Update on Using Isocort.

[pmgamer18]

Just got back from the Dr.'s and my testis are great it looks like doing the Isocort has made a big difference in my labs across the board. The only thing that stayed the same was my low cortisol levels still between 9 to 10 doing a morning test.

My Dr. said he wants me to hold off taking anymore Armour he said my Thyroid test came up from the last ones. I have only been the max dose of isocort for 12 days and the blood test was 3 weeks ago so he feels things could be even better. Three office visits ago he did not believe in Adrenal Fatigue now he is up on all of it this is what I like about him. You show him something and if it is good like the book Adrenal Fatigue I showed him. He will dig into this and come around.

I am shocked my Total and Free T levels only came down to what they were before starting Isocort. Yet I am doing a lot less T. I have cut my dose from 64 mgs down to 41 mgs every 3 days. And my Total T came down from 1359 to 909 range 262 to 1598 ng/dl.
Free T came down from 33.5 to 25.7 range 8.8 to 27 pg/ml.
DHEA-SO4 is up from 302 to 492 range 80 to 560 ug/dl
Progesterone is 0.457 down from 0.73 range 0.27 to 0.90 ng/ml.
Pregnenolone is 21 was <20 range <20 to 150 ng/ml
IGF-1 is way up from 125 to 210 range 75 to 228 ng/ml.
Glucose fasting is up 107 from 65 range 65 to 140 mg/dl.
Thyroid Microsomal 10.2 range <35 Iu/ml.
Thyroglobulin <20 range <40 Iu/mL.

Alkaline Phosphatase is low 23 test was redone range 40 to 150 Iu/L not sure what this means.

So I am to stop the 45 mgs of Armour and stay on the Isocort and keep my T and HCG dose the same. In 60 days I go back in for testing.

[1cc]

Your Free T looks great, but did you do this lab the day before your shot or the day of your shot?

I'm surprised that your DHEA-S went up. Are you still taking 25mg DHEA, or did you increase it?What time was this lab taken and what time do you take your DHEA?

Your fasting glucose could be up because of the cortisol.

I'm surprised about your IGF-1. I wonder what could have caused that to increase. Do you eat a hypoglycemic diet or do you eat a lot of refined carbs and sugar? It would be good to get Marianco's input on this.

[pcgizzmo]

Originally Posted by pmgamer18

Just got back from the Dr.'s and my testis are great it looks like doing the Isocort has made a big difference in my labs across the board. The only thing that stayed the same was my low cortisol levels still between 9 to 10 doing a morning test.

My Dr. said he wants me to hold off taking anymore Armour he said my Thyroid test came up from the last ones. I have only been the max dose of isocort for 12 days and the blood test was 3 weeks ago so he feels things could be even better. Three office visits ago he did not believe in Adrenal Fatigue now he is up on all of it this is what I like about him. You show him something and if it is good like the book Adrenal Fatigue I showed him. He will dig into this and come around.

I am shocked my Total and Free T levels only came down to what they were before starting Isocort. Yet I am doing a lot less T. I have cut my dose from 64 mgs down to 41 mgs every 3 days. And my Total T came down from 1359 to 909 range 262 to 1598 ng/dl.
Free T came down from 33.5 to 25.7 range 8.8 to 27 pg/ml.
DHEA-SO4 is up from 302 to 492 range 80 to 560 ug/dl
Progesterone is 0.457 down from 0.73 range 0.27 to 0.90 ng/ml.
Pregnenolone is 21 was <20 range <20 to 150 ng/ml
IGF-1 is way up from 125 to 210 range 75 to 228 ng/ml.
Glucose fasting is up 107 from 65 range 65 to 140 mg/dl.
Thyroid Microsomal 10.2 range <35 Iu/ml.
Thyroglobulin <20 range <40 Iu/mL.

Alkaline Phosphatase is low 23 test was redone range 40 to 150 Iu/L not sure what this means.

So I am to stop the 45 mgs of Armour and stay on the Isocort and keep my T and HCG dose the same. In 60 days I go back in for testing.

Looks like you are definetly on to something Phil congratulations. Glad you are feeling good and doing better.

Paul

[pmgamer18]

Originally Posted by 1cc

Your Free T looks great, but did you do this lab the day before your shot or the day of your shot?

I'm surprised that your DHEA-S went up. Are you still taking 25mg DHEA, or did you increase it?What time was this lab taken and what time do you take your DHEA?

Your fasting glucose could be up because of the cortisol.

I'm surprised about your IGF-1. I wonder what could have caused that to increase. Do you eat a hypoglycemic diet or do you eat a lot of refined carbs and sugar? It would be good to get Marianco's input on this.

My Dr. wants me to do my tests the day of me shot and do the tests fasting now food after 9:00 pm. Yes I upped the DHEA a long time ago to 2 pills one in the morning and one at noon but it could have taken this long to come up. I eat a Weight Watchers program low carbs and no sugar. The labs were done at 8:00 am. and no meds or or shots were done. My Dr. feels my body was in stress with the low cortisol levels and doing the Isocort = 20mgs of cortisol lowered my stress levels a lot that is why I get this feeling of well being so strong it like a ton of weight is lifted off my shoulders. It's almost like the feeling I got when I first started on prozac yrs. ago. But with out feeling sleepy.

[pmgamer18]

Originally Posted by pcgizzmo

Looks like you are definetly on to something Phil congratulations. Glad you are feeling good and doing better.

Paul

Thanks Paul I owe it all to the guys here and Marianco's input.

[1cc]

Originally Posted by pmgamer18

My Dr. wants me to do my tests the day of me shot and do the tests fasting now food after 9:00 pm.

In that case, your Free T is still a little high. As soon as you take your shot, your Free T is going to go over the top. BTW, did you get E2 done?

[magic8989]

Those labs are looking good there. What did he say bout the thyroid article that you had a thread linked to? I think it is pretty incredible how everything is linking together. I mean you are able to keep pretty much the same T levels at a reduced dose just by treating the adrenals.


I started on 8 isocort caps a few days and will see how it goes.

[pmgamer18]

Originally Posted by 1cc

In that case, your Free T is still a little high. As soon as you take your shot, your Free T is going to go over the top. BTW, did you get E2 done?

Yes doing .25 mgs every 6 days and my E2 was 28 so this is not bad. Last test is was to low 15 but then I was doing .5 mgs every 3 days.

[021mk]

I am doing Isocort and a dissecated thyroid supplement. I am feeling great, but I also increased my androgel from 5 gram to 7.5 7 days ago, so I am not sure if it's the increased androgel or the thyroid supplement/isocort since I started those supplements around the same time I increased the androgel.
BTW, I clipped my hair today and noticed that i have some dime-size spots on my head. Not sure if they are balding spots or some scalp rash. I've read here that Andrigel creates weird looking bald spots on some people. If so, are these bld spots reversible? What would it mean if I am loosing my hair in this fashion due to androgel?

[Vforcer2]

Originally Posted by pmgamer18

My Dr. wants me to do my tests the day of me shot and do the tests fasting now food after 9:00 pm. Yes I upped the DHEA a long time ago to 2 pills one in the morning and one at noon but it could have taken this long to come up. I eat a Weight Watchers program low carbs and no sugar. The labs were done at 8:00 am. and no meds or or shots were done. My Dr. feels my body was in stress with the low cortisol levels and doing the Isocort = 20mgs of cortisol lowered my stress levels a lot that is why I get this feeling of well being so strong it like a ton of weight is lifted off my shoulders. It's almost like the feeling I got when I first started on prozac yrs. ago. But with out feeling sleepy.

Fasting or a hypocaloric diet will increase GH release resulting in increased IGF-1.

[marianco]

Originally Posted by pmgamer18

Just got back from the Dr.'s and my testis are great it looks like doing the Isocort has made a big difference in my labs across the board. The only thing that stayed the same was my low cortisol levels still between 9 to 10 doing a morning test.

My Dr. said he wants me to hold off taking anymore Armour he said my Thyroid test came up from the last ones. I have only been the max dose of isocort for 12 days and the blood test was 3 weeks ago so he feels things could be even better. Three office visits ago he did not believe in Adrenal Fatigue now he is up on all of it this is what I like about him. You show him something and if it is good like the book Adrenal Fatigue I showed him. He will dig into this and come around.

I am shocked my Total and Free T levels only came down to what they were before starting Isocort. Yet I am doing a lot less T. I have cut my dose from 64 mgs down to 41 mgs every 3 days. And my Total T came down from 1359 to 909 range 262 to 1598 ng/dl.
Free T came down from 33.5 to 25.7 range 8.8 to 27 pg/ml.
DHEA-SO4 is up from 302 to 492 range 80 to 560 ug/dl
Progesterone is 0.457 down from 0.73 range 0.27 to 0.90 ng/ml.
Pregnenolone is 21 was <20 range <20 to 150 ng/ml
IGF-1 is way up from 125 to 210 range 75 to 228 ng/ml.
Glucose fasting is up 107 from 65 range 65 to 140 mg/dl.
Thyroid Microsomal 10.2 range <35 Iu/ml.
Thyroglobulin <20 range <40 Iu/mL.

Alkaline Phosphatase is low 23 test was redone range 40 to 150 Iu/L not sure what this means.

So I am to stop the 45 mgs of Armour and stay on the Isocort and keep my T and HCG dose the same. In 60 days I go back in for testing.

DHEA will increase IGF-1.

This is why I would treat adrenal fatigue first - which increases DHEA production - before I would consider growth hormone replacement therapy since the low IGF-1 level may instead represent adrenal fatigue reather than growth hormone deficiency.

Hydrocortisone at sub-replacement doses (i.e. less than or equal to 20 mg oral hydrocortisone a day in most people - some people need less) generally (with exceptions) has no side effects when given multiple times a day, other than the effects increased stomach acidity, nausea, diarrhea - while it is not yet absorbed. Some people need less than 20 mg a day.

Treatment of adrenal fatigue is a passive treatment. It takes time and the treatment to allow the adrenals to rest and recuperate from stress.

When adrenal fatigue is successfully addressed - and low blood sugars come back to a normal range - often insulin resistance/diabetes becomes uncovered. Insulin resistance/diabetes tends to increase fasting blood sugars. I would suspect insulin resistance if the blood sugar is greater than about 102.

Adequate thyroid hormone is necessary to allow HCG to increase testosterone production maximally. Thyroid hormone stimulates testicular steroid hormone production - including testosterone.

When a person becomes hypopituitary as a result of a head injury, the question I would have is does the person have panhypopituitarism - i.e. have multiple hormone deficiencies - such as low ACTH leading to low adrenal function, low TSH leading to hypothyrodism, low LH leading to hypogonadism, etc. In this case, multiple hormone replacement therapy is needed.

DHEA helps reduce insulin resistance.

SHBG usually is low if there is insulin resistance. Low SHBG may result in high Free Testosterone.

Free Testosterone is a tricky test to for making clinical decisions. Generally, the tests for free testosterone are not reliable. Free Testosterone can also be normal even with hypogonadal total testosterone. At this time, I prefer using total testosterone as the indicator for determining the adequacy of testosterone replacement.

With thyroid hormone replacement, it is important to base the dose on the clinical response as opposed to only lab testing. Improvement in hypothyroid symptoms, while avoiding the condition of hyperthyroidism is the goal. Symptoms of hyperthyroidism are numerous including tachycardia, anxiety, atrial fibrillation, sweating, insomnia, frequent bowel movements, etc.). There are people who can tolerate only small amounts of thyroid hormone without going into hyperthyroidism. Since some of the symptoms of hyperthyroidism are potentially lethal, care in treatment is necessary. It is important to keep in consultation with one's physician.

[Matt Muscle]

Originally Posted by marianco

Hydrocortisone at sub-replacement doses (i.e. less than or equal to 20 mg oral hydrocortisone a day in most people - some people need less) generally (with exceptions) has no side effects when given multiple times a day, other than the effects increased stomach acidity, nausea, diarrhea - while it is not yet absorbed. Some people need less than 20 mg a day.

Treatment of adrenal fatigue is a passive treatment. It takes time and the treatment to allow the adrenals to rest and recuperate from stress.

Marianco, thankyou for the post.
In your experience, if sub replacement dosages of hydrocortisone are used to treat Adrenal Fatigue, (thus giving the adrenal glands some time to recover), once this therapy is withdrawn, (gradually of course) is there any chance that the glands will become dependant on the external cortisol, or is this usually only the case when full replacement dosages are used, which would cause the adrenals to shut down?

[love_en]

Dr Jeffries has seen cases where the adrenals have come back after they were rested by replacement doses of hydrocortisone. I understand the risk of permanent suppression when replacement cortisol is given to borderline secondary patients. However, I am receptive to the idea of resting the adrenals in cases of borderline primary insuficiency and low adrenal reserve. I will be placing myself on replacement doses of prednisolone shortly. To see if it changes a lifetime of chronic illness.

I have avoided going this route for a long time with the use of licorice. I can only speculate the reason why it did not casue the hypertension and water retention it is notorious for in me, is the nature of my adrenal problem goes beyond low cortisol. I have a hard time retaining sodium and tend to accumulate potassium. I am no longer on licorice, but the only thing keeping me from falling down is salt. I put a pinch of salt in every bottle or glass of water I drink. I salt everything I eat a little past the point of it being palatable. When I had my ACTH stim test done, I was not sharp enough to ask for the aldosterone and renin tests. But given the attitudes of the doctors I have seen to date, those results would have probably screamed adrenal insufficiency and they would not have paid attention. As is I am the hypochodriac that knows too much.

[The_Skeptic]

Originally Posted by marianco

When a person becomes hypopituitary as a result of a head injury, the question I would have is does the person have panhypopituitarism - i.e. have multiple hormone deficiencies - such as low ACTH leading to low adrenal function, low TSH leading to hypothyrodism, low LH leading to hypogonadism, etc. In this case, multiple hormone replacement therapy is needed..

I am hypopituitary because of a head injury I suffered as a child. Eleven years ago, when I first got diagnosed with secondary hypogonadism, a blood test revealed that my total testosterone was 238 and my FSH was 4.0 (.5-20) and my LH was 2.5 (.5-18).

And the TSH was .9, which the test indicates is "normal", but I would like to hear your opinion on this.

A few tests that I had over the years since going on TRT indicates that the TSH had increased slightly from the original pre-TRT blood test.

[marianco]

Originally Posted by Matt Muscle

Marianco, thankyou for the post.
In your experience, if sub replacement dosages of hydrocortisone are used to treat Adrenal Fatigue, (thus giving the adrenal glands some time to recover), once this therapy is withdrawn, (gradually of course) is there any chance that the glands will become dependant on the external cortisol, or is this usually only the case when full replacement dosages are used, which would cause the adrenals to shut down?

Generally, a sub-replacement dose results in the actual cortisol levels being the same with or without the external cortisol. This means that when therapy is withdrawn once the adrenals are fully functional, there is no withdrawal. The adrenals will have the full capacity to make the amount of cortisol the brain wants at a moment's notice.

Generally, when full replacement doses (or higher) are used (this means a "medicinal" dose), the adrenals shut down because the brain stops making ACTH to signal the adrenals to work. It can be very difficult to restart the adrenals when such a dose is used for a long time. In some people, it may take two years to get then restarted, if not longer. This makes the person dependent on external cortisol or its equivalents (e.g. Prednisone).