤗 I had dropped back to 10mcg T3 taken first thing during the summer (after the addition of HC) but since the weather turned cold last month I have added back in 5mcg around 6pm... my prescription is for 100mcg T4 and 15mcg T3

Back story...

When I added in the HC I don't know if it improved my conversion as my fT4 dropped to 35% and my fT3 95% so I added in and extra 100mcg T4 per week and dropped to 10mcg T3 and this felt good.... this seems to have held my fT4 at 50% Happy place (NHS test last week but too early to check fT3... ties in with my recent post 🙄)

Incoguto profile image
Incoguto in reply to TiggerMe

I'd say HC improves conversion or makes hormones work more efficiently.I am not splitting my dose, but also my ft4 is quite low, at 28%. When I took 15mcg more per day, it got up to 75%...

TiggerMe profile image
TiggerMe in reply to Incoguto

I previously took my T3 as one dose, it's hard to know quite what is going on, as if it's working well that is because it is making it into the cells rather than just swimming around in the blood 😬

Incoguto profile image
Incoguto in reply to TiggerMe

Exactly my thoughts 😅 every single time, is it good that it's high, is it bad, because I feel bad 😂 honestly, always in between two scenarios!

TiggerMe profile image
TiggerMe in reply to Incoguto

My blood serum at 9am every time I've tested 298

and I reacted well enough to SST rose to 500 ish🙄

Incoguto profile image
Incoguto in reply to TiggerMe

Wow...so you passed the test. My blood serum is mid range or high, but saliva dire. And with 25 mg hydro 2nd day I am not anxious or anything, the opposite.

ainslie profile image
ainslie

3 days won’t be enough to prove anything, when you start HC there is a period when you have your natural production and the added HC, after a while your natural production slows down then you see the real effects of the HC (if any), it needs at least a few weeks to trial it properly. There is different views on taking it after 12 noon, Hertoghe says no , Jeffries says yes, I think Peatfield was okay with 4pm dose, who knows , I take 7.5 at 9am, 5 at 1pm, 2.5mg at 4pm. My view is if you don’t need it don’t take it, if you need it try to find out why first then if ALL else fails then take it for as short a time as poss. Hertoghe believes in giving it to most of his patients, he takes 30mg first thing in morning and that’s all, strange but true.

Incoguto profile image
Incoguto in reply to ainslie

Yeah that makes sense, thank you ainslie.

I'm going to consult with my doctor next week.I have some sort of thyroid med intolerance. My saliva cortisol in 2015 when I felt well and was taking Armour was 66% of range in the morning, and right now it's 7%. I take 90 t4 and 23 t3 and I find it hard to tolerate. Used to take much bigger doses.

May I ask why you're taking hydro?

My problems started when I suddenly stopped tolerating 3 grains of Armour, been on many combos of thyroid meds since apart from t3 only. I can't tolerate anything

ainslie profile image
ainslie in reply to Incoguto

I am on hydrocortisone because Hertoghe reckoned I had adrenal fatigue many years ago, I don’t think it’s done me any harm or maybe any good

Incoguto profile image
Incoguto in reply to ainslie

I understand, thank you ainslie. It is really hard to know what to do.

birkie profile image
birkie

Hi incoguto💞

May I ask why your having trouble tolerating thyroid medication?

I've been having the same problem since starting on thyroid medication after full thyroidectomy In 2019.

I have colitis and are lactose intolerant.

I've been on just about every thyroid medication there is except NDT my endo and gp just keep giving the synthetic T4, T3, liquid ect.

I got put on T3 then back to T4 then back to T3 because of bad symptoms, my T3 was dire on T4 not absorbing ect.

I've been on Roma T3 for over a year now with much the same symptoms which is mainly diarrhea, cramps, inflammation in gut and feeling very sick especially in the morning with a horrid metallic taste in my mouth🤢.

Due to this year's blood results a gp as referred me back to endo again, I'm afraid this endo is quite horrible 🙄 she as no concept of thyroid conditions especially when I don't have one, she is a diabetic specialist 🙄

Anyway as for HC my story concerning them relates to my colitis diagnosis in 2015 I was given 4 months supply after being discharged from hospital, and I can tell you it was the best 4 months of my life.

My bowle pain was way better, my body pain eased so much so I returned to the gym I felt amazing.

I to took the 10mg in the morning then 10mg in the afternoon, nothing after that time.

But I was told to ween off them after the 4 months, almost immediately after stopping them everything came back, all the pain, bowles, body, back to feeling awful again, then gp gave me buscopan for my colitis which flared up constantly, until I took charge and went dairy free, did a food diary and managed to keep the colitis under some control.

That was until I had my thyroidectomy and were put on thyroid medication and bang the bowle and stomach went nuts again, and as continued this way even when taking the lactose free🙄.

I'm going to try to ask for NDT and perhaps some HC to calm my bowles down, I have constant pain with diarrhoea everyday it's getting silly now and annoying 😠 and as much as I try to explain to my gp... If I'm having diarrhoea when taking the t3 surely the absorbtion will be effected?

Brick and wall come to mind🙄

Incoguto profile image
Incoguto in reply to birkie

I am sorry to hear this birkie, I wish we didn't have to struggle through this.I had to quit my job in July due to this, really annoying.

I'm glad to hear that hydro was helping you, it definitely helps with pain and other problems.

NDT for me is way better than the synthetic combo, but I'm not good just on NDT and I'm not sure why, yet!

I have taken 5mg HC only this morning as opposed to 25mg the other two days. I have asked me endo, who is generally amazing, for a phone consult, as I want to know what he would recommend taking in terms of HC.

Oh I know, I feel you, but we need to keep going! I'd say try NDT for sure.

I have no idea why I'm having issues tolerating meds, I always have symptoms, while I was pretty well up until 2017 on Armour only.

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