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» LymeNet Flash » Questions and Discussion » Medical Questions » Cortef--maximum dose?

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Author Topic: Cortef--maximum dose?
whitmore
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I have very low cortisol levels. This is more likely a result of a pituitary problem rather than an adrenal one, since ACTH is not elevated.

To fix this, it means that cortef has to be taken not to augment the cortisol produced by the adrenals, but to replace it. This might mean as much as 25 to 30 mg per day, especially if thyroid medications are taken.

Of course the mantra is 'no steroids', but apparently without adequate cortisol,ABX don't work(Dr. S, I believe).

I'd love to hear from others who have taken cortef during lyme treatment. And if anyone has taken a full replacement dose of cortisol while being treated for lyme and co.


Regards.

Sue

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Keebler
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I can't speak to dose as I could not tolerate it (but I can't tolerate much so don't be deterred by my reaction. Most do very well with gradual tapering).

but you can find the range most likely at William Jefferies website.

You'll want to get Jefferies' book: Safe Uses of Cortisol

You'll also want the book by James L. Wilson: Adrenal Fatigue

(and when you get that, cover over the huge word "fatigue" on the cover with this prettier word: "support" - psychologically, that matters, IMO.)

Just Google the names for their own sites, and then at Amazon to see reader reviews.

Public Libraries and the inter-library loan system can help you locate the books if budget is an issue.


Yes, indeed, as you mention, steroids can cause major trouble. But that's not the KIND or DOSE of steroids for Cortef (hydrocortisone) to help with adrenal exhaustion.

It does seem that this may be required for lyme treatment to work for some who are more depleted.

Others will surely answer to the range of their doses, but each person would start at very, very dose and then gradually work up to their optimum - but not exceeding physiological dose (that is the dose the body is supposed to make on its own, no more).

Dose will be an individual range but always start with a TINY, TINY dose and give that some time before increasing.

What turns out to be your best dose of Cortef may be below the physiological dose as some can't tolerate even that much.

If that turns out to be the case, other kinds of adrenal supports (adaptogens) are often very helpful in combination.

Many LLMDs use "low dose" Cortef but only up to what the typical physiological dose would be.
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Keebler
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As we know, the HPA-axis can just get clobbered with lyme.

HPA axis explained:

http://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93adrenal_axis

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In addition to addressing infection(s) head on with a thorough protocol:
-----------

This author discusses the importance of addressing hormonal imbalance in chronic Lyme disease

http://www.thefreelibrary.com/Heal+the+hormones+to+heal+from+Lyme+disease.-a0231544999


HEAL THE HORMONES TO HEAL FROM LYME DISEASE

- by Connie Strasheim - Townsend Letter - July, 2010

be sure to scroll down past a section of ads that looks like the end of the article. This is a four-page article.

-----------------------------------

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/89790

Topic: NATURAL SLEEP & ADRENAL SUPPORT

The Wilson Adrenal Book here is "required" reading for a good understanding of what's going on and what we can do to help (and what hurts) adrenal / endocrine matters - it has such important detail.
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[ 09-23-2013, 12:15 PM: Message edited by: Keebler ]

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Keebler
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[posting for other readers here, too.]

You mentioned awareness of the "no steroid" caution.

The link below is not about low dose Cortef . . . still, you might want to have this at your fingertips just in case you need this at any time.

This is why higher doses of Cortef -- or steroids such as prednisone, other steroids, or shots (even if typical "normal" doses) are not used, except in emergencies:

http://flash.lymenet.org/scripts/ultimatebb.cgi/topic/1/100984?#000000

Topic: what do STEROIDS actually do to those who have lyme?
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fourwinds
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I have been on a "physiological dose" of Cortef for several years. Prednisone is 4X stronger than

Cortef and is immunosuppressive, Cortef is usually dosed to replace what the body normally would/should be making.

Keebler's resource reference (Dr. William Jeffries) is a great one to have on hand if you are treating with Cortef.

I do not have a thyroid ( I take natural dessicated thyroid) and only take 20 mg of Cortef (5 mg 4X per day. I HAVE had to stress

dose (temporarily increase) my dosing on occasion (once when I got a severe stomach flu...)

Some people really need to ramp up slowly on it... here is a great example of how to:


http://www.stopthethyroidmadness.com/adrenal-info/how-to-treat/

I was told by my LLDNP to watch my thryoid levels as I am treating Babesia, as Mepron and Malarone can lower them.....

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Lymetoo
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My LLMD said the body can produce as much as 30mg of hydrocortisone per day.

So he would prescribe UP TO 30mg of Cortef.

I took that much for a few years, then tapered it to 10mg. I just didn't want to take more than I "had" to.

--------------------
--Lymetutu--
Opinions, not medical advice!

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Lymetoo
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quote:
Originally posted by fourwinds:
Prednisone is 4X stronger than Cortef and is immunosuppressive, Cortef is usually dosed to replace what the body normally would/should be making.

That is important to remember.

--------------------
--Lymetutu--
Opinions, not medical advice!

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MichaelTampa
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The "stop the thyroid madness" book mentions that their book discusses aldosterone as well and the steroid sometimes needed to replace it, and presumably concurrent use with hydrocortisone.

Can anyone comment on whether the Dr. Jeffries book, "safe uses of cortisol", also covers this topic adequately?

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Keebler
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Michael,

I don't have that book. However, you may be able to get it at the library. You may find a clue about your question in the Table of Contents or the Index here, where you can take a look in the book at Amazon.

There is also a search engine for the book, there are:

5 results for aldosterone (you may be able to see some of those pages)

http://www.amazon.com/Safe-Uses-Cortisol-William-Jefferies/dp/0398066213#reader_0398066213

Safe Uses of Cortisol - by William Jefferies
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