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Addison's Disease Message Board

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Hi guys,

I was so happy when finally I was diagnosed with adrenal fatigue and prescribed Cortef. For years I have been struggling with intolerance to thyroid meds, iron and other supplements, and everything I have ever tried to take. I am currently on a very small dose of Armour, 2x a day .31 grain.

I was prescribed 5 mg Cortef to take in the morning and another one if I need in the afternoon. I started by taking 2.5 mg in the morning and 2.5 mg in the afternoon. At first I would have nice energy kick after each dose but it would not last for more then couple of hours and then I would crush. Then I tried to take 5 mg in the morning but that did not go well at all. I was fogy, crushed, my back was hurting, I was nervous, I just felt awful. Then my doctor switched me to 2.5 mg SR Cortisol. I took it for two days and felt awful, I had no energy and was so depressed all day, I just felt very bad.
I continue by taking my regular Cortef but less then 5 mg, maybe 3.5 or 4 (I cut off one small corner of the pill) I was expecting that I will need some time to adjust, but now more then two weeks later I feel worse then before I started it. I am always sleepy, I feel lightheaded, I have no energy, I am more depressed and I am crushing more then before. Higher dose seems to make me feel worse, smaller dose makes me feel very sleepy.
My appointment is coming up soon, but what can I do until then? Am I doing something wrong?
My saliva test clearly showed low adrenal function.
Thank you so much for any suggestions you might offer.
Thanks both of you for replying to my post.
My doctor knows how sensitive I am to everything so he wanted me to start slow and take time to adjust. I am sure he will have some suggestions for me when I see him, but I don't know what to do 20 days until then.
Rumpled, do you suggest I need more Cortef in the morning, maybe 10 mg? See, what I experience on 5 mg I am not sure if that's because I am not getting enough or because my body is not used to cortisol and reacting like with everything else. I get tightness in the chest and throat, I feel speedy but crushed and sleepy at the same time, I am fogy and I feel like I am on the clouds (in a bad way). I also noticed that I get lightheaded easily and I get sick feeling if I do sudden move or try to do something crazy, like dance.
I don't know what is worse, 2.5 or 5 mg so far. In the beginning when I started taking Cortef I felt better for period of time after taking a dose, even though I was more sleepy and I was crushing more then before Cortef, I still felt better then I do now two weeks later.
I will give you more food for thought, all of which disagrees the other poster.

A replacement dose or hydrocortisone (short acting) is at least 25 mg and Medrol (long acting) lasts a lot longer than hydrocortisone. Do the research and you'll see the other poster has it wrong about HC lasting longer than Medrol. Medrol is much stonger, lasts much longer. I haven't seen anyone get Cushing's from 25 to 30 mg HC, nor have I heard of this in the 5 years and thousands of people I've helped with hormone problems (I'm a patient, not a doc). Taking 20 mg and less is under treatment pure and simple, but there are some who say the sky will fall on you if you take more, hogwash. You do want to take the minimum amount it takes to make you feel better, but I've not seen that in others less than 25 mg do it.

HC is anywhere from 1 to 8 hour half life. Those who only get a 1 to 3 hour half life or so out of HC usually end up on Medrol which has a half life of 8 to 16 hours depending on the individual. Medrol's half life is roughly the same as prednisone, but Medrol is much better on the liver so is recommended.

HC can usually be dosed to approximate the diurnal cycle of natural cortisol, but Medrol can't approximate so is why you should give HC every chance to work which includes raising up to but not past 30 mg. You're welcome.
Hi neighbor, as you see, I have not much experience with Cortef, but what I can suggest is that you don't even try lowering it now since you have mono. Wait until you are completely better and ready for it. Why do you want to lower it, are you having side effects?
Another suggestion is to take 15 mg first thing in the morning, 10 at lunch time and 5 in the afternoon. Maybe lower dose in the afternoon will help you sleep better.

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