Using Hc and cannot wean

[marsaday1971]

I have been using Hc 25mg a day for 10mths now. In that time i have been trying to get the thyroid balanced out. I have done that now by switching from NTH to T4 and T3. The T3 has made a very big difference it seems.

So i now take 112.5 mg T4 and 37.5 mgT3 per day and 25mg Hc (10/10/5)

I have been fully balanced for 11 weeks now.

So i thought i would try and come off the HC slowly and tried to reduce by 2.5mg, but my body does not like it. It notices the missed 2.5mg by the late afternoon.

What does this tell you ?

Am i weaning incorrectly or am i just not ready to do so yet?

I do a lot of exercise and sports and do not need to stress dose. 25mg Hc is all i need it seems

[pmgamer18]

If you have been over doing it with exercising on HC they your Adrenals never had a chance to heal. If your coming off HC slow and start to feel shaky and fatigued even sick to your stomach your not ready. Some people have had AI for so long there Adreanls will not get better. Read this FAQ’s I helped with at STTM forums in this they talk about coming off HC.
http://www.stopthethyroidmadness.com/adrenal-info/faq/
@marsaday1971 3005 wrote:

I have been using Hc 25mg a day for 10mths now. In that time i have been trying to get the thyroid balanced out. I have done that now by switching from NTH to T4 and T3. The T3 has made a very big difference it seems.

So i now take 112.5 mg T4 and 37.5 mgT3 per day and 25mg Hc (10/10/5)

I have been fully balanced for 11 weeks now.

So i thought i would try and come off the HC slowly and tried to reduce by 2.5mg, but my body does not like it. It notices the missed 2.5mg by the late afternoon.

What does this tell you ?

Am i weaning incorrectly or am i just not ready to do so yet?

I do a lot of exercise and sports and do not need to stress dose. 25mg Hc is all i need it seems

[DrMariano2]

@marsaday1971 3005 wrote:

I have been using Hc 25mg a day for 10mths now. In that time i have been trying to get the thyroid balanced out. I have done that now by switching from NTH to T4 and T3. The T3 has made a very big difference it seems.

So i now take 112.5 mg T4 and 37.5 mgT3 per day and 25mg Hc (10/10/5)

I have been fully balanced for 11 weeks now.

So i thought i would try and come off the HC slowly and tried to reduce by 2.5mg, but my body does not like it. It notices the missed 2.5mg by the late afternoon.

What does this tell you ?

Am i weaning incorrectly or am i just not ready to do so yet?

I do a lot of exercise and sports and do not need to stress dose. 25mg Hc is all i need it seems

HC = Hydrocortisone.

Generally, unless one has structural problems with the adrenal glands (e.g. Addison’s Disease, Primary Adrenal Insufficiency), then problems in adrenal function indicate there are problems in the other systems (nervous system, endocrine system, immune system, etc.). The sum of the signals that regulate adrenal function suppress (or increase) adrenal signaling.

People have called the suppressed state “adrenal fatigue”. But adrenals are not “tired”. They are suppressed. In psychiatry, this is called hypothalamic-pituitary-adrenal dysregulation. I’d call it “adrenal dysregulation” for short. It can also be called non-adrenal illness affecting adrenal function.

The use of hydrocortisone and other adrenal hormones supports the signaling actions of the adrenal glands. They do not treat the adrenal glands themselves. They do the signaling actions of the adrenal hormones as if the adrenal glands were functioning at a higher state of activity.

The actions of hydrocortisone and other adrenal hormones hopefully addresses and corrects the problem(s) that suppressed adrenal function in the first place. Thus, after a time, one can wean a person off hydrocortisone

For example, in post-traumatic stress disorder (PTSD), the extreme external stress a person experiences causes significant changes in nervous system function, immune system function, endocrine system function, metabolism and nutritional status in a huge systemic simultaneous cascade. The sympathetic nervous system and immune system, for example, becomes chronically overactivated. This can cause insulin resistance. Zinc and iodine become lost through the renal system, etc. etc. The adrenal gland function becomes severely suppressed – to the point I often see Cortisol levels below 5 ug/dL Adding hydrocortisone can improve function by calming down the sympathetic nervous system, reducing recall of traumatic memories in the circuits that process environmental threats, calms down inflammatory immune system signaling. With the reduced sympathetic nervous system activity, the renal system stops excreting vitals minerals. The patient, then, will be on the way toward healing. With work on compartmentalizing traumatic memories then leaving them in the past, one can help reduce the size of the brain circuitry that becomes devoted to the traumatic memories – which can prolong the illness via re-living those memories. Once significant improvement in the system returns, adrenal dysregulation ceases. One can then wean off hydrocortisone.

When one can’t wean off hydrocortisone, this means there may be other problems in the system which were not addressed by the addition of hydrocortisone. These may be additional, perhaps hidden problems that were not originally realized as problems contributing to adrenal dysregulation. For example, a person may have a chronic infection or unaddressed nutritional problem or severe external stress or diabetes or or other systemic problem in addition to PTSD.

The addition of hydrocortisone compensates for both the identified problem (e.g. PTSD) and the other systemic problems. Removing hydrocortisone destabilizes the balance one is in since the other systemic problems were not addressed in treatment.

Certainly, hypothyroidism can lead to a cascade of systemic signaling changes that can cause adrenal dysregulation. But when one can’t wean off hydrocortisone once thyroid function is addressed, that means there are other problems which have not been addressed, to which hydrocortisone compensated to allow function.

In medicine, when a treatment has an unexpected course or response, one reassesses and reconsiders the diagnosis. Something else is afoot.

[Jean]

@pmgamer18 3006 wrote:

If you have been over doing it with exercising on HC they your Adrenals never had a chance to heal. If your coming off HC slow and start to feel shaky and fatigued even sick to your stomach your not ready. Some people have had AI for so long there Adreanls will not get better. Read this FAQ’s I helped with at STTM forums in this they talk about coming off HC.
http://www.stopthethyroidmadness.com/adrenal-info/faq/

After many etempt to stop HC, it’s a crash.

But now, I’ve stopped (no really tapering) 10 year’s of HC. I’ve taken 10 day to stop 30 mg of HC. The first an second week, I don’t feel well but at this time I’m feel great.

At this time, after stopping hydrocortisone since 4 week my blood morning cortisol is 17,30 ( norme is 6.2-19.2).

I don’t known why if because I take supplement that help to fight “silence inflammation” or antidepressant with low dose of stimulant.

I think many anti aging doctor give HC to fast for patients who have fatigue

What the real problem of adrenal fatigue; Dr Mariano explain the dysregualtion of HPA axis is more appropriate that “adrenal fatigue”.

I think there are anothers problems : liver problems (Low 11 beta-HSD1), high transcortine, low glucocorticoid receptor sensitivity….
I’m not sure that the answer is Hydrocortisone for this pmetabolics probems

[marsaday1971]

Right so Dr M is saying something else is causing the adrenals to not work properly.

What about the length of time my thyroid has been good (11 weeks fully optimised and 2 yrs since i started thyroid hormones with success, but not optimisation) versus being ill for 16 yrs?

So for many yrs my adrenals and thyroid have been “sick”. Would this affect the length of time HC would help the healing process.

I have no stress in my life, am happily married and mortgage free, but still have this adrenal problem. I had stress growing up, but that is in the past and am happy – certainly when i am optimised.

In the last 2 days i stopped taking sea salt and today i noticed my adrenals have shut down (similar to reducing the HC). So i have taken salt this afternoon and can feel the adrenals working again.

So i am sensitive to salt intake and coming off HC. I have no emotional stress, but i still have this prolem. How else can i feed my adrenals what they want?

I have 2 adrenal stress profiles and both show the same pattern – Plenty of cortisol in the morning, but dropping very quickly by noon. What is making the cortisol disappear ?

june 08 started thyroid meds, coming off anti depressant usage (one tablet per day). This is when i found out about low thyroid due to low fertility as trying for a baby. I stopped the anti depressant one month after this test.

8am 34.9 (12-33)
noon 10.8 (10-28)
4pm 8.8 (6-11.8)
midnight 3.4 (1-5)

june 09 still taking thyroid meds. fully off anti depressant for 10 mths. this result seems worse than the first test.

8am 15.6 (12-22)
noon 2.7 (5-9)
4pm 3.4 (3-7)
10pm 0.9 (1-3)

[DrMariano2]

Unless a person has Addison’s Disease or Adrenal Insufficiency, the adrenal glands are not “sick”. They are being turned off. There are signaling problems involving other parts of the body which end up shutting down the Adrenals.

It is not about external stress. One can have internal stress, such as infections, nutritional deficiencies, metabolic problems, nervous system, other endocrine system problems, and immune system problems, that cause adrenal function to be suppressed.

Thyroid problems can contribute to adrenal dysregulation. But it is only one contributing factor. Often there are several occurring at the same time. Treatment with thyroid hormone only addresses one of the problems. Treatment with hydrocortisone may suppress one ofvthe others, particularly inflammatory signaling. But Hydrocortisone does not always address the cause of inflammation in a curative manner. Because of this, continued bandaging of the problem with hydrocortisone is needed until the root problem is addressed.

Ask yourself why does salt appear to help improve adrenal function.

The most important questions are “Why?”and “How?”

Hydrocortisone is anti-inflammatory.

Salt, by reducing aldosterone production, is anti-inflammatory. Aldosterone, aside from controlling salt balance, is also an inflammatory signal.

Using Hydrocortisone does not feed the adrenal glands. It is an attempt to do what the adrenals are suppose to do, if they were not suppressed in function.

Hydrocortisone does not heal the adrenal glands. Adding hydrocortisone is doing adrenal’s job, because it isn’t doing it. If doing it’s job actually addressed the problems which led to suppression of adrenal function, e.g. Psychological trauma, the, one can recover adrenal function and won’t need hydrocortisone some day. If not, e.g. Infection or nutritional problem, etc. Then hydrocortisone won’t fix the problem and continued use may be necessary to maintain mental and physical function. Hopefully in this case, the cause of adrenal dysregulation may be found in the future so that hydrocortisone treatment won’t be necessary.

[marsaday1971]

Ok, this is good news for me as there may be a tangible reason why the adrenals are not working correctly.

So salt reduces inflammation then ? and aldosterone causes inflammation ? I tried florinef (1/2 tablet) for 2 days earlier this yr thinking the aldosterone was part of the problem and it made me so unwell – very low in mood, depressed even. I stopped it on the second day.

Would this make sense to you ?

I exercise a lot (always have done since a kid) and i play sport 4 times a week. Usually i am playing something and resting the next day. I dont often go 2 days without having a sweat.

Now ever since i was 13 and playing more competitive sport i have been a “sweater”. I sweat loads and people laugh at me sometimes for it. It is just the way the body works. Does this mean anything? Since i started the salt dosing last yr i have noticed a big improvement in adrenal health.

One other thing which may be relevant. When young (pre 21) i had a very sensitive para sympathetic nervous system. By this i mean i was very sensitive to personal contact and could sweat easily in the day and go red very easily. I wasnt very relaxed at all.

My body was basically finely tuned to my environment ready to spring into action (thats how i see it now). We lived through a traumatic upbringing from 7 until 18 when i left home. mum liked drinking and had many boyfriends and so i know this is why i was very sensitive to life. Then i became unwell and all this dampened down – i was much less sensitive. Now i am well and older i am no longer as sensitive which is a good thing i reckon. life is different and much calmer.

According to you i still have some signaling problem going on caused by the youthful stress ? If true then how can i fix it without have counseling ? I have done this many yrs ago and it helped a lot. I have my wife to talk to now and i am really over everything that has happened, so trying to fix stuff mentally is not how i see it. This is definitley some hormonal problem and i have been proved correct by sorting out the thyroid and addressing vitamin problems (like the salt).

I take a lot of vit and minerals as we are trying for a baby and i have a low S count. So far nothing has worked and we are down for ICSI hopefully soon. I can say only the salt, hc and thyroid meds make a difference.

thanks for your input.

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