Question about timing of cortisol doses

Discussion in 'Fibromyalgia and ME & Chronic Fatigue Syndrome' started by kchase77, Mar 4, 2013.

  1. kchase77

    kchase77 Member

    Hi all,

    What happens if I can't wake to take that 7am or even an 11am dose of hydrocortisone? I've never been able to get up that early in my entire life.

    Can I start with a 3pm and then a later one and then try for morning the following day?

    I am at a loss as to how I will do this.

    [This Message was Edited on 03/05/2013]
  2. kchase77

    kchase77 Member

    Exactly the same.....see above.
  3. kchase77

    kchase77 Member

    Hi all,

    As you know the HC gave me some pretty severe overdose symptoms and some suggested I take an adrenal cortex extract like Isocort. So I've been looking into it.

    Have read Isocort is no longer made from New Zealand lamb and have also read that extract made from NZ lamb is the very best to take. That said, does anyone have a source for it made from the lamb? I ordered a product called Cortol Ace and the product description on the site I purchased from said it was sourced from New Zealand range-grazed lamb, however the bottle says bovine. I am not happy about this as I am not sure where the bovine is from so have written for a replacement or refund.

    Also, what is the diff between the extract and the HC? Just a weaker version of HC or is there something else? Would like to hear from anyone who knows.

  4. kchase77

    kchase77 Member

    No one has any thoughts about this?
  5. sunflowergirl

    sunflowergirl Active Member

    Contrary to what some have posted about cortisol, I would suggest seeing an integrative doctor first before taking this. What I've read is that cortisol can really mess a person up. When you do an adrenal saliva test, it is 4 times at various times of the morning and evening and then a doctor can see what your reading is.

    I did an adrenal saliva test 2 years ago, thru an integrative doctor, and it came back questionable since cortisol showed OK. Now I'm seeing another integrative doctor who said she would do this test again since I'm having big time anxiety.

  6. IanH

    IanH Active Member

    Do you have long sleep? I note you said that you may not wake until 11am. That suggests "long sleep" to me.

    Your cortisol levels will be high if you have long sleep.

    You need to provide more information.
    Your sleep periods
    The form of hyrocortisone you a taking
    The dose
    What tests have you had? and what results did they show?

  7. kchase77

    kchase77 Member

    Hi Sunflowergirl and IanH and thank you for your replies.

    Yes, I am totally doing this on my own because I do not have the money for the doctor or the saliva tests.

    I've never been able to get out of bed before noon or later so have always worked afternoon and midnight shifts. I've always been a sitter...reading or watching TV because I've never had the energy to do more than that. I had no children as I knew I'd not be able to care for them and I am divorced.

    I recently started going thru peri-menopause (based on my own research and diagnosis) and this has made the low energy even worse. I've always been able to sleep forever...10, 12, 14 whatever hours. I'd work an 8-hour shift and come home and collapse on the sofa. I am not an outdoors person sofa and bed and I are life-long pals.

    After doing a lot of reading on the Internet, I decided to give this a try on my own. I don't plan on taking more than 20mg per day. Because I have always been a night person though, I fail to see how I am going to break this cycle to be awake to take this medication during day light hours. It may seem silly, but I don't function at all on days. In fact, my ideal sleep shift is about 6 or 7 am to about 6 or 7pm....I can last about 12 hours then have to go back to bed.

    I can set an alarm clock of course but I wonder if it is even possible to break this kind of life and sleep cycle that has been with me my whole life. From what I've read, people taking this med during the day had some semblance of daytime life before their fatigue while I have never had any.

    I ordered generic hydrocortisone from an online pharmacy I trust and received them yesterday. One hundred tabs of 5mg to begin with. It would be very nice if this was something I could take on the sleep cycle I am already on and gradually transition to days but I don't think that's how it works.

    I also take 200mg generic Zoloft and 300mg generic Effexor XR daily for major depression and anxiety. I have been diagnosed with BPD (Borderline Personality Disorder). I take these meds also on my own after seeing a doctor for a few years. Now I just continue the regimen on my own and it works well.

    I have not started taking the HC so don't have a dose yet.

    Please let me know if I can tell you anything else.


    P.S. I won't be able to see a doctor because I have no money for that. I have to self-treat for everything.
    [This Message was Edited on 03/05/2013]
  8. IanH

    IanH Active Member

    Zoloft is an SSRI which will be increasing your serotonin levels. If you take hydrocortisone you may lower your serotonin because the corticosteroids lower serotonin levels. This may be no problem for you but just be aware that the two are acting in opposition. Which is what you want in order to be more alert during the day. BUT you should not take the cortisone when you go to sleep.

    Do you drive? If so you will need to be careful. I know you will be aware that the zoloft requires care in driving.

    Now, the effexor (venlaflaxin) is an SNRI and also interacts with hydrocortisone. The most common side effect of the two together is increased anxiety but this may be countered by your zoloft.

    Since you are on an altered sleep cycle and a long sleeper you might be able to take the first dose on awakening, whatever the time. However as I have pointed out you will need to be careful with this combination.

    Is there not a better alternative to improve your daily wakefulness?
    Do you have ME/CFS? in addition to depression?

    Your best answer is to exercise and it would be best if you could find a routine that will allow you to exercise daily. The BEST treatment for depression is exercise - by far.
  9. kchase77

    kchase77 Member

    I started exercising regularly about two months ago but found it made the fatigue even more profound. I would have to lie down and even sleep afterwards so I stopped. And exercise has never done that to me before.

    Never heard of needing to be careful driving on Zoloft. Have been taking it for about 15 years and driving all the time. That's very interesting.

    Have never been diagnosed with anything other than the mental health issues....nothing physical at all. Probably would never have thought anything was wrong until the peri-menopause started and made the exhaustion and fatigue even worse. I always just thought I was a night person and nothing could be done about it.

    I also took this quiz last night and scored way above 15 on each one....10 on the one test for endorphins.

    I've never been able to get going without massive doses of a diet coke fiend. Vitamin B12 gave me a great boost of energy about 7 years ago but then after awhile it no longer did.

    There is one thing I remember a doctor telling me when I was about 19...I am 51 now. He said I was borderline anemic and told me to take iron. I did but stopped when it made me constipated.

    It is now 5:30am where I am so since I woke up and had a few hours sleep I will give the HC a try and see how it goes today. Normally if I woke at this time I'd just go right back to sleep but will force myself to stay up and try to get thru the day.

    Thanks very much for the reply.
    [This Message was Edited on 03/06/2013]
  10. kchase77

    kchase77 Member

    Took 10mg HC at 6:30am...felt nothing.
    Took 5mg at 11:30am...nothing.
    At 12:30pm, so tired I had to lie down and slept till almost 4pm.
    Took another 5mg at 4pm...still feel nothing except fatigue.

    That's 20mg and I feel more tired than ever.

    Only had a small amount of caffeine today...usually takes LOTS to get me going.

    Well, we will soldier on and see if it gets any better.
  11. IanH

    IanH Active Member

    As I said earlier because you have depression and you are a long sleeper you should not have low cortisol levels.

    However if your response to exercise is more fatigue and "malaise" then you may have ME/CFS. You may have always had ME/CFS???

    When you were diagnosed with depression your doctors should have advised exercise an it is a concern that you find exercise too difficult.

    Regarding driving on SSRIs the warning is about interactions with SSRIs, like no alcohol. Also when both SSRIs and SNRIs are taken together the risks are heightened.
  12. kchase77

    kchase77 Member

    The terrible fatigue with exercising only started about 2-3 months ago so not a life-long situation. I put this extra fatigue down to peri-menopause. And then when I read about adrenals and had almost every single symptom of adrenal fatigue, I thought I'd try the HC. I have read online of it causing more tiredness to some in the beginning till the body adjusts. I will give it awhile and least till what I have runs out.

    I have never heard of being a long sleeper. And I thought depression was one symptom of adrenal fatigue.

    I don't drink alcohol at all so no worries there and I have never had any bad side effects from either of those two meds....they have in fact saved my life. Without them I think I'd be dead by now.

    What is ME/CFS? Not familiar with those letters.

    Thanks again.
  13. kchase77

    kchase77 Member

    Was exhausted last night even after taking that nap yesterday afternoon but still didn't sleep until 1am. Slept well, went to the bathroom once maybe twice instead of the half dozen or so I usually do. Granted I had very little caffeine yesterday and I'm sure that's part of it.

    Didn't need the extra heat I normally use to sleep either...didn't get cold. Woke up at 7:16 and I feel much, much better. Took 10mg HC on waking and we'll see what the rest of the day brings.

    Definitely looking up though since yesterday!
  14. freida

    freida Active Member

    I thought I'd say hi to you, since I've been thinking of you.
    I'm glad to see you are doing pretty well, so far.

    I was going to suggest, that even though I was hesitant to advise anything, since it would be better to have a dr doing the advising on htese meds,

    what I would do in your situation, is to take the cortisol as soon as waking , whenever that is, and either hope that it eventually gets earlier in the day,
    OR, set the clock for 1 hour ealier the next day, and each day, so as to gradually make the time earlier.
    Even by half hour increments, after starting whenever you naturally woke up, the first day.

    It seems like you have been doing pretty much that, and it seems that you are being careful, and that is all good.

    I hope for the best outcome, and some improvements for you!

    CFS, is for CHronic Fatigue Syndrome, and ME is for the name for it, that is used in England and Canada, and many countries other than the U.S.

    Many of us, here at this site, have it, and the name does not describe it well, since we have many ill symptoms to deal with all of the time, and persistent difficulties. SOme of us are entirely unable to do normal daily activities, becuase of it.

    One of the symptoms most of us have of CFS/ME, is inability to exercise, or post-exhertional malaise, meaning overly exhausted weak and even sick from any activity or exercise. SOunds like what you describe, but that does not definitely mean that you have CFS. Low thyroid and other conditions could cause that too.

    It is not know what causes CFS/ME, or how to get well, though we all try many treatments, and some improve, to different degrees.

    There is no absolute test to prove the diagnosis, yet at this time, so some of us are not sure if we have that or something else.

    Hope that answers some of your questions,
    and hope you know this is a friendly group, whatever your difficulty is.

    Take care!

    Personally, I would only take one dose daily, in morning, or whatever time you wake up.
    I personally would NOT take it later in the day, hours after being awake, and especially not as late as 4pm.

    It would be natural for the body to produce most of it in morning for the day's energy, and then less of it, later in the day, and much less by evening, when it's time to wind down toward sleep.

    Also, I would not expect to feel the difference very quickly, the first few days. It would be more gradual, I think.

    So it would take a while, of taking it early in your day, to see what effect it was having for you.

    Again, we are not drs and cannot give actual medical advising here. We just share our own ideas and what we have tried. Each person needs to decide what they are doing.

    [This Message was Edited on 03/07/2013]
    [This Message was Edited on 03/07/2013]
    [This Message was Edited on 03/07/2013]
  15. kchase77

    kchase77 Member

    Wow, thanks for your great reply!

    I am not sure I have CFS/ME. I have always at least been able to have a job but not much physical activity beyond that. The hardest thing for me was getting going once awake and forget anything before noon or later. I also got shaky without regularly scheduled meals.

    One thing I've noticed since taking the HC is I no longer need caffeine or food first thing when I wake up and can actually wait several hours till I have anything. That's unheard of.

    Today was worse than yesterday. I am taking a late dose around 5-7pm and then not being able to sleep till really late. This morning I awoke at 9am, took my dose, and then went straight back to bed and slept till almost 2pm. So will cut out that late dose for sure. I am doing 10mg in early am, 5mg mid-am, and 5mg late pm/evening.

    I can definitely feel the effects though and they are not unpleasant. Never thought I would ever get out of bed feeling refreshed...what a feeling that is. Like winning the sleep lotto! lol

    One other thing I've noticed is I no longer have to get up many times at night to urinate. Seems I am sleeping deeper and am able to hold it longer. Before I had to get up at least once an hour just to go to the bathroom. Man, that was really dragging me down.....can't get any decent sleep that way.

    I just found a site that is treating CFS with cortisol and I will see if I can find it again. I've looked at so much stuff about this and I did not save it. If I find will post for you.

    Thanks again for the lovely reply and encouragement![This Message was Edited on 03/08/2013]
  16. kchase77

    kchase77 Member

    Am experiencing a tightness in my chest so I think I may have been taking too much too soon.

    Does anyone have any experience with this happening?

    Not much info online about it.

  17. kchase77

    kchase77 Member

    Well, the tightness has subsided somewhat but oh am I sore! Feel like I've had a bout of bronchitis that's lasted six months and I've hacked and coughed all that time. Very sore....hope it goes away completely soon.

    So on 20mg a day, I have essentially overdosed on HC...cause that's an allergic reaction above.

    Should I quit for awhile and then start up again slowly?
  18. mbofov

    mbofov Member

    I don't have any suggestions on the hydrocortisol, I've no experience with it, but I do have experience with weak adrenals.

    My chiropractor who does muscle testing helped me several years ago when I was weak as a kitten - my adrenals were wiped out (after regular docs were unable to help). He gave me Drenatrophin PMG by Standard Process and within a couple of days my energy started to pick up. I had to take about 3 times the regular dose for a couple of weeks because I was so weak. Drenatrophin is an adrenal glandular, and adrenal glandulars have helped many people with their adrenals. I had no bad side effects with it, and I am very sensitive to meds. Also, pantothenic acid is very important for adrenal health. I take 500 mg. a day, plus a B complex.

    Also, licorice is supposed to help raise cortisol levels.

    So these are some non-drug alternatives you might try instead of the hydrocortisol.

    Re your iron deficiency: There are forms of iron which do not cause constipation. Just ask at your health food store, or do an on-line search.

    Also, re B12 - you may need folate as well as B12. Not folic acid - folic acid is synthetic and can actually cause a folate deficiency. Many people have trouble converting folic acid to a form usaeable by the body, but unfortunately many many products are spiked with folic acid.

    Anyways, I'd been taking B12 for years but my energy did not pick up until I added in folate, in the form of metafolin (brand name). Within a couple of days my energy noticeably increased. I take two 800 mcg. tablets of Solgar folate (metafolin) a day (one a.m., one p.m.) and 5,000 mcg. of sublingual methyl B12 (Jarrow brand).

    If you start taking B12 and folate, it is very possible that your need for potassium may suddenly increase as your body starts to heal and cells regenerate. If this occurs, it can cause low potassium, which can cause severe fatigue and other problems. So it would be very good to have potassium rich foods on hand, and even a potassium supplement if need be. After feeling better for a couple of days after starting the metafolin, I hit a brick wall, felt horrible, and finally realized my potassium had tanked. I ended up taking 1,000 mg. of potassium (titrated up slowly) to that level for several days and then backed down, and now take 400 mg. daily. But if you can get enough in your food, then great.

    I'm sure you know diet sodas are basically poison - aspartame is a neurotoxin, very bad for your brain, so it would be really good to get off of it.

    If you could get the money to see a doctor, I have found that integrative medicine doctors are best (see to search for one in your area). They're knowledagle about diet etc. that regular docs know nothing about.

    A cheaper alternative which might help you would be to see a chiropractor who does muscle testing. Mine helped me so much after years of seeing regular doctors who could do nothing for me. He found my weak adrenals within minutes, and helped me with several digestive issues and other problems. To find one you can just call chiros in the phone book, ask if they do muscle testing, or you can go to the Standard Process website and call customer service - they'll give you the names of practitioners in your area who buy their products and thus do muscle testing. I think I would have ended up bedridden without my chiropractor.

    Also, omega 3 fatty acids are very important for brain health and mental health. Good sources are fish oil and flaxseed oil, you can find more. But they are very important for mood and way too often overlooked.

    Good luck with everything -

    Best wishes,

  19. freida

    freida Active Member

    Thanks for your nice reply to my post, Jody. :)

    Mary always has lots of good ideas, and again this time.

    About the licorice she mentions,
    it is licorice root, not the candy of course,
    and it comes in tea form.
    Very good to try, unless one has high blood pressure, then it might add to that, so should not be tried.
    If not any tendency to high blood pressure,
    you could stop the med and try the tea instead. It might be all you need.

    About the med, that chest reaction is important, I think.
    I would probably stop the med, wait till I had no more chest symptom,
    then IF you want to re-try the med, try a MUCH lower dose per day.

    Just ideas, for you to consider,
    and Mary had some other good ones too.

  20. kchase77

    kchase77 Member

    Hello ladies!

    Hope you two are feeling better than I am. OMG, I still feel like I have been hit with a Mack truck. What in the world does that stuff do to you? I am still so sore but marginally better....I think it will take some time for this to go away completely.

    I did read that you should contact a doctor or take yourself to the ER if feeling tightness in chest or difficulty breathing but I didn't. I figured it would subside if I stopped the medication and I was right but wasn't prepared for the terrible soreness. Still hurts to breath in thru my mouth...a deep breath. Would like to know exactly what it did to me but found nothing online.

    I did take over the counter for adrenals called Adrenergize and I also tried Rhodiola and Ashwaganda but they did very little. And I am impatient and just wanted to see some results.....Boy, did I see a result...just the wrong kind!

    I am going to have to print out these posts and go with them in hand to the store and get what I can. It's a shame that the HC costs $21.00 for 100 tabs 5mg but the supplements cost tons more than that. That's another reason I went with the was cheaper.

    Looks like this is not a quick fix and I had so hoped it would be. I did get some good results before the bad one and I liked what I saw, or rather felt. Was so wonderful to practically hop out of bed at 7am and feel refreshed. If nothing else, I'll treasure that moment. :)

    Will report back as time goes on and let you know how it is going, how I do with the supplements, etc.

    Thanks so much for all the considerate advice and the effort to tell me about it. You guys rock!

  21. kchase77

    kchase77 Member

    How do you guys feel about this product above? $23 a bottle for 32 ounces and at 1 teaspoon a day should last quite a long time.

    I also stopped taking my sublingual B12 because the effects did not last once I hit perimenopause and it was also expensive. I had read about using folate with B12 and have a bottle of Wonder Labs folic acid (folate) 800mcg in my pantry. I think I gave up easily on this because of the expense of buying so many different bottles of stuff and the fact I didn't see any good results. I want and need to feel better NOW and not years from now....I know you know the feeling.

    Wish I could see a doc but living on $1200 a month disability precludes me from even affording the deductible on Medicare. It's a vicious cycle when one has no money.[This Message was Edited on 03/09/2013]
  22. kchase77

    kchase77 Member

    This one requires refrigeration and should be used up within one month.

    Just wondering what you guys thought. This one is a lot more expensive than the nanoparticle one. :)