Heal your Adrenals with this Easy Program

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Éiriú Eolas (pronounced “AIR-oo OH-lahss”), the amazing scientific stress-control, healing, detoxing and rejuvenation program which is THE KEY that will help you to change your life in a REAL and immediately noticeable way. Available online at eebreathe.com

If you are “adrenals are shot”, then your stress-coping abilities are severely depleted. That is, you’ll just stress out.

Adrenal fatigue can affect anyone who experiences frequent, persistent, or severe mental, emotional or physical stress. It can be a contributing factor in health conditions ranging from allergies to obesity. Despite its prevalence in our modern world, adrenal fatigue is for the most part ignored and misunderstood by the medical community.

The adrenals are located on top of your kidneys and they are responsible for producing noradrenaline and adrenaline which are important for your “fight or flight” acute response. Your adrenals are also responsible for producing steroid hormones from cholesterol, including DHEA, progesterone, estrogen, testosterone and cortisol.

Cortisol has a fundamental role in coping with chronic prolonged stress (psychological, physical or emotional). Cortisol is anti-inflammatory; it increases stamina, boosts mental and physical energy and has a role in your immune/defense system response. It is here where the low fat scam takes its toll. But several things may go wrong other than low cholesterol levels. For instance, your adrenals and your HPA axis might be overstressed or dysfunctional.

The hypothalamus-pituitary-adrenal (HPA) axis is what can be considered the head master of your adrenals. As the name suggests, the HPA axis is composed of the hypothalamus, the pituitary gland (both in the brain), and the adrenal glands.

Our hypothalamus is that part of the brain considered to be the master gland of the endocrine system due to its homeostatic (balance) effect over all our hormonal system.

This is why the HPA axis regulates many functions such as blood pressure, digestion, circadian rhythms, sex drive, body temperature, balance and coordination, heart rate, sweating, water balance, blood sugar levels, adrenal hormones, thyroid hormones and metabolism.

The HPA axis, as the head master overseeing your adrenals, has an effect in your reactions to stress. What is more, chronic stress can suppress the HPA axis, leading to lower production of cortisol by the adrenals.

If there is an imbalance of the HPA axis, it will disrupt your body’s ability to maintain the homeostasis of the hormonal system. Thyroid function may become compromised by any disruption to the HPA axis, so stress can definitely have an effect on thyroid function. A dysfunctional HPA-axis can cause estrogen, testosterone, and progesterone to become imbalanced as well.

If you have leptin resistance due to a high carbohydrate intake, that will make your HPA axis most unhappy as well. Leptin is a major hormone that ultimately influences all other hormones and the functions of the hypothalamus in the brain. Thus, leptin controls the function of the HPA axis. As it happens, it seems that leptin enhances your flight or fight response and it inhibits the secretion of steroid hormones (cortisol) by the adrenals.[1] Thereby it promotes the stress response and it discourages anti-inflammatory effects.

An imbalance in your HPA axis is known to cause symptoms such as muscle or joint pain, dizziness, fatigue, low body temperature, a compromised immune system, constipation or diarrhea, abdominal pain, depression, and less mental acuity.[2]

People with low cortisol levels have a tendency towards allergies, especially hay fever, and the beginnings of arthritis. Low cortisol is associated particularly with autoimmune disorders, such as asthma, arthritis, allergies, ulcerative colitis, and fatigue.

Adrenal Fatigue: The 21st Century Syndrome


Adrenal fatigue refers to the concept of too much stress depleting your adrenals and causing a decrease in the output of adrenal hormones, particularly cortisol. Even though mainstream medicine denies its existence, adrenal fatigue has been called hypoadrenia, neurasthenia, non-Addison’s hypoadrenia, subclinical hypoadrenia, adrenal neurasthenia and so forth.[3]

Low cortisol levels may make you less able to respond when you need to, and it has been associated with low grade, frequent emotional (and sometimes physical) abuse and neglect.[4] There is a strong link between low cortisol and post-traumatic stress disorder (PTSD). Low cortisol has also been associated with a lack of positive good feeling.

Years of poor sleep, excessive stimulants such as coffee, chronic psychological stress (anything from a divorce to an economic collapse without mentioning stressful climate changes…), surgeries, traumatic events, and environmental toxicity can have a very heavy toll in your adrenals.

The adrenals, in their effort to regulate blood sugar extremes from a lifetime of a high carb diet, become overburdened, eventually burning them out.

People can look normal, yet they are living with a general sense of unwellness. People who suffer from adrenal fatigue often have problems regulating their blood sugar, they tend to experience more delayed food allergies, they are more vulnerable to infections and they tend to have pains and mood problems such as anxiety and depression other than sleeping problems. People with frequent respiratory infections, rhinitis, asthma, frequent colds, allergies, fibromyalgia, chronic fatigue syndrome, diabetes, autoimmune disorders tend to have adrenal fatigue. In fact, allergies seem to get worse when there is more stress since cortisol is needed to counteract the inflammatory reactions.

People with adrenal fatigue tend to skip breakfast. They wake up without appetite and the only thing they want is coffee. This has the effect of stimulating their adrenals, extracting the very last juice of them so they can start-up the day. Under more stress, they can faint easily if they skip further meals or just drop exhausted anywhere. So if you are to heal your adrenal function, you must absolutely eat a big fatty breakfast.

Other hormones produced by the adrenals also may leave the ladies prone to more facial hair or acne.

People can crave more salt since the adrenals are also responsible for releasing a hormone related with salt and water. In adrenal fatigue, more sodium is lost than usual, leading to drops in blood pressure, tiredness and lots of salt craving. It is a crime to deprive a person with adrenal fatigue of salt. As it happens, salt has anti-inflammatory effects since it is a natural anti-histaminic. Why do you think it is recommended for sinus congestion?

Since the adrenals produce the rejuvenating steroid hormone DHEA (dehydroepiandrosterone) – precursor for estrogen, progesterone and testosterone – people with adrenal fatigue tend to have bone loss, loss of muscle mass, depression, aching joints, decreased sex drive and so forth.

Another thing often overlooked is that if you are meant to normalize a low thyroid function, you must absolutely heal your adrenals first, otherwise, nothing will happen. Thyroid function often normalizes when you support your adrenals and remove delayed food allergies. Thyroid problems often mean gluten intolerance, and if gluten is removed on time, and you support your adrenals, the damage is reversible.

Adrenal Fatigue Protocol


Adrenal fatigue symptoms and signs include chronic stress, tiredness, excess facial or body hair growth in women, several food sensitivities, multiple chemical sensitivities, hair loss, acne, salt cravings, recurrent infections, low blood pressure, tend to skip breakfast in the morning (lack of appetite and/or drink only coffee), or feeling cold. Keep in mind that you’ll never normalize a low thyroid function (diagnosed either by lab tests or clinical symptoms) if you don’t address adrenal fatigue.

First, try titrating doses of vitamin C since it is a very important nutrient for adrenal function and repair, other than cholesterol. Most folks need only to up their intake of this important nutrient in the form of supplemental vitamin C (most fruits are so loaded in sugar that it makes them useless for the little C that can be obtained from them). For more information on vitamin C, see Heal Thyself with Homemade Liposomal Vitamin C.

Low Dose Hydrocortisone

Dosage as follows[5]:

– Start with 2.5 mg (a quarter of a 10-mg tablet or half of a 5-mg tablet) per day between 6 and 8 am for one week.
– Increase the dose to 5 mg per day between 6 and 8 am if you saw no positive response with the lower dose for one week.
– Increase the dose to 10 mg per day between 6 and 8 am if you saw no positive response with the previous dose for one week
– Maintain your dose of 10 mg in the early morning and add 5 mg at noon if you saw no positive response with the previous dose for one week.
– Maintain your dose of 10 mg in the early morning and 5mg at noon, add 5 mg at 4pm if you saw no positive response with the previous dose for one week.

If at any point you experience carbohydrate cravings, bloating or insomnia, feel hyper, or have any other negative symptoms, either stop or reduce the dose. This is not meant to be a permanent therapy, you can stop this protocol a few days after you feel better, regardless of the dose you were taking. In case of illness or trauma or physical stress, you can take hydrocortisone again with double the dose.

Ask your physician for a hydrocortisone prescription. Most doctors will prescribe therapeutic or  lower doses of cortisone for inflammatory conditions, do they shouldn’t have a problem prescribing such a low dose of hydrocortisone. We are not talking here about therapeutic dosages. This is very important to understand.

Hydrocortisone is the chemical form of the cortisone your adrenal gland produces. The average daily production of hydrocortisone in your body is about 30 to 40 mg. If you have adrenal insufficiency (low adrenal function or adrenal fatigue), you may be producing much less and have symptoms as a consequence. By supplementing your low production with 5 to 20 mg of hydrocortisone, your body’s supply becomes normal and symptoms should promptly disappear.

The misunderstanding with this low dose hydrocortisone protocol stems from the use of high-dose cortisone therapies like prednisone, medrol, etc. With such high doses there are significant side effects such as high blood pressure, osteoporosis, Cushing syndrome, immune supression and so forth. But these effects have absolutely nothing to do with low-dose hydrocortisone treatment. In fact, the reason why most doctors are reluctant to prescribe it is because the dose is way too low in order to make any difference whatsoever. Keep in mind that mainstream science is completely ignorant about adrenal fatigue. The low doses we are talking here is even much lower of what your body normally produces, even if your adrenal’s output of hydrocortisone is normal. High-dose mainstream treatment of cortisone is several times your body’s daily output, that is, 60 to 300 mg of hydrocortisone per day. So if someone tells you that you are crazy for being in cortisone because it has serious side effects, you can reassure them that you are taking below levels of physiological doses of what your body already produces. Remember, it is not prednisone, it is hydrocortisone. 5 mg of hydrocortisone is the same as about 1 mg of prednisone. Fludan.com sells hydrocortisone in powder form which people can then weight with a scale for mg, such as a jewel scale. If you are unable to get a hold of hydrocortisone or experience unsuitable symptoms on it, you can use low dose progesterone cream to support adrenal function.

Keep in mind also that the best test to see if you will benefit from this therapy is the trial one, that is no lab test will be able to tell you with accuracy if your adrenals need a boost. People who have negative tests often benefit from low dose hydrocortisone therapy.

Of course, these are temporary measures. As useful as they may be, they will never replace the need for eating a diet that is most supportive to your body’s physiology and functioning. For more information on a healing diet that will prolong your life and support your adrenals, see Primal Body, Primal Mind by Nora Gedgaudas. Eating animal fats and protein, cutting out on sugar, grains and foods full with anti-nutrients is essential to heal our bodies.


A note of caution

Those with chronic fatigue, recurrent infections and joint pains should keep in mind that iron overload (ask your physician to test for ferritin, transferrin, TIBC and iron) should be ruled out. Ferritin levels should be ideally less than 80 and transferrin saturation should be ideally less than 40%. If you are above those levels, you might want to donate some blood or refer to the Iron Disorders Institute. A great book on the subject is The Elephant Iron by Roberta Crawford. In addition to that, people with iron overload are discouraged from taking vitamin C without proper monitoring.

For an immediate stress-relief breathing and meditation program, check out Éiriú Eolas (pronounced “AIR-oo OH-lahss”), the amazing scientific stress-control, healing, detoxing and rejuvenation program which is THE KEY that will help  you to change your life in a REAL and immediately noticeable way. Full program available online for free at eebreathe.com.



[1] Malendowicz LK, Rucinski M. et al. Leptin and the regulation of the hypothalamic-pituitary-adrenal axis. Int Rev Cytol. 2007;263:63-102.

[2] Rodger H. Murphree. Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome: The Definitive Guide for Patients and Physician. Harrison & Hampton Publishing; 2 edition (January 2003)

[3] James L. Wilson. Adrenal Fatigue: The 21st Century Stress Syndrome. 2001, Smart Publications.

[4] Sue Gerhardt. Why Love Matters: How Affection Shapes a Baby’s Brain.Routledge; 1 edition (24 Jun 2004)

[5] Sidney MacDonald Baker. Detoxification and Healing: The Key to Optimal Health. McGraw-Hill; 2 edition (August 27, 2003)

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  1. Amy M  May 1, 2015

    Such terrific information, thank you.
    My question to you is this;
    My mornings are not so bad, my crashing point starts at about 11:30am and goes till 5pm when my cortisol is the lowest. Is it okay to just take the cortef as needed during that time instead of in the am?

    My dr told me to take 5 mg 4x a day but I don’t want to take more than necessary.

    Also I get horrible acid reflux from the cortef (despite taking it with full meals) Any suggestions? I already do gluten, dairy, egg free low carb diet.

    • Gabriela Segura, MD  May 1, 2015

      You can experiment with an isolated dose at around 11 am, IMO, it is worth doing some experimentation.

      I would take betaine HCl with meals and cortef. It might help with the reflux. Best!

    • Steve Weiss  September 17, 2015

      Hello Amy!

      Curious how you’re feeling now that it’s been a few months since your question, but some food for thought… The most easily overlooked answer to your side affects could be food sensitivities and the absolute dreck that Big Pharma and the AMA allow in pills to fill up the space. SOoooo many people have a problem with this.

      In the brand name Cortef alone the inactive ingredient “filler(s)” are calcium stearate, corn starch, lactose, mineral oil, sorbic acid, sucrose (!?) Not a single one of these is necessary, beneficial, or shouldn’t be replaced — especially if you have a corn or dairy intolerance or allergy. Mineral oil is a petroleum distillate. Stearates don’t belong in anything, especially the unwell (super heated and catalyzed, alkalized, not-non-reactive, *hydrogenated* artificial additive). Exposing the figurative grains of sand on a beach more “straws” that have broken the back of world health, beyond the artificial crutch of life extension or the new and improved it’s become, Google searches are the newly initiateds best friend (with some caveats, conditions, and peer reviewed backing).

      It may sound a bit radical and extreme until you consider our recently, constantly exposed history, but short of the sucrose which is essentially table sugar (yet still a bleached, reduced, and further processed unnatural compound that became the pseudo-poison the holistic community considers it to be, which is still contraindicated in an adrenal compromised condition) — these ingredients are “Generally Recognized As Safe.” Yet, just like teflon, mercury amalgam dental fillings, cigarettes, leaded gas, arsenic-tainted chicken feed, hydrogenated oils, biosludge fertilizer, fluoridated water, Aspartame, MSG, BPA/BPS, SLS, DATEM, azodicarbonamide, brominated tris and brominated vegetable oil, etc, etc, plus the roughly 80,000+ chemicals grandfathered into our lives by special interests and selfishness, yet contraindicated, unnecessary, and unsustainable. It’s taken the body thousands to millions of years to identify and mitigate even natural compounds, yet the gauntlet we exist in for “convenience,” with unnatural to toxic to teratogenic — to the yet unknown consequence-ridden synthetics — even in such small amounts if not from nearly every single facet of our life should soon be exposed as the real missing link to our just this side of caveman-style science.

      Whoops for the rant, but forewarned is forearmed…

  2. Linda M.  May 2, 2015

    Hi doc,

    My 24-hr salivary cortisol results are below:

    AM: 10.24 [5.1-40.2, optimal range 18-35]
    Noon: 2.97 [2.1-15.7, optimal 6-12]
    Eve: 1.34 [1.8-12, optimal 4-8]
    Night: 0.65 [0.9-9.2, optimal 2-6]

    The flagged results were eve and night, but none of my results are in the optimal range. My naturopath prescribed me hydrocortisone sr 5mg twice/day. She didn’t explain what stage of adrenal fatigue I have or anything. I haven’t yet started taking the hydrocortisone. She said I’d need it for 3-6 mos. What’s your opinion?

    Thank you!

    • Gabriela Segura, MD  May 3, 2015

      In my experience, clinical symptoms are more reliable than any lab test. If your practitioner has more context of your situation and has suggested that specific dose, I would experiment with that recommendation. You could start with the lowest dose of 2.5 mg first thing in the morning and then build up to the suggested dose if necessary or if there are no improvements.

      If you don’t have iron overload, you can also try titrating doses of vitamin C for a period of time. Vitamin C helps to heal the adrenals as well, you just have to wean off progressively from a high dose. Best!

      • Linda M.  May 3, 2015

        Hi doc, thanks for your quick reply.

        My Iron panel results:
        Iron: 47 [50-212 ug/dL]
        Ferritin: 113 [22-291 ng/mL]
        Total Iron binding capacity: 235 [228-428 ug/dL]
        Iron binding capacity, unsaturated: 188 [110-370 ug/dL]
        Trasnferrin, % saturation: 20 [14-57%]

        Unfortunately I feel like my naturopath really doesn’t know what to do with me, but she’s not admitting it! I’m shopping for another doc in the meantime, but it’s frustrating that I seem to absorb some things but not others.

      • Gabriela Segura, MD  May 3, 2015

        No iron overload, Linda. Good job. Absolutely everyone should have these checked and research about it, not relying on usual lab ranges. Ferritin is a teensy higher than usual but as a marker of inflammation. Hope the new measures and protocols will help. Best of health for you!

  3. Eddie G.  May 14, 2015

    Hi Dr. Segura,
    Can you please comment on my saliva cortisol test results. I have also provided my iron panel, thyroid panel and other lab results. I have had current health conditions for 10 years. It wasn’t as bad as it is now, but seems to have progressed over this time. From my research and reading numerous books on adrenal fatigue, I have come to the conclusion that a physiological dose of Hydrocortisone is what might help my situation. My ENT is willing to prescribe the HC and it’s all up to me. He is a very open minded physician and was the individual who recommend the book by Dr. Hotze, “Hormones, Health and Happiness” which discusses many of the issues I have. Best regards and hoping to hear from you. PS: If you need any additional information please let me know.
    Cortisol (Saliva) Test Results
    Cortisol 4AM, 0.528 ng/ml Ref. Range: 0.1 – 0.9
    Cortisol 8AM, 0.155 ng/ml Ref. Range: 0.1 – 0.9 (LOW)
    Cortisol 12PM, 0.128 ng/ml Ref. Range: 0.1 – 0.3 (LOW)
    Cortisol 5PM, 0.015 ng/ml Ref. Range: 0.06 – 0.19
    Cortisol 9PM, 0.010 ng/ml Ref. Range: 0.04 – 0.10 .

    Iron, Serum: 133 Range 40-155 ug/dL
    Iron Bind. Cap. : 317 Range 250-450 ug/dL
    UIBC : 184 Range 150-375
    Iron Saturation: 42 Range 15-55%
    Ferritin Serum 171, Range 30-400

    Thyroid Peroxidase (TPO) Ab: 5 Range 0-34 IU/mL
    Antithroglobulin Ab, Result: <1 Range 0.0-0.9 IU/mL
    Reverse T3, Serum, Result 21.3, Range 9.2-24.1 ng/dL
    TSH, Result: 1.5, Range 0.45-4.500 uIU/mL
    Triiodothyronine, Free Serum, Result 3.3, Range 2.0-4.4 pg/mL
    T4, Free (Direct), Result:1.28, Range: 0.82-1.77 ng/dL
    T4, 10.1 RR 4.5-12.1 mcg/dL

    Pregnenolone, MS Result: 73 ng/dL 01, Reference Range: Adults: <151
    DHEA, Serum: 180 ng/dL, Reference interval: 31-707
    Aldosterone LCMS, Serum, Result: 6.0, ng/dL Reference Range 0.0 – 30.0
    Homocysteine, Plasma: 8.3, RR 0.0-15.0
    C-Reactive Protein, Cardiac: 0.56, RR: Low 3.00
    Vitamin D: 50.8, RR: 30-100 ng/mL
    Glutathione, Total: 211, Reference Interval: 176-323
    Prolactin 3.9, RR 2.0-18.0 ng/mL
    Testosterone 308, RR 241-827 ng/dL

    Average Daily Temperature @ 3, 6 and 9 hours after waking
    Date Average
    04/26/15 97.7
    04/27/15 97.8
    04/28/15 97.8
    04/29/15 97.8
    04/30/15 97.8

    Notes on myself:
    • I am 58 years of age, 5′ 9″ in height, 172 lbs
    • Symptoms of a leaky gut
    • Allergies
    • Very dry skin
    • Eye inflammation and gritty eyes in the evenings
    • Inflammation in joints
    • Back hurts often.
    • I get startled easily,
    • Super sensitive to perfumes, chemicals, etc
    • Chronic constipation
    • Muscle loss
    • Fat accumulation around my waist
    • Extreme hair loss over the last 5-7 years.
    • I rarely exercise because I normally feel drained.


    • Gabriela Segura, MD  May 15, 2015

      Hello Eddie,

      One thing stands out: your iron saturation. According to the lab, it is in range. According to iron overload research and my personal experience, it is too high. It could partly explain your fatigue. Do read the following article:

      The Iron Elephant – The Dangers of Iron Overload

      A saturation of 42% and ferritin higher than 150 (which is your case) is iron overload. Excess iron is very oxidizing to your body. This might sound counterintuitive because you are feeling tired, but if there is no medical contraindication, I would go to the blood bank and give a blood donation. You could alternatively ask your physician for a decanting prescription, some 450 cc. You can recommend him the book quoted in the link above and also the following one: “Exposing the Hidden Dangers of Iron: What Every Medical Professional Should Know about the Impact of Iron on the Disease Process ” available at:


      Nevertheless, I think that having some low dose hydrocortisone won’t hurt. See how you feel with the lowest dose first thing in the morning. It will support your adrenals and this is something you can do for a month or so, depending on the results you get.

      I hope that you have done dietary changes. Pain management can be achieved by removing gluten, soy, night shade family (aubergines, tomato, potato, red peppers), GMOs, coffee. Your diet has to be moderately restricted in carbs, foregoing all grains if possible. If you are finding it hard to get all the info in one place, you can get “Primal Body, Primal Mind” by Nora Gedgaudas. I think she did a pretty good job in condensing huge amounts of information regarding the diet into one place.

      Topical DMSO will help you relieve the pain:


      Hope this helps!

      • Eddie G.  May 15, 2015

        Thank you Dr. Segura for that wonderful reply. I really appreciate it. I have another question if you don’t mind. Would supplementing with low dosage DHEA and Pregnenolone help me with my unbalanced hormones? I read the Pregnenolone is the mother of all hormones and also the feel good hormone, which I need immensely.

        in regards to my high iron, should I cut back on my Vitamin C intake since it increases iron absorption? I also eat a lot of iron rich foods as well. My Vitamin C intake is 3 to 4 grams daily. I take it because it helps the adrenals.

        Best regards y munchas gracias!

      • Gabriela Segura, MD  May 16, 2015

        Hello! I would decant some iron first before taking vitamin C. Fatigue could stem from iron overload and not strictly from adrenal fatigue.

        Avoiding iron rich foods is not worth it. Iron is everywhere. Doing a “paleo” diet restricted in carbs is still the best way to go.

        As for DHEA and pregnelolone, those are definitely good supplements. You can experiment with them, I don’t see why not.

        Much healing your way!

      • Eddie  August 5, 2015

        :I know it’s been a few months since I posted to this comment, but you mentioned that the iron saturation could be contributing to my fatigue. Do you feel that the iron saturation is affecting my adrenals in regards to the low cortisol production? As this point I have yet to donate blood, but I am schedule to donate this coming Saturday for the first time in my life. I also have not started on HC, but did start on Adrenal Cortex Extract this week. The Hydrocortisone therapy will be my last option. I’m a bit hesitant from some comments people that have used it have posted on health forums. Of course some people have great things to say about it. Best regards.

      • Gabriela Segura, MD  August 16, 2015

        Iron overload oxidizes your body and it is a main cause for fatigue. Donating blood is correlated with better health and less heart attacks, you will also be potentially helping someone who would truly need the blood. So yeah, overall, it is a good idea.

        Sounds like a good plan. HC should be the last option. There is great stuff out there like adrenal cortex extract, for instance ashwagandha and rhodiola rosea. Best!

  4. Eddie G.  May 16, 2015

    Hi Dr. Segura, Thank you sincerely for all your comments. I respect all your suggestions and take them to heart.

    I really enjoy reading your articles. Is there a way to get on a mail list to get notified when you publish new articles? Also, is there a way to get notified when “new comments” are posted to one of your articles? Best regards!

    Health & Happiness!

    • Gabriela Segura, MD  May 16, 2015

      Hello Eddie,

      Thank you for your feedback! At the bottom page of https://health-matrix.net/, you’ll find a subscription to the newsletter. Best regards!

      • Eddie  August 5, 2015

        I enrolled for your newsletter in May of this year, but I haven’t received any newsletters. Do you know if I am in your system. Thanks

      • Gabriela Segura, MD  August 16, 2015

        Apologies Eddie, I’m sure you are. It is me who has been completely swamped with work and have not been able to update the blog. I’m participating fairly regularly on a health and wellness radio show, which you can listen at http://www.blogtalkradio.com/sottradionetwork, those with the tag “health and wellness”. For instance, http://www.blogtalkradio.com/sottradionetwork/2015/07/17/the-health-and-wellness-show–17-july-2015–the-importance-of-sleep.

        I’m still VERY active on research in all lines, so stay in tune for some updates in this blog where I’ll share very important research regarding mitochondrial dysfunction and stealth infections. Those who have not benefited with detox, diet, supplements and stress reduction programs are finally seeing some results when they deal with chronic stealth infections. Best!

  5. Victor  May 17, 2015

    Hello Dr!
    I have suffered from adrenal fatigue for 2 years now but I have gotten better the last couple of months due to changes in training and diet.

    I still dont feel like myself and i recently did a saliva testing:
    Cortisol Morning 20.77 nmol/L 5.1-40.2; optimal range: 18-35*
    Cortisol Noon 7.34 nmol/L 2.1-15.7; optimal range: 6-12*
    Cortisol Evening 3.30 nmol/L 1.8-12; optimal range: 4-8*
    Cortisol Night 1.14 nmol/L 0.9-9.2; optimal range: 2-6*

    I try to eat as perfect as i can with lots of proteins, healthy fats and vegetables and I also supplement with daily multivitamin, d vitamin and omega 3. I havn’t eaten gluten or grains for 6 months now and my stomach is a lot better.

    I recently tried supplementing with Nutri-Meds Adrenal Cortex and Whole Adrenal but cortex just made me more tired and whole adrenal made me nervous.

    It feels like no matter how healthy I eat and how much sleep I get my adrenals will never fully heal by themself, so I was thinking about hydrocortisone and its ability to heal the adrenals.

    Is it possible to do this healing protocol and then stop taking hydrocortisone once your adrenals are healed or will the HC just make your adrenals even more tired leading to a permanent damage on ur adrenals?

    I have read somewhere that your adrenals heal better if you take hydrocortisone every other day but I dont know if thats true or not.

    Best Regards Victor

    • Gabriela Segura, MD  May 17, 2015

      Hello Victor,

      Low doses of hydrocortisone doesn’t “damage” the adrenals, it is a physiological dose. You can experiment with it to see if you feel better. If it doesn’t work or if you feel more nervous, you can stop right away.

      Whole adrenals can make symptoms worse because it may have the medulla which has catecholamines. It is preferable to use only adrenal CORTEX supplements. However, I would only use one adrenal support at a time. That is, if you are trying low doses of hydrocortisone, don’t use adrenal Cortex.

      I highly recommend you do breathing exercises and meditation. Check out eebreathe.com, the whole program is available online.


  6. RB  May 18, 2015

    The estimate of the total cortisol release is a bit outdated. The most recent data suggests that the daily release of cortisol is ~10 mg per day. Current protocols call for a daily replacement dose of 15 mg to 25 mg hydrocortisone.

    • Adriane  August 20, 2015

      I’d be interested in seeing the source of the newer total daily hydrocortisone estimate. Thanks!

  7. Barbata  May 22, 2015

    Very informative article. I have been debating whether to rely solely on herbs or try this approach. I a! In such bad shape I think I need to do this peotocol.

    Question… You mention there is no lab work that can accurately show adrenal fatigue. What about the 4 point Saliva Adrenal Panel? I have had several done over the years and my latest showed low cortisol.

    • Gabriela Segura, MD  May 22, 2015

      You can use it as a guide, but I would trust your clinical response. If you get better with this protocol, good. If not, time to try something else. There is a huge lab work influence in North America. In my experience, you can work with half (or less) from what is generally asked in the US and still have a pretty good idea of your patient, just as long as you do a detailed medical history and physical examination.

  8. Nancy S  July 2, 2015

    Hi Dr. Segura-
    I find your protocol extremely interesting and I came to it in a back handed sort of way. My allergist gave me prednisone and every time I tried to get off it my symptoms returned so I got tested. My only allergy is to grasses and they are mostly gone now but not my symptoms. When they returned I started on 5mg. prednisone. I would like to use your protocol with the prednisone while I clean up my system with diet and exercise. I wondering how long to stay on the 5mg and when to start to reduce the dosage. You clearly explain ramping up but not how and when to stop.
    Your advice will be greatly appreciated. For now I think I’ll stick to the 5mg a day. I start a new job in two weeks and if I return to the state I was in I won’t last a month.
    Thank you!
    Kind Regards,

  9. Lisa  July 26, 2015

    what a wonderful and informative article!!! I do not have a thyroid. When I had surgery, 30 years ago, to check a single suspicious nodule they found that all that was left of my thyroid was that benign nodule . It had been attacked by hoshimotos. Since then I have syruggled horribly with my weight and mental well being. Recently I have had adrenal fatigue, elevated autoimmune antibodies and symptoms of possible early Lupus. On July 3rd I got a terrible cough and have been sick for over three weeks. The doctor tried a second round of antibiotics and added in some prednisone. While the cough is MUCH better, I have felt like I was hit by a truck ever since I finished the five days of prednisone. I keep falling asleep and feel TERRIBLE!!! I am wondering if that aggravated my, already struggling adrenal situation and what I might be able to do to recover! While I was struggling before, I WAS able to make it through the day and keep going, now I am completely miserable!!!
    Thank you for ANY help and suggestions!!!

    • Gabriela Segura, MD  July 26, 2015

      Hello Lisa,

      Are you on a moderately on a grain free diet, eating enough animal fats and avoiding toxic foods including GMOs and trans fats? By order of things, that is your priority number one. See for instance “Primal Body, Primal Mind” by Nora Gedgaudas. In your case I would remove all dairy as well, keeping butter or clarified butter at the most.

      I don’t know which supplements you take, but the ones suggested in Primal Body Primal Mind are great. Last, I would read “Plague Time” by Paul Ewald. You might be dealing with a chronic stealth infection and only by dealing with that, you would be able to feel better.

      Hope this helps,

  10. Eddie  August 5, 2015

    Hi Dr. Segura, you mentioned that if Hydrocortisone doesn’t work for you that you can just stop. From What I’ve read you have to wean off it or your adrenals will crash. In other words, it is recommended that one cut there dosage in low amounts and slowly. What is your experience with patients who have been on physiological doses of Hydrocortisone? Thanks.

    • Gabriela Segura, MD  August 16, 2015

      Low dose hydrocortisone is not like the therapeutic dose where you have to wean off progressively. You can just stop and that is about it. I also have a lot of clinical experience with the therapeutic hydrocortisone dose. In my experience, even though you use high doses, you can also just stop it if cortisone was used only for 2-3 days. If it was used longer than that, then you must absolutely wean off progressively.


  11. Paulo  August 5, 2015

    Very informative, thanks.

    I have Hashimoto’s and have been on levothyroxine for 9 years, initially 50 mg but up to 100 mg last year. A recent doctor told me it may still be insufficient as he was also diagnosing stage 2 adrenal fatigue. I have been taking hydrocortisone for maybe 2 weeks now built up to 5 mg breakfast and 2.5 mg lunch. Can one take Ashwagandha as well as hydrocortisone? I am not sure if they counteract.

    Diurnal tests-
    6am. 3.4 (low)
    12pm 3.6 (high)
    5.30pm 2.2 (high)
    9pm. 0.8. (Norm)

    TSH 0.36
    Free T3 2.8
    Free T4. 1.43
    Ferritin. 129
    Iron. 122
    Binding capacity. 301
    Iron saturation. 41
    B12. 404
    Vit D. 30.4

    I am taking daily 10,000 Iu Vit D and 5,000 B12 and a high dose Vit C.

    Do you think this is a good medicinal program that I am on? I have been out of action for a few months and somewhat feeling hopeful. My thyroid does still ache occasionally and I have low stamina.

    • Gabriela Segura, MD  August 16, 2015

      I think it is fairly reasonable program. I’m weary about B vitamins due to methylation problems. At least make sure your B12 is sublingual. You can check more about methylation issues here: http://beyondmthfr.com/

      If you are having adrenal support and thyroid medication, I personally would still try ashwagandha just because it has so many good results. From this website:


      Theoretically, ashwagandha might have additive effects when used with thyroid supplements. There is preliminary evidence that ashwagandha might boost thyroid hormone synthesis and/or secretion (3710, 19281, 19282).

      Worst case scenario, your dose of levothyroxine has to go down.

      If you can donate some blood, I would do so. You saturation at 41% and ferritin at 129 is suggestive of iron overload. If you cannot donate due, you can research on EDTA to chelate iron and other heavy metals. A course of EDTA is generally a good alternative for those who can’t donate blood and it will also help you detox and heal your gut. Iron overload is a frequent cause of fatigue.


      • Adriane  August 20, 2015

        I’ve read that ashwagandha is from the nightshade family. I’m sensitive to nightshades, especially potatoes and peppers. Should ashwagandha be avoided in this case?

      • Gabriela Segura, MD  August 21, 2015

        I think the medical properties makes it worthwhile to use, particularly the ashwagandha extracts in adrenal support supplements. I’m sensitive to the nightshade family but didn’t reacted to my adrenal support.

  12. Paulo  August 5, 2015

    It have also been a lacto-vegetarian for 16 years and eat wheat. I tried gluten free for 6 weeks back in May but was already feeling so low I couldn’t understand if it had any difference on me. Due to living conditions I resumed eating gluten.

    • Gabriela Segura, MD  August 16, 2015

      Bad idea, both things. I’m sorry to say it, but your current health problems could be due to long term effects of your diet. A vegetarian diet is possibly the worst one for the average person in the modern world. Do read “The Vegetarian Myth” by Lierre Keith to know why.

      You can transition into a normal diet, although it could take you some time and troubleshooting. The thyroid problem could be due to gluten alone. Some people normalize their levels after removing gluten, if permanent damage is yet not done.

      You have to look into the diet in terms of anti-inflammatory foods and inflammatory foods and that you might not notice the benefits immediately.

      Hope this helps.

  13. Ben  August 29, 2015

    Hi, my name is Ben, 27 and i been treat for hypothyroidism since 2 year without success, here my saliva test results,
    First AM : 0,307 ug/dL (0,1 – 0,9)
    Mid AM : 0,118 (0,1 – 0,9)
    Noon : 0,415 (0,1 – 0,3)
    Mid PM : 0,176 (0,06 – 0,19)
    Late PM : 0,048 (0,04 – 0,1)
    Overnight : 0,036 (0,04 – 0,9)

    DHEA : 3,4 ng/ml (2 – 15)

    As you can see my cortisol is very low morning and increase between Mid AM and Noon, very weird, can it explain because i wake up at 11am-Noon, since 2 years as i’m very tired ?
    If yes, is that why i have to take cortisol between 6 and 8AM (Same thing for DHEA ?)

    Considering i got a very low cortisol, will i have to reach a very high dose to heal ?

    I was treat for hashimoto (with no success) before the doctor check my adrenal, would it be possible that by healing adrenal, hypo heal by itself without taking levothyroxine anymore ? (My issues started after a 4 months period of stress and i’m pretty sure hypo is a consequence of adrenal exhaustion)

    What do you think of taking Magnesium , “Adrenal Cocktail” add to Vit C as supplements ? 25 DHEA supplement ?

    Thank you for taking on your time to answer me,

    Benjamin Gachet

    • Gabriela Segura, MD  August 30, 2015

      Those are all good supplements Benjamin, and yes, restoring your circadian rhythm by waking up early and taking an adrenal support first thing in the morning will help you. Hashimoto’s is autoimmune and although stress was the last straw, you’ll have to look into gluten intolerance which always messes up the adrenal glands. You can check out “Wheat Belly” by William Davis for more info on gluten toxicity. Supporting the adrenals with low dose hydrocortisone or supplements like ashwagandha will help, but making dietary changes is paramount.

      Eventually, if dietary changes and supplements don’t help, I recommend you read “Why Can’t I get better” by Richard Horowitz. Hope you’ll feel better!

      • Ben  August 30, 2015

        Thank you for the answer, when you say that it’s better to wake up early (7-8am) can i take my cortisol, DHEA and supplements and come baqck to sleep after ?
        Or do i need to stay awake ?

      • Gabriela Segura, MD  August 31, 2015

        The idea is to stay awake. It will help you to balance your circadian rhythm. You could have a nap if too tired. But waking up early will help you go to bed earlier. Best!

  14. Erin  September 4, 2015

    Hi Dr. Segura,

    I was recently diagnosed with adrenal fatigue and after trying some supplements to get my energy back (without success) my ND has now prescribed low dose hydrocortisone. She wants me to take 5mg 3x/day, but I am very worried about weight gain. Can you tell me if there is definite weight gain even with these low doses? Thank you.

    • Gabriela Segura, MD  September 4, 2015

      Erin, if you have severe adrenal fatigue, low dose hydrocortisone will help you. Keep in mind that the dose is not the therapeutic dose which causes weight gain. The low dose is the dose your adrenals should produce under normal circumstances. Hope you get better!

  15. Emily  September 15, 2015

    Dear Dr Segura,

    Thank you for the great article! I have recently been diagnosed with ‘Non classical congenital adrenal Hyperplasia’ I have a severe case of facial hirsutism and mild acne. I also often feel very tired, anxious, irritable emotional and mildly depressed.

    I have been prescribed a small 2.5mg dose of Prednisolone. Could you please tell me the benefits of taking this drug? Do you expect this to help stop the hair growth on my face? The facial hair is a high reason for the stress I constantly feel under. I have not started to take it yet, but hoped I could get some positive news that it may help to stop it. If you also had any tips on foods to eat or ways to control my symptoms that would be marvellous.

    Thank you so much.


    • Gabriela Segura, MD  September 15, 2015

      Hello Emily,

      Your dose of prednisolone is the equivalent of 10 mg of hydrocortisone, still a low dose and enough to help you balance your hormones. It could help you with your health problems, including the hair growth in your face, but doing dietary changes is very important to balance up hormones as well. I highly recommend you do the Paleo diet. You can use the book recommended on the post, or any other resource on the topic. I think you’ll notice the difference it will have in your health very quickly. Another possibility is to use progesterone cream. You can read more about it here:



    • Gudrun  December 8, 2017

      Hi Emily,

      I also have NCCAH – dianosed 15 years ago. I have lots of insights and might be able to help with specific issues you’re having. Feel free to email me: gudrun.arnadottir1 [at] gmail [dot] com

      Hope to hear from you!

  16. susan  September 17, 2015

    thank you for this interesting article…I have been trying to understand what is happening to my daughter and reading everything I can…

    My daughter has alopecia areata – we have worked with numerous doctors…we are now working with a nutritionist…she is working to help her adrenals and other food sensititivies…she is on a gluten free, diary free, soy free diet…eats mostly whole foods – lots of salmon, egss, grass fed beef, avocados, whole grain (gluten free) bread, brown rice, pumpkin seed, coconut milk, brown rice pasta.

    Her hair has grown back – full thick hair – was completely bald before nutrition changes…she still gets some minor flare ups with small spots, but the hair starts to grow again.

    She asked for her blood work..,below are her results – no one seems too concern, but I am concerned that her iron levels are so high…is this iron overload? I do not have a base line of this before we started the diet and supplements…wish I did!!

    IRON & TIBC 307
    UIBC 118
    Iron Serum 189
    Iron Saturation 62
    Ferritin, Serum 66
    Vit. D 70.8
    B12 1266

    She is taking the following supplements: Cytozeme ad (neonatal bovine adrenal supplement), Immuno gg (colostrum) chorella, mozeme, drinks cilantro water, vitamin D (2000), choline, tumeric, quercetin and takes an allergy pill.

    We are stopping the chorella and other supplements that help with absorption – they don’t have iron in them, but help with absorption. She will be retested in two weeks…

    Any thoughts?

    • Gabriela Segura, MD  September 18, 2015

      Before I forget, make sure the whole grain is not corn, that is very toxic. I don’t trust the gluten free industry. Brown rice also has 5% of gluten-like proteins. Wild rice is a safe substitute though.

      Sometimes dietary changes increases absorption of everything, stuff starts working again and body starts healing. An anti-inflammatory diet is sometimes enough to heal even the most problematic things. In some people, as they absorb nutrients like they originally were intended to do it, iron overload issues get uncovered. Genes for absorbing iron better are very frequent across the population, it is what helped our ancestors survive famines and the like. Hemochromatosis is the extreme, but there is a whole garden variety out there. In your daughter’s case, iron saturation is very high but ferritin is normal. I would monitor those tests and see how they go.

      There is nothing you can do dietary speaking, except avoid orange juice and be careful on vitamin C loading. That increases iron absorption. Iron is everywhere. If your daughter is on the right age and has no contraindications, she can become a blood donor. That will take care of the iron saturation issue. I made a dedicated post on iron overload, you can read it here:



  17. Jo  September 17, 2015

    Hello Gabriela, and many thanks for your great blog!
    Have been on Cortef for ongoing adrenal fatigue for a month now. I’ve been experimenting, and have gone up to 20mg in total over a day, but no significant improvement. Am now at 10mg in am; thinking of trying 12.5 tomorrow am and 15 next am – if still no improvement, can I just drop back down without having to wean? I’m wary of going over 20mg/day total.
    (Diet: I’m gluten free, and eat meat. So far, the only supplement I’ve had good results withis D-Ribose.)
    Many thanks!

    • Gabriela Segura, MD  September 18, 2015

      NT Factor, CoQ10 and adaptogens such as rhodiola and ashwagandha are also very good options. People usually report good results with them. But yeah, don’t worry, you could stop at any time with those doses. Best!

  18. Jo  September 18, 2015

    PS update: from taking 10mg am and 5mg pm, and having been on Cortef over a month, how would you suggest coming off it ( what steps would you suggest?) the higher doses make me feel more tired, so I don’t think it’s that I’m not taking enough, I guess it doesn’t work for everyone. Many thanks for your help!

    • Gabriela Segura, MD  September 18, 2015

      You can also try with NT Factor, CoQ10, D ribose and adaptogens such as rhodiola and ashwagandha. You can pretty much stop it if it doesn’t work. Perhaps the fatigue problem is rooted elsewhere. Best!

      • Jo  September 21, 2015

        Thank you! very much appreciated. This is a great site.

      • Gabriela Segura, MD  September 22, 2015

        Your welcome! :)

  19. Jake  October 29, 2015

    Hi Dr. I have done saliva cortisol testing and here are my results:

    DHEAS 12 (2 – 23)
    Cortisol morning 3.3 (3.7 – 9.5)
    Cortisol noon 2.8 (1.2 – 3.0)
    Cortisol evening 1.0 (0.6 – 1.9)
    Cortisol night 1.0 (0.4 – 1.0)

    I have been dealing with depression/ptsd/anxiety for over 20 years and was diagnosed with hashimoto’s and hypothyroidism 4 years ago. I get to see an Endo in a few month’s but was wondering if i should even bring up my cortisol levels with him? Knowing that ‘Adrenal fatigue’ isn’t techniqually a true illness (i belive it to be) can i expect any help with that? I want to be able to atleast try Hydrocortisone and see if it works for me. At the moment i feel like a complete zombie and am just existing.

    Thyroid medication/antidepressants never worked for me. (14 AD meds, Straight T4, T4/T3 combo’s Armour Etc etc) Do you believe that their is a link bewteen having hashimoto’s and problems with adrenals? When do you think the medical community will finally accept that adrenal fatigue is real? The one thing i don’t understand is for the mental issues i have been going through, i’m suprised my Cortisol levels aren’t completely bottomed out.(I guess you can’t technically develop addison’s from adrenal fatigue can you?)

    I guess the last question is, if i have to buy the hydrocortisone from that website do i get the Hydrocortisone USP (Micronized) or Hydrocortisone Acetate USP (Micronized)? Thanks for the info and i’ll definitely read over all your posts! Apreciate it.

    • Gabriela Segura, MD  October 29, 2015

      It is very important to address the root(s) of the problems. Due to the problems that you share, gluten intolerance and environmental toxicity could be two important factors. I suggest you read “Primal Body, Primal Mind” by Nora Gedgaudas for some clues. Of course you can try hydrocortisone USP, but with those levels, you can really start with adaptogens and other supplements for adrenal support before jumping to a low dose hydrocortisone. Doing a heavy metal detox would likely be helpful as well. You’ll find more clues on the posts. I’m currently researching and experimenting stealth infections as a cause of autoimmune diseases. You can research Garth Nicolson for some clues. That would be another line of investigation. In any case, step by step, do address dietary intolerances that might be exacerbating your hormonal imbalance and move on from there. You could start with adrenal adaptogens and move on from there as well. Best!

  20. Renae  November 6, 2015

    hello Dr Segura,
    I’m so happy I’ve stumbled across your Site. I will try to keep a long story short…4 years ago I began experiencing ongoing extreme fear for no reason 24/7. After many Drs. Told me I had anxiety a neurologist finally discovered seizure activity in my left temporal lobe and I spent the next 3.5 years trying to get my symptoms under control with anti seizures. Fatigue had always been an on going problem for me throughout this but my neuro just put it down to the stress my brain was going through. In late 2014 early 2015 my life was finally returning to normal but the fatigue continued- after blood tests it was discovered I had low ferritin (normal iron) and an iron infusion was given to me in two stages. The first infusion made me feel amazing- the second sent me spiralling backwards and gave me copper toxicity.I have now been bed ridden for nearly 5 months and have ALL the symptoms of adrenal exhaustion. I’ve also been working with a consultant with HTMA which shows I have copper dysregulation and my blood tests for coq10 have come back at 390 (range 800-1400 Aus) my biggest fear is trying the HC as so many therapists are against it and there are many horror stories on the net. I’ve been supplementing with ubiquinol for over a week which has slightly helped mentally but not with fatigue. Do you believe the iron could have damaged my mitochondria so badly that it’s caused this crash or do you believe my adrenals we’re put through so many years of stress they won’t recover without a boost of HC? Ps. I have no food intolerances or allergies and have cut out sugar completely for over 5 months.
    Thank you for your time.

    • Gabriela Segura, MD  November 7, 2015

      Hello Renae, I think there might be another factor here. Excessive iron is harmful, but it doesn’t sound like you had iron overload. To determine your levels, you need to check for TIBC, iron, transferrin and ferritin. Have you read “Why Can’t I Get Better” by Richard Horowitz? Maybe there is some stealth infection underneath. Herpes virus also is known to cause issues on the temporal lobe. In any case, I would support the adrenals and do a gluten free diet. You might not have food intolerances, but some foods are just inflammatory: GMOs, excitotoxins, fructose, grains, sugar, soy.

      I will keep up the detective work, it sounds like there is something else going here. Best!

  21. Renae  November 6, 2015

    …..sorry, that was “causing iron toxicity”

  22. Henry  November 8, 2015

    Thanks for sharing your knowledge with us! I was recommended vitamin c enemas as a highly effective way of getting vitamin c to the adrenal glands. What is your opinion of this as a treatment?

    • Gabriela Segura, MD  November 9, 2015

      I think it is an excellent idea and a good alternative in case there is no IV vitamin C option on an emergency setting. You get sodium ascorbate specifically.

      • Henry  November 9, 2015

        Thanks again! I’m new to this. I can’t find any recipes intended for delivering vitamin c. Could I just add the appropriate amount of sodium ascorbate to a standard recipe product such as a coffee mix?

      • Gabriela Segura, MD  November 9, 2015

        A clue here from the Orthomolecular people:


        “Rectal administration of sodium ascorbate is a method that can be used in emergencies, and in developing world circumstances, when IV is unavailable or unsuitable. Nurses can quickly be trained to mix 15-30 g of sodium ascorbate in 250-500 ml clean water, and give it by enema. It can be safely and effectively used in children. An enema also removes from the bowel material that may be challenging. This has been done successfully with aboriginal people in the Australian outback.”

  23. Luca  November 24, 2015

    Hello, I’m not having available the hydrocortisone, how about if I use the equivalent dose prednisone every other day? I start with 1 mg of prednisone every other day and I do not take the weekend, and could not help me end my production?
    also even if prednisone is not natural cortisol, the dose so low equivalent may well go anyway?

    • Gabriela Segura, MD  November 24, 2015

      It is best to use hydrocortisone, which you can get online, i.e. at fludan.com If there is no other way, that could be an option. But know that you can get it online.

      • Luca  November 24, 2015

        unfortunately I am in Italy and hence the package is blocked at customs.
        she show me a similar protocol with prednisone is as dosing frequency as that, I would be most grateful

      • Gabriela Segura, MD  November 24, 2015

        The dose is so ridiculous, that a mainstream doctor might prescribe it. You can use the following calculator to know how much prednisone you need:


        1.25 mg prednisone equals 5mg of hydrocortisone.

        Also, make sure you find out about the root of the problem for the adrenal fatigue. Stealth infections and toxicity are major culprits. For more information, read: http://www.drbrownstein.com/Iodine-Why-You-Need-It-p/iodine.htm

  24. Luca  November 24, 2015

    ok thanks a lot, a last question in your opinion 1000 mg per day of licorice extract could replace the low dose of cortisone and be effective?

    • Gabriela Segura, MD  November 24, 2015

      No, it is really not the same. You can take licorice if it makes you feel better though.

  25. Mark  November 24, 2015

    Thanks for the brilliant information you provide here Gabriela.
    Ive had fatigue issues on and off for about 5 years, up and down in terms of severity. This year Ive had 2 pretty bad periods, including the past 6 weeks. My symptoms are fatigue, general feeling of being unwell, often agitation, high levels of anxiety. Until July this year I had not heard of adrenal fatigue.

    I recently did a cortisone saliva test that came back as follows:
    8.30am – 8.75 nmol/l (5.1 – 40.2)
    1pm – 3.09 (2.1 – 15.7)
    6pm – 4.07 (1.8-12)
    11pm – <0.33 (0.9 – 9.2)

    DHEA – 276.29 (137-338)

    These are within 'normal range', but lower than optimal.
    An integrative doctor has me on 10mg of hydrocortisone in the mornings since August, and Ive just started on 5mg in the afternoon. I also take adrenal support supplements.

    A couple of questions – I am on a hydrocortisone from a compounding pharmacy. I see many people take cortef. Are these the same?
    – Also, my regular doctor is concerned about the amount of hydrocortisone im taking taken in regards to problems with osteoporosis? Is this something be concerned about at these dosages?
    – I also have the herpex simplex virus, I see in another article you write about potential links between this and ongoing fatigue? If this is the case are there any steps you would recommend to counter?
    Any advice is very much appreciated.

    Many thanks

    • Gabriela Segura, MD  November 24, 2015

      Thank you for sharing, Mark. Cortef is a brand name, hydrocortisone is the generic. Sometimes brands have more potency, but nothing extraordinary which a dose adjustment shouldn’t resolve. Low dose hydrocortisone is safe and not related with osteoporosis. Like I explained in the article, it is not the same. The hysteria is unfounded.

      For herpes simplex virus, I suggest you look into lugol treatment: http://www.drbrownstein.com/Iodine-Why-You-Need-It-p/iodine.htm

      You have to heal the root of the cause which often is toxicity and stealth infections. Lugol can deal with both.

      • Mark  November 27, 2015

        Thanks so much for your comments Dr Gabriela. A quick follow up – is it safe to stop taking low dose hydrocortisone for a period, then begin again, or is continuity a necessity? I feel I am not getting much benefit from it and would like to try without for a while.
        I think Ive seen you answer this before but couldn’t find the post, apologies.

      • Gabriela Segura, MD  November 27, 2015

        You can stop it any time you want, Mark. Best!

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