IsoCort and Pregnancy

[marianco]

For information see this link: http://drugsafetysite.com/hydrocortisone
and this link: Endotext.com - Endocrinology of Pregnancy, Adrenal Disorders of Pregnancy

IsoCort contains about 2.5 mg of Hydrocortisone as its active ingredient. 40% of this is eliminated by the liver when it is absorbed. 7.5 mg of hydrocortisone in IsoCort becomes 4.5 mg after absorption.

The average adult female produces about 15 to 25 mg of Hydrocortisone a day when at rest with mild stresses. Higher when there is more stress.

During pregnancy, there is an increased demand for hydrocortisone production.

Thyroid hormone production, itself, increases. HCG, in this case, acts like TSH, stimulating thyroid hormone production. Thyroid treatment is generally continued through pregnancy. Pregnancy usually increases thyroid hormone levels by up to 50%. If it does not, there is a risk for gestational diabetes, preeclampsia, etc.

The studies on toxicity and birth defects with hydrocortisone during pregnancy use very high doses of hydrocortisone for inflammatory illnesses such as lupus.

Subphysiologic doses of hydrocortisone - i.e. doses which give less than the total amount produced each day by the body (such as 3 pellets of IsoCort) - generally don't effect total cortisol levels.

Thus, in general, 3 pellets of IsoCort in divided doses, is a safe dose during pregnancy. And generally, if a person has adrenal fatigue, the benefits would outweigh the risks. Untreated adrenal fatigue would increase the risk of a miscarriage.

It would generally be useful to consult with a gynecologist regarding this information prior to becoming pregnant.

Hi Dr. Mariano,

I've been lurking on this MESO-Rx board for some time, and I've read many of your posts about adrenal fatigue, hypothyroidism and the like -- thank you for being such a great source of information!

I was wondering if I could trouble you with a question? I've spent over a week trying to google the answer with no luck whatsoever. The question is this: Is Isocort really contraindicated during pregnancy? Is it really that bad? I've read how the offending ingredients are Prunus spp. and Lomatium Dissectum Root Isolate, but given the entire ingredients are listed as 5mg, maybe there are just trace amounts of these things in each pellet?

The reason I ask is that my doctor refuses to believe I have a thyroid problem (even when I had a TSH of nearly 6), let alone an adrenal fatigue problem, so I've been treating myself with Armour bought online. I found at first that I couldn't tolerate even a 15mg dose of Armour, so I assumed I needed the Isocort, and boy, did that make a difference. I'm now at TSH of 1.83 and feeling better (but could feel better still). I'm taking 3 pellets of Isocort a day.

I am now trying to conceive, and I would really like to continue taking the Isocort in order to keep taking the Armour. In your opinion, do you think this is safe? If I stop taking it, my T3 numbers go too high (187 on a scale of 70-170), and of course optimal thyroid treatment is very important to the baby -- so which is worse? Taking Isocort or not getting enough thyroid meds to my cells?

Looking forward to hearing from you (if you have time!), and thanks again for all your generous posts & the help you've already given on this board -- I appreciate your posts immensely.

Regards,

[Ravenna]

Thanks, Marianco, for answering my question -- I appreciate your time and response very, very much. However, I'm still worried about the amount of Prunus spp. and Lomatium Dissectum Root Isolate in the Isocort. I'm assuming you're saying that the amount is so tiny, there is no need to worry?

[marianco]

You have a good point which I did not initially consider.

It looks like these are used as adaptogens, antiinflammatories - and thus would have synergistic actions with IsoCort. The safety of herbals in pregnancy is generally not known.

I don't know what "krebs concentrate" means. Does this mean that hardly any is used such as in a Homeopathic treatment? I don't know. It would sure be interesting to know. But I'm sure Bezwecken keeps the whole thing a secret to keep themselves safe legally. But it does keep us in the dark.

Generally, I would not like any medication during pregnancy if possible - including herbal medications, since there are many unknowns. However, the benefits of the treatment need to be taken into account compared to the risks. For example, I have kept some mothers on antipsychotic and antidepressant medications despite the risks because the risks with no treatment are even worse - e.g. full blown illness with a risk to the fetus. Some medications such as the anticonvulsants, I would generally remove unless the mother has seizures, given the risks of birth defects. But then counseling on whether or not to keep the pregnancy is important. Antiseizure medications are generally studied in women who are not in child bearing age or are sterilized. Thus the answer is "it depends" with a generaly preference to remove all but the necessary treatments. Given the improvements/changes physiologically that occur during pregnancy, surprisingly or not surprisingly, many medications are not needed since pregnancy can itself correct many problems - at least during the short time one is pregnant.

Perhaps rather than IsoCort, a straight equivalent dose of hydrocortisone (e.g. 2.5 mg) would be better. Hydrocortisone can cause acid reflux compared to IsoCort, which is why taking it with food is best. But then, would such a low dose be needed with the general improvement in adrenal and thyroid function in pregnancy - unless there is a more serious metabolic problem occurring?

If a woman is in her first pregnancy, then a lot of things are not known, such as what course will she take. Age would be an important consideration for the risk of the pregnancy to the fetus and mother. The older the mother, the more likely it is preferred to minimize medications and herbal treatments except those considered critically important for the health of mother and fetus.

All of this is why it would be generally best to consult with a gynecologist about this issue.

Some info that is helpful:

Lomatium | Herbal Remedies, Supplements | PDRHealth

Lomatium dissectum - American Indian/Native American 1st Nati - tribe.net

Prunus - Wikipedia, the free encyclopedia

Pygeum - Wikipedia, the free encyclopedia

Originally Posted by Ravenna

Thanks, Marianco, for answering my question -- I appreciate your time and response very, very much. However, I'm still worried about the amount of Prunus spp. and Lomatium Dissectum Root Isolate in the Isocort. I'm assuming you're saying that the amount is so tiny, there is no need to worry?