Question: MY DOCTOR WON'T PRESCRIBE HC, IS THERE ANYTHING OVER THE COUNTER THAT I CAN USE?
Answer: Yes, you can use OTC hydrocortisone cream. It's the same stuff you use for itching. Dosing instructions can be found in the files here (under HC cream FAQ):
Question: WHY IS IT BEING SUGGESTED TO START AT A FULL DOSE OF HC INSTEAD OF RAMPING UP THE DOSAGE THE WAY THE STOP THE THYROID MADNESS WEBSITE AND BOOK SUGGESTS?
Answer: We have learned much since that was posted to the STTM site and have come to the conclusion that starting on a full dose of HC is the best way to go.
It's the way the adrenals work. The hypothalamus makes a hormone that stimulates the pituitary that makes a hormone that stimulates the adrenals to make cortisol (and the other cortical hormones). The whole thing is called the HPA axis. We aim to take enough HC that the adrenals don't have to make any - a full replacement dose. This lets the adrenals rest so they recover. If you take less than you need, what happens is the HPA axis gets "turned down" when you take HC, and therefore makes LESS than before you were on HC, so your overall amount of cortisol is less than if you weren't taking any. So... generally speaking, small doses of HC are not helpful - and can make you worse. But it does depend on your salivary results. If most of your numbers are normal (not "in range", but actually normal), sometimes small doses of HC (usually as Isocort) can be helpful.
~Thanks to Jackie Patti
Question: DO PEOPLE HAVE TO BE ON HC FOREVER OR IS IT POSSIBLE TO COME OFF THE HC? WILL I BECOME DEPENDENT ON THE HC?
Answer: HC is not an addictive medication much like you're not addicted to your own cortisol. HC is a identical to the cortisol your own body makes. The length of time someone is on HC is very variable. Some people have to be on it forever if they have destruction of the adrenal glands or the pituitary, say from autoimmune issues or trauma, and some people only need to "rest" their adrenals and can WEAN off successfully and return their adrenals to fully working order.
Question: WHAT ARE THE SYMPTOMS OF HIGH CORTISOL/WHAT ARE SOME INDICATIONS OF TAKING TO MUCH HC?
Answer: Round face, fluid retention, easy bruising, high BP, stretch marks, muscle weakness ~Val Taylor
Question: IS CORTEF THE SAME AS HYDROCORTISONE?
Answer: Cortef and hydrocortisone are the same things. Cortef is simply the brand name of hydrocoritsone. HC can be purchased in the generic version simply known as hydrocortisone.
Question: WHAT ARE THE INGREDIENTS OF BRAND CORTEF
Answer: Calcium stearate ~ corn starch ~ lactose ~ mineral oil ~ sorbic acid ~ sucrose
Question: WHAT ARE THE INGREDIENTS OF DOUGLAS HYDROCORTISONE
Answer: Lactose ~ Maize cornflour ~ Talc ~ Magnesium stearate ~ Polyvinylpyrrolidinone
Question: HOW LONG DOES IT TAKE TO NOTICE ANYTHING WHEN TAKING HC
Answer: That is very individual. Some people notice and can "feel" the HC right away. Some people never feel it and it works in the background as it should. What HC does is allow thyroid meds to work properly. This is USUALLY where the "feeling better" comes from. There is no real way to tell how long each person will take.
Question: HOW DO I DOSE HC (HYDROCORTISONE)?
Answer: Moderators will recommend a total dose of HC in miiligrams or Isocort in pellets if warranted based on your salivary results. Each person is different in how much they need but the general rule of 20-25mg of HC is usually in order.
For typical HC dosing, we use a pattern like the following:
20 mg: 7.5 - 7.5 - 5 - 2.5
25 mg: 10 - 7.5 - 5 - 2.5
30 mg: 10 - 10 - 5 - 5
Dosing times would look like this for a 25mg dose?
With Isocort, the same 4 hour dosing applies, except the dose is measured in pellets rather than in mg, so dosing might be 5 - 3 - 2 -1 which is how many Isocort pellets to take at each dosing time.
Some people have stomach problems taking HC on an empty stomach, so it's best to take with food, even if a small amount. Something as little as a cup of coffee with cream will help.
The bedtime dose should be taken in bed, with lights out, as you're going to sleep. This will prevent it being metabolized too rapidly, and will just provide a slow trickle of cortisol to you overnight. Some people are not able to take a bedtime dose you will have to experiment with this.
Question: I AM TAKING ISOCORT AND THE BOTTLE SAYS EACH PELLET IS 2.5 OF CORTISOL, IS THIS CORRECT?
Answer: We have found that each pellet is more in the range of 1.5mg, at best, not 2.5mg
Question: HOW DO I DEAL WITH INSOMNIA?Answer: When our cortisol rhythm is disturbed, we tend to have high cortisol in the evening or night and resulting sleep disorder. The main thing that will help your sleep is getting on enough HC or Isocort during the day that your nighttime production of cortisol is suppressed.
Question: I AM DOING BLOOD TESTING IN THE MORNING FOR VARIOUS THINGS INCLUDING THYROID AND FERRITIN, DO I NEED TO TAKE MY HC AFTER THE BLOOD DRAW?
Answer: No, you can take HC before the blood draw.
Question: I'M TAKING A STEROID OTHER THAN HYDROCORTISONE SUCH AS MEDROL, PREDNISONE ETC, CAN YOU TELL ME WHAT MY STEROID WOULD EQUAL IN HC?Answer: http://www.globalrph.com/steroid.cgi