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-   -   how can I tell if I am getting too much, or not enough, hydrocortisone? (

itskt2u 08-04-2003 02:30 PM

how can I tell if I am getting too much, or not enough, hydrocortisone?
can anyone tell me what to look for? I have a way to monitor my blood pressure and pulse rate at home; Drs advise 'lowest amount that feels best' but I am still experimenting with my dose and never feel normal anyway. Supposedly a few weeks on the right dose of hydrocortisone (thyroid too) will allow me to feel much better.

orion 08-04-2003 08:45 PM

First off, no one knows what the proper dose for Addison's is. It is thought to be around 0.18mg/pound of weight so a 150 pound person should be around 25mg/day. But a normal body regulates cortisol on a minute by minute basis and can sometimes triple or more the dose you receive. Of course you can't do that because the need for more cortisol is not directly obvious. Worse, the dose that makes you feel find today, might be too big or small tomorrow when you get an infection or the flu.

So what I am saying is, you won't be able to find the perfect amount, but it is somewhere between 15 and 30 mg/day for most people. It used to be thought you should try to be as low as possible, but now people wonder if being too low harms your immune system because cortisol is a powerful regulator of immunity.

Normally, when you get sick, cortisol goes high for a day or two and then suddenly drops. The drop signals your immune system to go into high gear and attack the virus/bacteria you have. This also happens at night when your immune system ramps up as the cortisol levels plunge. That's why it's wise to take most cortisol in the morning and little at night and to take more cortisol when you get sick and then drop it after a few days.

Your thyroid dose is a bit easier because you can take blood tests for that. However the normal range of thyroid is pretty wide so what makes one person feel energetic won't for another. Again, you will have to experiment, remembering that changes take a week to come into full effect and not to change by more than 0.025mg/2 weeks. Watch for symptoms of high and low thyroid incase you go too far.

It took me 2 years to balance my hormones. I now take 25mg/day of hydrocortisone and 0.175mg of synthroid. My original starting dose was 15mg/day and 0.1mg. Both doses gave me normal blood readings.

itskt2u 08-05-2003 08:15 AM

thanks orion-

glad to know it can take something like 2 years to get things straight (so I won't be so impatient!); I have been on thyroid almost 15 years, but on hydrocortisone only a few weeks

do you feel well, or close to it, now?

my thyroid dose cannot be regulated by blood tests, because I have hypothalamic dysfunction which skews the lab results


orion 08-06-2003 04:47 PM

Yes I feel physically good most days. Getting sick, with the flu is harder to deal with. Also I am balancing 5 hormones so it's a bit tricky at best.

Can't your thyroid be monitored using T3 and T4 instead of TSH? That's how mine is monitored, puting T3 and T4 in the up 25% range.

itskt2u 08-09-2003 07:06 PM

Do you mean in the upper 25% of 'normal' range for the T3 and T4 tests? I think my new endocrinologist is trying to monitor my dose this way, and I am awaiting new labs for T3 and T4; the first test done with only T4 shows it below the normal range (and I take 180mg of Armour thyroid!). Previous doctors didn't seem to care to make it right; they test one thing and send you on your way if it's 'normal'.


GhostH 08-11-2003 07:34 AM


I just picked up a digital blood pressure machine on ebay.

In the next month I intend to test BP 4 times daily & make notes as to med levels, over all feeling, high stress days etc.

I believe there is a direct connection that might help us self regulate a bit better.

If your inclined sounds like it wouldn't be hard for you to do the same. Be easy enough to compare results here.

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