alternatives to HC

[masterpp]

guys i feel good on HC (low dose, 5mg x2 ed) and ill work my way up to 20mg per day.

my question is, are there any alternatives to HC which can be used long term and in a similar way, but which dont need to be taken every 4 hours, which i fine a bit of a pain.


cheers

[JanSz]

Originally Posted by masterpp

guys i feel good on HC (low dose, 5mg x2 ed) and ill work my way up to 20mg per day.

my question is, are there any alternatives to HC which can be used long term and in a similar way, but which dont need to be taken every 4 hours, which i fine a bit of a pain.


cheers

Hypopituitary Support
Equivalent maximum doses (do not take pregnenolone or any other adrenal supplement* that breaks down into cortisol with these)

cortisone acetate 37 1/2 (weak, not recommended)
hydrocortisone 30 mg
cortef 30 mg
prednisone 7 1/2 mg
prednisolone 7 1/2 mg
triamcinolone 6 mg
methylprednisolone 6 mg
**dexamethasone 1 mg
betamethasone 0.8 mg

*Isocort max dose 8 pellets-is said to have 2 1/2 mg of cortisol per pellet, so 8 pellets is 20 mg of cortisol.

**info sources can range from 1 mg dex = 6 mg medrol = 30 mg Cortef* to 1 mg dex =16 mg medrol=80 mg Cortef.* In my experiance with dex (your experiance may differ), I've found the equivalents to be closer to 1 mg dexamethasone=
40 mg Prednisone
32 mg Medrol
\160 mg Cortef/HC.

***1 mg medrol =1/32 mg dexamethasone
* The relative mineralcorticoid potencies of different steroids

*************************** Human Aldosterone 300
***************** Fludrocortisone Acetate (Florinef) 150
********************* Deoxycorticosterone acetate 20*
************************* Cortisol/hydrocortisone 2
************************************ Cortisone 2
*********************************** Prednisone 1
********************************* Prednisolone 1
*************************** Methylprednisolone 0.5
******************************** Triamcinolone 0
****************************** Dexamethasone 0
****************************** Betamethasone 0

**************** These figures are rough estimations

*** Glucocorticoid* Potencies of Different Steroids

********* deoxycorticosterone acetate************ 0
********* Human Aldosterone *********************** 0.3
********* cortisone acetate**************************** 0.8
********* hydrocortisone******************************* 1.0
********* prednisone************************************* 4.0
********* prednisolone********************************** 4.0
********* triamcinolone******************************** 5.0*********
********* methylprednisolone*********************** 6.0
******* *Fludrocortisone acetate (florinef) **** 12
********* betamethasone*************************** 24 - 30
********* dexamethasone***************************** 32

*potency is locked up for most people, few actually experiance a significant amount.* A rare few need**** to lower their cortisol therapy by up to 1/3.

********* These figures are rough estimations


Glucocorticoid half lives

cortisone acetate 30 minutes (weak, not recommended)
cortisone (oral) 0.8 - 8 hours
hydrocortisone 1 -8 hours
cortisone (IM) 1.3 -18 hours
prednisone 16 -36 hours
prednisolone 18 - 36 hours
triamcinolone 18- 36 hours
methylprednisolone 18- 36 hours
dexamethasone 36 - 54 hours
betamethasone 36- 54 hours

[masterpp]

so really, if one doesnt want to do prednisone (crazy long term i here), its got to either be cortef- which needs to be frequently dosed, or medrol

is that a fair summary

[JanSz]

Originally Posted by masterpp

so really, if one doesnt want to do prednisone (crazy long term i here), its got to either be cortef- which needs to be frequently dosed, or medrol

is that a fair summary

Try Phil or look thru
stopthethyroidmadness.com

yes, this are the two names that I hear, but the whole project is very touchy.

Cortef you eat now and if few hours it is gone.
The other two may over lap your sleeping time, you really have to know what you are doing.

Stop The Thyroid Madness » Safe Uses of Cortisol

Stop The Thyroid Madness » How to treat adrenals–for the patient and their doctors

Stop The Thyroid Madness » ADRENALS FAQ–the most frequently asked questions
========================

Try this search, read what they say, let me know:

search: medrol site:Stop The Thyroid Madness » Index Page

search: medrol site:www.stopthethyroidmadness.com - Yahoo! Search Results
--------\

search: prednisone site:Stop The Thyroid Madness » Index Page

search: prednisone site:www.stopthethyroidmadness.com - Yahoo! Search Results
=============
Why HC instead of Prednisone?
Stop The Thyroid Madness :: View topic - Why HC instead of Prednisone?

Quote:
The reason that most people with adrenal fatigue or Addison's are on HC rather than pred is that it is bioidentical, has some mineralcorticoid activity, and can be easily adjusted as needed.

Prednisone is long-acting, not bioidentical, and has no mineralcoritcoid activity. It isn't "addicting" as most drugs are addicting, but most doc's prescribe it for inflammation of some kind at very high doses. This will completely and sometimes permanently suppress adrenal function, along with giving symptoms of Cushing's--too much cortisol. At the doses we would use, it would NOT have these effects.

Because pred IS harder on the liver, if someone needs something "stronger" than HC, we tend to prefer Medrol.

Personally, I would insist on HC unless it wasn't "enough" ... then I'd insist on Medrol.
_________________
.

[JanSz]

I found this for you.
Stop The Thyroid Madness :: View topic - about medrol...
-------------------
This is a copy of that post
------------------------------------
Medrol is a steroid a bit stronger than prednisone, but much better on your liver. Prednisone has to be converted into prednisolone in the liver which is hard on it and why I don't recommend it and why I won't touch prednisone. Medrol (methylprednisolone) skips the conversion. The methyl group aids the liver.

Post your schedule of how you are taking the Medrol and how you raised from 2 to 3 grains.

The next step up from Medrol is dexamethasone, a steroid you don't want until Medrol has been tried every which way for at least 6 months. I don't talk about Dexamethasone much, but from what you describe (your first person I've suspected in over a year and the first on these forums I've suspected that Medrol may not be strong enough for you) Medrol may not be strong enough for you. Less than 1% of people treated for AI need dex. Dexamethasone is a much stronger steroid than Medrol and is a totally different game than cortef, pred and Medrol, especially if you don't know how to use it.

If any one of these symptoms are present while on 6 mg Medrol (morning nausea or vomiting in the morning, leg cramps or spasms (calves-taking magnesium the night before I found helped me) upon waking, still crave sugar, change doses and times but to no avail, stress dose often, back pain and or spasms which gets worse which a sudden stress like with a near miss car accident or someone cuts you off, etc, you run out of steam or collapse at the end of the day, maybe having to lay around until bedtime) this suggests Medrol may not be strong enough.

All of these symptoms I experianced while on 6 mg Medrol for two years. My day always ended at 8pm when I would have to lay on the couch and I had those other symptoms I mentioned. I of course tried different times and dosing. When I added dex and lowered Medrol all these symptoms disapeared. I used the conversions that I've seen on the net and my books, but I found out the hard way (25 pound weight gain, stretch marks) that dex is much stronger than reported (sources say 1 mg dex = 30 mg HC = 6 mg Medrol). I've found through using dex (Since Jan 25th 2006) that it's closer to 1 mg dex = 160 mg HC = 32 mg Medrol = 40 mg prednisone. I have found one source that supports the conversions are wrong except they say 1 mg dex = to 80 mg HC. I'm sure it's different in each person.

I must stress that dex is an absolute last resort and I recommend trying Medrol every which way first for at least 6 months before trying a very small dose of dex (no more than 1/32 mg) added to medrol (then reduce medrol by 1 mg 5 days later). Keep in mind that the use of Dexamethasone is at anyones own risk. From my experiance I think adding a bit of dex to medrol is a good idea, but I've never heard of a doctor doing this combo. Using dex is not an exact science and I'm the only one that I've seen who has experiamented with super low doses of it (Addison's patients who are put on dex and I've not seen less than 1/2 mg given, end up getting messed up with Cushing's syndrome) Again, you don't want dex if Medrol can do the job just like you don't want Medrol if HC or cortef works well.

I now take 1/32 mg dex at wake and at bedtime.

I also take 125 mcg of florinef at wake which is giving my the full glucorticoid potency potential (majority of people experiance little or no glucocorticoid potency from florinef). Sources support what I've found that 100 mcg has the potential to replace 2 mg of Medrol or 2 1/2 mg or prednisone. I figured this out when I gained weight and got stretch marks within 1 month after adding 100 mcg florinef to my 6 mg medrol. So I ended up getting the equivalent of 8 mg medrol.

I take 1 1/2 mg Medrol at bedtime.

I've worked on lowering Medrol as low as I could in finding the equivalent dose of Dex. I did the same with the florinef when I added that over 2 years ago. So the 125mcg florinef and 1 1/2 Medrol I'm taking together is like taking 4 mg Medrol alone. The other 1/16 mg dex (1/32 mg wake and bedtime) is replacing the other 2 mg Medrol.

I take 3 grain Thyroid-S at bedtime, 1/2 grain at wake. I started doing that about 2 weeks ago. Until I did this I couldn't get rid of the weight I gained when I had taken much higher doses of dex (1/4 to 1/2 mg). Now I've lost 8 pounds.

I might as well talk about my TRT (testosterone replacement therapy) too. It's not really TRT since I use HCG alone (is virtually identical to pituitary hormone Lutropin or LH which stimulates sex hormone production) and not Testosterone Cypionate (enanthate is also sometimes used) though I used to use both HCG and TC (.15 cc once a week) together, but found HCG alone (.2 cc twice a week) worked a whole lot better.

I hope your doc can help you. Hang in there and keep us informed. You're welcome,
Chris
_________________
Hypopituitary Issues Moderator - I'm not a doc, but a patient who shares my knowledge and experiance. Always do your own research of anything someone tells you. That pic is what I looked like in Sept 03, I look nothing like that now.

[eeso]

If u feel good on a lower dose of HC, don't force yourself up to the 'magical' 20mg. I felt good on 12mg and forced myself up to 20 which was stupid and things declined. go on how u feel.

[s0b]

I think dosing with lower than the ultimate 20-25 mg or 30 is not all that safe..

I dosed on 10-12 mg per day for about 6 weeks and it messed up my axis even more. Apart from the hypothyroidism caused (which i didnt see it coming) i got many many side effects and had to quit cold turkey.

Plus using HC is not so simple. You have to know what to eat and what NOT to eat, etc salt, sugar and some other major food constituents are basically prohibited while on HC unless you wanna end up in the ER with very serious issues. (or unless you have serious adrenal gland destruction and need the mineralocorticoid function so you add florinef or other similar drugs. I think its a very risky treatment to take HC for adrenal fatigue.

You have to pay very close attention to your HC dosing also and do regular tests, regarding other hormones and electrolytes. HC supplementation is quite devious, it can change the way the rest of the stress axis may function, cause rebound hormone raises and other weird effects. Also pay attention to your RBC count.
Some people are steroid responders and may develop glaucoma from using cortisone, if this happens then parts of your vision get lost for life. For example, noticing a difficulty to detect motion in your periphery is the original sign of damage to large optical fibers. This is irreversible, and it may happen without any previous indication. Within one-two weeks one may loose serious part of his vision. 5-10% of individuals are steroid responders.

I would really like to hear testimonies from people that were on 10 mg (apprxmatly half a dose) how did they feel and for how long where they on this treatment.

[masterpp]

as ever thanks for the rapid response guys

im gonna sit on 10mg for a while

dont want to go above 20mg ever, incase i get caught without my HC dont want to have issues!!!!!

my hair shed really reall really has calmed down since going on HC.

god knows what my old endo and i have done to myself.

i guess that the elevated cortisol i had before trt really was the first signs of adrenal fatigue, and the combination of an intensive excercise programe, over dose of armour, and no adrenal support, really packed my adrenals in.

im bascially going to do hc for the next 6 months and see how i go

im adding in thyroid meds very slowly- im on 50mg of eltroxin, the mildest thyroid med- which is about half a grain of armour.

im gonna make another post about adrenal support and thyroid meds

thanks again boys

[1ainslie]

Originally Posted by s0b

I think dosing with lower than the ultimate 20-25 mg or 30 is not all that safe..

I dosed on 10-12 mg per day for about 6 weeks and it messed up my axis even more. Apart from the hypothyroidism caused (which i didnt see it coming) i got many many side effects and had to quit cold turkey.

Plus using HC is not so simple. You have to know what to eat and what NOT to eat, etc salt, sugar and some other major food constituents are basically prohibited while on HC unless you wanna end up in the ER with very serious issues. (or unless you have serious adrenal gland destruction and need the mineralocorticoid function so you add florinef or other similar drugs. I think its a very risky treatment to take HC for adrenal fatigue.

You have to pay very close attention to your HC dosing also and do regular tests, regarding other hormones and electrolytes. HC supplementation is quite devious, it can change the way the rest of the stress axis may function, cause rebound hormone raises and other weird effects. Also pay attention to your RBC count.
Some people are steroid responders and may develop glaucoma from using cortisone, if this happens then parts of your vision get lost for life. For example, noticing a difficulty to detect motion in your periphery is the original sign of damage to large optical fibers. This is irreversible, and it may happen without any previous indication. Within one-two weeks one may loose serious part of his vision. 5-10% of individuals are steroid responders.

I would really like to hear testimonies from people that were on 10 mg (apprxmatly half a dose) how did they feel and for how long where they on this treatment.

What do you mean by ER

[coz]

I use medrol and prefer it, as you don't have to dose every 4 hours. I take 2mg when I wake and another 1mg late afternoon (although it could all be taken in the morning).

You could use 2mg of medrol a day, which would be equivalent to 10mg HC