I have been taking cortef for the last few weeks and I am not really feeling better at all and actually seem like I am gaining a little weight and it is harder for me to put on muscle. I added 2.5 mgs every three days until I got to 10 mg, and have to stay on this dose until more labs are run in about six weeks into treatment.

I was put on the medication for low cortisol levels and I am wondering what could possibly be causing me to feel worse.

I have been reading a lot that when you are starting cortisol monotherapy, you have to really look out for other various hormone levels/signals such as pregnelone, progesterone, dhea, testosterone, aldosterone, etc., to make sure that these aren’t going too high or low. I have read that taking cortisol alone can suppress other hormone levels.

There is two things that I think may be happening with my situation.

1. The cortef is making some other hormone level go either too high or low, which is why I am feeling worse.

2. The current dose I am on 10 mg is too small and is kind of a middle of the road dose, which is bad for cortisol treatment I think. I think it is good to either take a full replacement dose such as 20 mgs or higher or take something like 2.5 mg in the afternoon. I could be wrong, but this seems to make sense being that 10 mg is just enough to suppress your normal cortisol output, without giving you the full dose your body really needs.

I read about cortef increasing your appetite, but I thought that the medication would give me more energy and would make my thyroid work better so I would lose weight. It seems like it is doing the opposite. One of the reasons why I am so concerned is that before going on cortef, my appetite was out of control and now this has even made it worse. And I am not losing any weight. Has anyone have this happen to them when they first starting using the medication?

Here is a brief summary on what has been found so far on my labs. I will post more when I can get a new printer with scanner. Basically it seems like my entire endocrine system is shot. First went my testosterone, then probably my thyroid which caused me to gain a lot of weight, and lastly was my adrenals. I am now in process of getting everything corrected again and could you your help.

Low testesterone, low cortisol, normal/high hypothyroid levels, low dht, high insulin, high leptin, low iron, low red blood cells count, low estrogen, low cholesterol, erosive esphagitis.

I was tested head to toe this summer for the reasons why my iron and red blood cell counts were low, but the only thing the docs found was that my esophagus is getting tore up because I have a acid reflux issue. I think my low cholesterol levels and low iron levels are also connected to low cortisol levels and possible low thyroid levels.

One thing I have not tested is pregnelone which may be important in my case. I heard that this can’t be tested through quest, but the Rheins urine panel can test for it. I am thinking of do the rheins test, would this be a good idea?

As the question states on the subject line, what did you expect when you started cortef treatment or what should I expect in general. As stated earlier, I thought I would have a lot more energy and would feel generally more healthier, but this not the case. Maybe its too low a dose I am on or something else is going on, not sure yet.

The last question, should I ask my doctor to move up time the frame of when I should get tested going into the treatment. I have not told him yet that I am feeling worse, but I am assuming that he would want to test me earlier rather than later to see what is going on. I mean, what are the advantages of me feeling like shit for the next 4 weeks, when I could get tested in 2-3 weeks or just make a change in the treatment now.

The only reason I think my doctor would want me to stay on the current dose of 10 mg is because he said we should build an adrenal reserve for me staying on the low dose that I am on. However, when weighing the pros and cons I am not sure which is better. The options are staying on 10 mg until six weeks into treatment and feeling like shit but are building an adrenal reserve, or getting tested 4-5 weeks into treatment and seeing what is going on and adjusting my medication accordingly, but are not building that extra week or two of adrenal reserve. In your opinion, would it be worth it to feel like shit for an extra couple weeks just to build the adrenal reserve, or would you ask your doctor to test you a week or two earlier than scheduled because you feel worse off now than when started the medication. Thanks in advance.