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. Jordan Kyle Bokser  July 30, 2016

    Hello Doc.

    I have been dealing with adrenal issues for a few years now.

    recently my MD prescribed me HC at 5mg morning 2mg lunch 2mg dinner.

    At this low of a dose do i run the risk of exhausting and atrophying my adrenals?

    I am taking the sea salt. adrenal cortex 5g vit c 400mg mag a day atm

    • Gabriela Segura, MD  July 31, 2016

      That is a very low dose, don’t worry. If you don’t have iron overload, you could take more vitamin C.

  2. Spencer Steele  July 30, 2016

    Also going to nurture the glands with adaptogens come next visit.

    • Gabriela Segura, MD  July 31, 2016

      Sounds pretty good for starters. I would not increase the iodoral dose just yet. Perhaps in a couple of weeks or one month. Other culprits to explore, specially if you don’t see progress with your current program: environmental toxicity (i.e. heavy metals, xenoestrogens) and other non-fungal stealth infections. A FIR sauna should help you with the detox.

      • Spencer Steele  July 31, 2016

        How does one go about testing or treating stealth infections :\.
        Where does one find a FIR sauna as well lol. Is a regular sauna better than nothing?
        Thanks Doc

  3. Spencer Steele  July 31, 2016

    5-10g Vitamin C
    5000iu Vitamin D3
    400mg magnesuim glyceniate at night
    switching to lugols 12.5mgs
    200mcg Selenium
    39mcg T4, 9mcg T3
    any other supplements I need?
    Always Appreciated!

  4. Tired Mama  August 1, 2016

    I started hydrocortisone 5 days ago. The first day I took 5mg upon waking then 2.5 at noon. I found it made me feel very sleepy about 30-45 after taking it. I reduced the dose to 2.5 waking and noon which is a bit better but I still feel the tired kick in. I have also been very hungry which is good since I’m underweight and do crave carbs more than before. I’m also taking progesterone cream 5mg morning and 5 mg night. Any higher causes terrible side effects. Vit C 2000 per day. Licorice root very small dose breakfast and lunch. My main question is … Is the Cortex suppressing my adrenals and making me tired ? Do I need more time to adjust?

    • Gabriela Segura, MD  August 11, 2016

      I think it is more an indication of something else at play in your health that needs to be addressed. I would also replace in minerals. There could be many causes, but minerals are always important when there is tiredness.

  5. Seana Moayer  August 11, 2016

    Do you thnk a 10mg hydrocortisone dosage needs to be tapered off if someone is on it say 6-12 months?

    You said before this is a very low dosage and wont cause supression or atrpohy of adrenal function.

    Thank you

    • Gabriela Segura, MD  August 12, 2016

      That is a very low dose, it really doesn’t need to be tapered off. Best!

    • Eddie  August 13, 2016

      Be sure to monitor your potassium levels. Taking HC may cause your levels to drop. Best

  6. Tahera Morshed  August 19, 2016

    Hydrocortisone is not available in my country (Bangladesh) . Can I use a very low dose of Prednisolone ? The lowest dose available is 5 mg . Will a quarter of that do ?

    • Gabriela Segura, MD  August 21, 2016

      That could do. A quarter of prednisolone 5mg is the equivalent of 5mg of hydrocortisone.

      • Tahera Morshed  August 21, 2016

        Thank You

  7. LWalsh  October 20, 2016

    Is it safe for my 81y/o father, who had a bilateral adrenal hemorrhage, to take desiccated bovine adrenal supplements along with his 20mg of hydrocortisone?

    • Gabriela Segura, MD  October 21, 2016

      It should be fine, although I would start with the lowest dose of hydrocortisone, 2.5mg and increase the dose if necessary.

    • Eddie  October 21, 2016

      LWalsh, You may consider adding Pantothenic Acid (B5) along with the HC. Vitamin B5 is essential for adrenal function. Also, if you’re not doing so already, you may want to add some vitamin C to your daily regimen. Vitamin C helps the adrenals produce cortisone and is an anti-stressor. Since Vitamin C is water soluble, you need to add it to your daily diet.

  8. Someone  January 6, 2017

    Hello, thanks for the article doc !! I have Addison disease and in the first 3 years I was felling sooooo goood at 30 mg of hydrocortisone, but then I saw another endocrinology doc and he wanted to put me on 40 mg and doing so for a year now I feel sooo bad I get sick a lot and my blood test always show high white cells 12000, and also my thyroid is overworking with no antibodies nor a goiter could it be that I took sooo much iodised salt ? Thank you

    • Gabriela Segura, MD  January 6, 2017

      I wouldn’t necessarily blame the iodized salt, although it is important that you get your sources from non refined salt sources. I actually love iodine! Have you tried lowering your hydrocortisone dose?

  9. Eddie  January 6, 2017

    Hi Dr. Segura, as I’ve mentioned before, I’ve had several saliva cortisol tests done and they’ve all come back demonstrating extremely low cortisol levels through the day. My ENT specialist prescribed a low dose HC of 30mg a day. I occasionally take 10 to 20 mgs on weekends but have not been able to bring myself to use it daily because of what I’ve read online. I’ve read that is can cause thinning of the skin, weight gain and decreased immune function. In your experience are these side effects occur often or are they the exception? Thanks.

    • Gabriela Segura, MD  January 7, 2017

      A low dose hydrocortisone is not the same as mainstream doses. Nevertheless most people do a low dose on an occasional basis when it is most needed. If you feel better while doing it, then do one or two weeks consecutively. Then use on the weekends or an occasional basis. The important thing is to get to the root causes of the adrenal fatigue. The rest is just little help here and there.

      • Eddie  January 7, 2017

        Hi Dr. Segura, If I use HC for two weeks, is it necessary to wean off it, or is that when someone uses HC on a long term basis? Thanks again for your comments.

      • Gabriela Segura, MD  January 7, 2017

        You can pretty much stop it, Eddie.

  10. Eddie  January 7, 2017

    Thanks again Dr. Segura. Have a great day!

  11. Liam  January 12, 2017

    Excellent article. Thank you so much. I find these dosings much better than other advices. I felt much better my first day of symptom dosing at 5mg within 15 minutes! Natural thyroid treatment alone has been several months with minimal improvement but this additional hydrocortisone has been excellent.
    Thanks again for the article.

    • Eddie  January 12, 2017

      Liam, the rule is one should always address weak adrenals before treating a low thyroid. I’ve read that treating a low thyroid without addressing adrenals first can be devastating on the adrenals. Adding the HC make have been what you really needed. Best.

  12. Stefano  February 26, 2017

    Hi doc,

    1-5 pm I feel fatigued, tired and with the need to sleep everyday. I also train everyday and have been skipping breakfast. Diet is okay… plenty of protein fruits veggies fats. Should i try hc to see how I feel?

    • Eddie  February 26, 2017

      You need to determine if your cortisol is low. Have your done a diurnal saliva cortisol test yet? Thanks

    • Gabriela Segura, MD  February 28, 2017

      I would try eating breakfast and skipping another meal instead. For training, choose your body work carefully. If you do “fight or flight” type of training, that will only strain your adrenals.

  13. Yolanda Pond  March 5, 2017

    What a miracle to find this website. I had a surgery and a very large scar. Dr wanted me to see a rehabilitation dr. She injected my scar with 204 mg of kenolog mixed with other stuff. This was a period of 3 months. Started loosing hair in clumps, then 2 months after dry mouth, dry skin, dizzy, nauseous and severely depressed and emotional. Went to several dr not understanding what was happening. They tested me for EVERYTHING!! Nothing showed up. Then I was getting so dizzy, nauseous and body ache I Couldnt to stand it I thought I was dying. Also still lots of hair falling out!!! They admitted me in hospital and did acth test. I had 2.4 levels and then when they gave me the acth it went up to 18 in a half and hour and 21 I an hour. They said I had adrenal fatigue. Started me on hydrocortisone at 25/15 made me very ill then lower to 20/10 still to high!! I felt even more sick on the pills!! Then lowered it to 10/10. Still inflammation and headaches, dizzy, nauseous. My question is I also have very abnormally high fsh and low progesterone. I am in perfect age for menopause. I am 46 and have had partial hystrectimy and they also think I am in menopause. Can menopause be the culprit!!! Causing the low cortisol levels am I taking to high i
    Of a dose. Should I be on progestrogen. Dr said hormones can’t kill me but my adrenal fatigue can. HELP!!!

    • Gabriela Segura, MD  March 20, 2017

      You can do a search on low dose progesterone cream, it might alleviate the symptoms.

      • Yolanda Pond  September 9, 2017

        Hi Dr. segura,

        i recently found out three months ago that I contracted a lung infection from having compromised immune system from having low cortisol. I had to have my right lower lung removed. My really low cortisol levels where caused by the steroid injections Dr. gave me. they returned back to normal after I took the small doses for two months. Endcrinologist said they know longer needed to see me. Then i had to have lung surgery. They took my levels after surgery and they are low again. I am going to have my levels checked again on monday with ATCH test. Are my adrenals or pituatary gland in danger at all times now? Do i now have to be concerned with an adrenal problem? I try taking progesterone cream and got headaches and broke out with bad acne. ugh :( Hair is falling out, dry skin and acne!! recently found out DHEA is also low.
        Thank you so much for your help.


      • Gabriela Segura, MD  September 11, 2017

        I’m sorry to hear that Yolanda. You might want to check biophotomodulation:

        I’m having excellent results with it and I’m not the only one. See for instance:


        It might support you in a more natural way. Check out the mercola article to find out a way to do it safely and cheaply. Hope you get better!

  14. Melissa A. Mathurin  March 17, 2017

    Good morning. Is it advisable when first starting hydrocortisone to take it at bedtime if your main symptom of low cortisol is the inability to fall asleep? My saliva test results are:

    8 am – 20 nM (13-24)
    Noon- 7 nM (5-10)
    5 pm- 3 nM (3-8)
    10 pm- 2 nM (1-4)

    cortisol burden 32 (23-42)

  15. Melissa  April 14, 2017

    I am trying to determine if I may have adrenal fatigue. I have been so nervous and panicky that much of the time I can’t still for months. I almost always feel far better and even almost normal in the late afternoon and nights. I usually sleep well at night. I have labs witg elevated thyroid antibodies but all thyroid hormone levels are normal each time ive had labs. I have also had a normal thyroid ultrasound. I thought it was hyperthyroid, but I feel so much better at night that I googled and it said at night many people often feel better with adrenal fatigue. Basically, Im so nervous all day that I can barely function but at night I feel almost normal. What are your thoughts?

    • Gabriela Segura, MD  April 14, 2017

      I would try eating an anti-inflammatory diet rich in animal saturated fat and I would take magnesium, taurine and GABA. If you have no excess iron in the body, vitamin C therapy is a good first option for detoxing and adrenal support purposes.

      • Melissa  April 15, 2017

        So the low dose hydrocortisone regimen described above would not be beneficial then?

    • patty  April 15, 2017

      Welcome to the club! I get up in the morning, eat, then have to lie down. I can hardly function til mid afternoon, then like Cinderella I become normal and very productive afternoon and evenings. I’ve been taking adrenal supplements, really good organic diet and much more for years, rest when I need to, etc… and it doesn’t seem to improve. Always have low cortisol morning and noon. However, learned a year ago that I had/have severe PTSD. Went through very intense therapy for several months (EMDR), and I am hoping that even though it made me worse short term (I got every respiratory bug around and took FOREVER to get over this winter/spring/ TOTALLY exhausted, that in the long run, the release of that severe stress will help me finally heal.

  16. Michael Landers  May 3, 2017

    Please help Dr. Segura. I am a 66 year old male with secondary adrenal insufficiency and HBP, diagnosed 4 years ago. I have been on Hydrocortizone 20/10/dly for that entire time period until recently. This level had stabilized most of my symptoms, including body temperature regulation and fatigue. However, about 6 months ago I noticed a gradual re-occurrence of hot flashes along with dizziness upon initial standing, then chronic vertigo, and extreme fatigue again.

    My MD took me off of some of my HBP medication which alleviated the initial dizziness from the LBP. However, all of the other mentioned symptoms remained and actually increased in severity. So, I self-medicated and increased my Hydrocortizone to 30/20/dly over the next few months. Unfortunately, my symptoms have continued to increase in severity. So much so that I now sway slightly standing still even and there are days that I sleep for most of the day, waking up periodically. Do you think I should increase my daily dosage? Thank you in advance for your help.

    • Gabriela Segura, MD  May 11, 2017

      Hello Michael,

      I wouldn’t recommend increasing the dose. It is important to get to the root of the cause of the adrenal insufficiency. Whether detox, nutritional support, dietary changes, etc… those should take precedence over hydrocortisone support. The moment the dose starts to be too big for physiological purposes, the worse. Work with your health care provider exploring several venues as to the root of the cause and/or do some research/detective work yourself. Every single step towards this direction would help. Hope you get better.

    • Eddie  May 11, 2017

      Hi Michael, have you checked your electrolytes recently? Hydrocortisone lowers calcium and potassium levels. You may also want to limit your sodium intake as HC causes sodium and water retention. This may contribute to the dizziness you are experiencing. Also, do you have optimal vitamin D levels? Optimal levels for D are around 70 ng/mL. If you do supplement with Vitamin D make sure it is D3. You will also need to take Vitamin K2 (MK-7) with the vitamin D3 and take them with a fatty meal since they are fat soluble vitamins. Finally, you need to avoid processed sugars. Eat fruits, mainly berries for sweet cravings. It’s all about the diet. Poor diets are usually what create our health issues. Best and keep us posted.

  17. Lauren  May 31, 2017

    My doctor diagnosed me with adrenal fatigue based on saliva test results. He prescribed hydrocortisone but I’m very scared to take it. How long does it stay in the body? If I react poorly, is it only very temporary? Thanks very much.

    • Gabriela Segura, MD  June 4, 2017

      You can stop it at any time in case of a bad reaction. If you are weary, you can try with adrenal cortex or any other milder adrenal support.

  18. Tiffany  June 4, 2017

    Thank you for your article. Stage 3 AF. Dr has me on cortisol2.5 mg AM qd and 2.5 mg at noon qd. I also take an adrenal cortex from him just one in the AM. For 2 weeks I’ve felt much better everything back, clearer thinking, I can exercise, no sugar or salt cravings, depression lifted. For 2 days now I feel I’m experiencing high cortisol symptoms: Insomnia, hair falling out, stomach bloating and pain, heart racing, irritable.
    So yesterday I stopped the PM dose. Not sure if I should stop the cortisol completely until these symptoms subside.
    This has occurred before but on 7.5mg of total daily cortisol. So Dr kept me on 5mg total to prevent exactly this.
    What can I do to bring it back down? Maybe the magic dose is 3.5mg/day but I need these high cortisol symptoms to go away fast. I couldn’t even sleep after taking an Ativan.

    I appreciate your advise.

    • Gabriela Segura, MD  June 4, 2017

      Phosphatidylcholine (PC) and Phosphatidylserine (PS) are used to lower cortisol level. You can also try with body work like massage therapy or any other type of energetic work such as acupuncture. Best!

  19. Alisha  June 9, 2017

    Such a great article…thank you!!
    I have been suffering from extreme fatigue, hair loss, salt cravings, moodiness, the whole nine yards for over a year. The hair loss is crazy, because I have also have thick hair, which has now become so thin. The doctors finally did some cortisol testing and found my levels are quite low in the morning….well below the normal range.
    The specialist wrote out for Cortef 20mg am and 20mg pm. To me, that seemed extreme to start with as I tend to lean towards natural remedies.
    When I mentioned the high dosage, she said I could take 5-10mg in the morning and again at night. This seems like a better option.
    I do have a supplement called Adrenal Restore that I love….contains Herbs and Probitoics. Also, Bone Broth and Collagen. Would these be ok to take together? I’ve yet to start the steriod, and am not taking the supplements regularly yet. To be honest, it scares me that I may need the Cortef indefinitely.

    • Gabriela Segura, MD  June 9, 2017

      You can give it a try and if you don’t like it, you can do something more natural. The important thing is to search for the root of the problem. As a temporary relief, it might do you some good.

  20. Mike  June 20, 2017

    Hi there,

    I am a male aged 40 and recently have been having problems with what I believe is Adrenal Insufficiency. The reason I say that is because my Endocrinologist is very hesitant to say one way or another if it is just Adrenal Insufficiency or in fact Addison’s Disease. My Cortisol production is low and according to the results of the Crotisol test that I recently had done the Endocrinologist said that the adrenal glands did not respond the way they should have.

    I have the typical symptoms of adrenal insufficiency that oddly enough seem to come in go in phases. The episodes (as I call them) can last up to weeks and then be fine for a few weeks, or even up to months. Then it comes back again. A few symptoms are:

    Low Cortisol production, hypoglycemia (often in the mornings/early afternoon), very low weight, sensitive to cold, easily dehydrated, very often tired, am easily fatigued from minimal physical activity usually characterized by headaches and feeling light headed, a general feeling of being light as a feather or light headed, slight anxiety or panic attacks, occasional pressure in my head and eyes, low thirst ( I have to force myself to drink unless it is really hot outside), reduced appetite. I could go on but I think you get the picture.

    The Endocrinologist prescribed me Hydrocortisone tablets (10mg). 10mg in the morning as soon as I get up and 5mg around noon. I have been reading of the many nasty side effect of Hydrocortisone and have been seeking natural alternatives/supplements. I read that you say a low dosage of Hydrocortisone should not prove too problematic, but then again you never know. So I thought natural supplements would be the better way to go. However, that is proving more difficult as I thought. The supplements that I have researched (adaptogens) all seem to lower Cortisol levels and not raise them. Then again some people say they can also raise levels. They also seem to strengthen the immune system too. That is problematic for me because I have been battling the the auto immune disorder Primary Biliary Cirrhosis/Cholangitis. My immune system is already too strong.

    I was just wondering if taking the a low dosage of Hydrocortisone such as my Endocrinologist prescribed (or the one you suggested here in the comments) would at least be worth a try. Or if you could please suggest some natural supplements (maybe Adrenal Cortex supplements) that can raise my Cortisol levels and not strengthen my immune system any more than it is. I also read that vitamin B-5 is a good place to start to boost production but as I said, the adaptogens are confusing me. Any help/advice would be greatly appreciated, and sorry for the long post LOL!

    • Gabriela Segura, MD  June 20, 2017

      If you are weary about the hydrocortisone, you can give adrenal cortex a try. Also, in your next blood test check for iron, ferritin, transferrin, iron saturation and TIBC (total iron binding capacity). If you don’t have iron overload according to the results explained in this post, then you can take megadoses of vitamin C (https://health-matrix.net/2013/06/17/heal-thyself-with-homemade-liposomal-vitamin-c/). It is good for both the autoimmune disease and the severe adrenal fatigue. Also B5.

      If you haven’t done an anti-inflammatory diet, I would do it ASAP. I would do something similar to the paleo diet which eliminates most food triggers which worsens autoimmune conditions.

      Ultimately, you might need a short trial of hydrocortisone to see if your condition gets better, at least a lower dose and temporarily.

      Hope you find relief.

  21. Mike  June 21, 2017

    Hello Dr. Segura,

    Thank you very much for your quick response, suggestions, advice, and well wishes. During my next blood test I will request that they check the Iron, Ferritin, Iron Saturation, and TIBC for iron overload. I’ll have to translate that all because I live in Germany and well… all my medical appointments are conducted in German. English is my native language as I am for the U.S. However, I can not go around demanding everyone speak English to me LOL! Anyway, that would be great if I could take mega doses of vitamin C so I’ll definitely have them check those levels. I’ll also look into the Anti Inflammatory and Paleo diets too. I just started researching special diets/foods that can boost Cortisol. Do I have to cut caffeine totally out of my diet though? I don’t consume that much of it. I drink only 4 small cups of either latte macchiatto or cappuccino a day and I did read that coffee promotes Cortisol secretion. I also only eat 3 little squares/pieces (not bars) of dark chocolate a day too.

    That is also about the extent of my sugar intake unless you include milk sugar (lactose) as part of that. I consume about 1 glass of milk a day, sometimes a few small pieces of fresh mozzarella (the kind that comes in water) or Balkan cheese (it kind of looks like Feta but is made from cow’s milk), usually 2 teaspoons of cream cheese, and a portion of cottage cheese. I know that lactose is a sugar but some say it is a healthier sugar than fructose, glucose, sucrose. and Ursofalk for PBC and Esomeprazol which has cortisol in it.

    Great to hear that I can try the Adrenal Cortex supplements. I was getting kind of frustrated with researching the Adaptogens. They all seemed to reduce Cortisol. The ones I found that did not, unfortunately boost the immune system. I just need to research the possible side effects of the Adrenal Cortex supplements and drug interactions. I do take 40 mg a day of Esomeprazol of for acid problems (which isn’t that bad anymore only when I consume food or drink that is too acidic or vinegary). Interesting, if I understood correctly Esomeprazol also contains Cortisol. I also take 750 mg a day of Ursofalk ( Ursodeoxycholic acid) tablets for the autoimmune PBC. This medication is really saving me. Before I started taking it all my liver enzyme levels were high, especially my GGT. At one point this got as high as 410 U/L. Thankfully this went down drastically after taking the Ursofalk and I am now well under the normal 50-60 U/L, usually around 28-32 U/L. I hope the Adrenal Cortex Supplement will not conflict with these medications. Yes, the B5 does seem like it will be a benefit too.

    The are valid reasons why I am concerned about taking the Hydrocortisone aside from the long list of side effects. I read it can slowly diminish the body’s function to naturally produce Cortisol if taken over a long period of time. I am also concerned about it weakening the immune system. Not that that might be a bad thing, but if it is weakened too much then I might be open to illness and infection more often/quickly. It also might cause weight gain. Not that I couldn’t stand to gain few kilos or pounds either LOL! But not too much. The heavier I am, the higher my liver enzyme levels are. I also suffer from Obstructive Sleep Apnea and the more weight I have, especially in the throat area, it becomes worse. I have tried a CPAP with numerous masks. Unfortunately, it did not work out for me.

    Oops sorry, I went on too long as before. Thank you again Dr. Segura for your advice, I greatly appreciate it.

    Kind regards

  22. Mike  June 21, 2017

    I was also wondering, what dosage of Adrenal Cortex supplement would be good to start with. Naturally nothing high as that could cause problems too.

    • Gabriela Segura, MD  June 21, 2017

      Just follow label instructions for starters.

      • Mike  June 22, 2017

        Hello Gabriela,

        Thank you for your response and suggestions. I’ll check out the link and read up on it. I think I know the point you are trying to make about the dairy products and caffeine. I heard this years ago. Back in 1997 is when I first started having acid reflux, slight Asthma, and Seborrheic Dermatitis really bad. The Sebhorrheic Dermatitis actually came after trauma. I was attacked and bitten by a dog. The bites tore my bottom right eye lid in half and ripped my nose open. After healing from the bites, I developed the dermatitis. At this point I first heard about the possibility of dairy and caffeine products causing or making these problems worse.

        So from 1998 until 2015 I did not consume any caffeine and very little if any dairy products. No milk, no cream, no ice cream, hardly any butter, and occasionally eggs and cheeses. However, these problems did not become better even with creams for the dermatitis, inhalers for the slight Asthma, and acid blockers/neutralizers for the acid reflux. And I was first diagnosed with the autoimmune disease in 2011 long after I stopped eating large amounts of dairy products and ceasing all caffeine intake.

        What did make a difference with the acid reflux was moving from the U.S. to Germany. The food is much better here in Europe I think. Not as processed and full other bad things that are in the foods in the U.S. I still have problems from time to time but only when I unknowingly eat something with pepper or certain spices or something that is overly acidic etc. My Seborrheic Dermatitis has also gotten better but I made a huge mistake. For many years I was taking a cortisone cream called Dermatop. I was never told by me dermatologist in the U.S. that you should not take cortisone creams for an extended period of time. It ruined the skin in my face making it very thin and more sensitive then it already was.

        Thankfully I found a good dermatologist over here that got me off of it and got me on a non steroidal cream that works wonderfully. The slight Asthma (and sleep apnea for that fact) also got better when I started to drop weight. I only really have the slight Asthma now when it is extremely hot and humid outside. In 2012 I weighed around 86 Kilograms (about 190 pounds). My height is only 172 cm (5’8) so that is a lot of stress on a small body. That was mostly due do overeating, being bloated from the autoimmune disease, and not being physically active . Once I started taking the Ursofalk my weight started to decrease (slowly) and then around 2014 I started reigning in my overeating and slowly began to be more physically active again (mostly walking and bike riding) despite having back problems. In 2015 due to not having success with the CPAP for my sleep apnea I decided to drop more weight and that seemed to work in helping relieve it. I now weigh about 55 Kilograms (120 pounds). That is 10 pounds less than I weighed when moving from the U.S. to Germany in 2003. In 2015 I also resumed consuming caffeine and started to consume more dairy products again. So I really don’t see much of a difference of my health (other than the current adrenal problem) when I do and do not consume dairy and caffeine. But I might be missing something, so I will definitely check out the link you posted.

        My diet consists of other things too besides dairy and caffeine LOL! I don’t eat a whole lot of meat but when I do, it is mostly beef, chicken, turkey, or fish. I cut pork totally out of my diet. Breads I do eat too but not tons of it. I am more partial to tortilla wraps, pita, or unleavened/flat breads (which I make myself). I rarely eat any fried foods and fast food. My meat is either baked or boiled. I avoid MSG when I can too. I could eat more vegetables than I do, but I am kind of picky about them. Raw tomatoes are a problem with acid. Tomato sauce I can do but it has to be cooked a long time. I do like oven baked onions and mushrooms with herbs. I would love to eat more fruits. Citrus and berries always give me acid reflux right away. I even tried cherries here recently. It was alright but a slight problem. Apples work best for me. I rarely eat potatoes. Grapes are problematic too especially pure, fresh grape juice.

        As far as snacks go I rarely eat potato chips. I mostly like tortilla and corn chips. The corn chips I make myself. I rarely eat cakes or pies (about once or twice a year and I make them myself including the icing/fillings). I do not drink any sodas or energy drinks. Aside from coffee and milk, I only drink water. I do drink alcohol but not much and only beer. I prefer the dark/malty kind as compared to the light/hoppy kind. I don’t drink wine even though it is supposed to be really healthy (in moderation) because it upsets my stomach especially red wine and very dry white wines.

        Rehashing all of this made think about something. In 2011 I remember seeing something in my Serology blood test results. It showed that I had a past (not acute) infection of EBV. I wonder if this has something to do with all the problems. Hmm…… I’ll have to ask my Hepatologist again but I think back then he told me that there was a past infection. I wonder if that is what triggered my immune system years ago to go in overdrive. If memory serves me correctly EBV stays in the body and goes dormant after the initial infection. In rare cases it could reactivate. Just a thought.

        Sorry this has gotten so long again LOL! But I am a talker, and once I get started………….. LOL! One final thing for now. About the Adrenal Cortex supplement. Are there 2 different types? 1 that contains Cortisol and 1 that does not? I found one yesterday from Thorne Research. Instead of Cortisol the main active ingredient is Bovine along with Microcrystalline Cellulose, Hypromellose capsule, and Silicon Dioxide. Will this still effectively raise my Cortisol levels?

        Thanks again Gabriela for taking the time to answer my questions and for your advice. As I said before, I greatly appreciate it.

        Kind Regards

      • Gabriela Segura, MD  June 22, 2017

        Hello Mike,

        I hope you will find relief. Past infections of EBV could be related to the chronic fatigue spectrum of conditions where it is very important to optimize mitochondrial function through diet, gentle detox (i.e FIR sauna), exercise that you can tolerate and nutritional supplements. Starting with basic support and better dietary choices will help. When you are dealing with that kind of stuff, the body can do with all the help it can receive.

        The bovine adrenal cortex should do. Recently reviewed that bovine is a better source for natural thyroid hormones. As long as it is adrenal CORTEX (not medulla), you’ll be fine. The medulla can raise the stress hormones to quick and fast.


  23. Mike  June 23, 2017

    Hello Gabriela,

    Thanks again for all of you advice and general interest. It is very kind of you and it means a lot. I am definitely looking into all that you are suggesting. Thank you for the heads up on the Adrenal CORTEX vs. Adrenal Medulla. Yes, raising the stress hormones too quick and fast would not be good at all. Great to know that the Adrenal CORTEX with Bovine is a safe alternative to the Hydrocortisone. Thanks again for the help and best wishes. I’ll let you know how things are coming along. If I have any more questions, I’ll be sure to ask. Have a nice day Gabriela.

    Kind Regards

  24. Mary  July 28, 2017

    I am always anxious and over-energetic. Hydrocortisone calms me down. For the first time im my life I feel like I am in peace and I don’t have to be doing something all the time. I sleep better. I thought Hydrocortisone would make me even more anxious and stressed. I am very happy to see this effect.

  25. C.S.  September 5, 2017

    Hello, Dr. Segura.
    Thank you so much for this informative and well-written article! I have been battling on many fronts since 2014, when my adrenals first “crashed,” and my much-loved doctor at that time put me on low dose of hydrocortisone, especially since my hypothyroidism started going out-of-control (hypothyroid dx in Dec 2011 after it crashed and burned).

    I have been afraid to take or stay on hydrocortisone for so long, in part because of the conflicting information, the weight & mass gain I get, as well as the striations (stretch marks. . . which are uncomfortable). I recently had to increase my dose of hydrocortisone from 5mg to 10mg because of the additional stress (the fires and smoke, the latter of which triggered severe asthma AGAIN). I am considering the possibility that I may need “stress dose” at 15mg/day, though, because I am still having such a difficult time functioning, which would be very short term (maybe a week?) and resume my 10mg daily along with my supplements.

    I was treated for adrenal insufficiency in 2014 w/ 15mg hydrocortisone daily. In early 2015 I was tapered off the hydrocortisone so I could do the ACTH stim test, which of course turned out “normal” (according to Veterans Administration hospital standards). Within days of stopping the hydrocortisone, however, asthma from hell descended on me, and I spent 3 months literally dying because my airways would not stay open. Finally, my primary doctor put me back on hydrocortisone (along with asthma medicine, which included a steroid in the inhaler) and told me that my longs were “probably steroid dependent.” I have since been off and on hydrocortisone, from 5-10 mg daily, as my body indicated I needed it. Then early this spring, my thyroid crashed AGAIN (in spite of me being on Armour thyroid, which I took with vitamin C) along with the asthma-from-hell/my airways won’t stay open (I had to do two pred shots and 2 courses of oral pred, the 5 day taper and the 10 day taper). I think it is important to mention that I’d been under severely increased stress since summer 2016, when we decided to move to a different climate to aid in my breathing recovery; we had two houses to sell in one state while finding a house in another state. Between Jan 2017-May 2017 we sold both houses, made 2 trips to another state (across three mountain passes!) and bought a house in said state. Within about two weeks of moving to our new, drier location at a much higher altitude, my breathing improved so much I was able to stop the 3x daily nebulizer treatments! I tried a couple of times to come off the 5mg/day of hydrocortisone, but each time experienced (within 2-3 days) a rather dramatic increase in all the negative symptoms of the below diagnoses. So I accepted I would have to be on 5mg/day for a long while. Then the severe wildfires started in my state, and the smoke triggered the asthma again to the point of having to be on nebulizer treatments again. I did see a walk-in clinic doctor, because the VA clinic has no openings for me (and I need my medicines!), who I explained my diagnoses and that I wanted to be able to “stress dose.” He was very understanding and accommodated my request in that regard. That is only about a month’s supply, however, and I don’t know when I’ll be able to find a new primary care provider. Ugh. I’m trying, though!

    That said, I do have a question that I hope you can provide some insight on. I suffer from the following diagnoses (all diagnosed by physicians and/or psychiatrists): PTSD, Hypothyroidism, Asthma, Fibromyalgia, Generalized Anxiety Disorder with Agoraphobia, OCD tendencies, Anemia (comes and goes), Polycystic Ovary Syndrome, Major Depressive Disorder, Migraines, Rhinitis, Bipolar type II, and during the initial treatment for adrenal insufficiency I had Chronic Fatigue Syndrome added to my wondeful list of issues! HERE’S MY QUESTION: the hydrocortisone at 10mg seems like a “magic pill” for me! GIVEN THE FOLLOWING INFORMATION, along with what I’ve already written, IS IT LIKELY I WILL HAVE TO OR NEED TO STAY ON HYDROCORTISONE LONG TERM (5+ years, maybe lifetime?) Seriously! I noticed a positive difference in my symptom presentations for each of the above diagnoses. I’ve read multiple sites (from government run to “alternative” medicine) and the listed side effects of even low dose hydrocortisone seem to be exactly opposite of what happens to me (other than the striations!). For ease, I’ve copied/pasted from the MedLinePlus government website, and in parentheses is what I experience while taking hydrocortisone (especially at the 10mg dose):
    * upset stomach (goes away)
    * stomach irritation (not an issue–I take it with food)
    * vomiting (no issue with or without)
    * headache (oh my gosh! My migraines decrease their frequency and even regular headaches practically disappear!)
    * dizziness (my dizziness nearly goes away)
    * insomnia (far less of an issue for me while on hydrocortisone!)
    * restlessness (not so much for me!)
    * depression (actually, my depression DECREASES!)
    * anxiety (my anxiety DECREASES!)
    * acne (eh, depends)
    * increased hair growth (I do get this a bit, in addition to already having it)
    * easy bruising (no more than usual for me)
    * irregular or absent menstrual periods (conversely, my menstrastion becomes regular!)

    Thank you for any information or insight you can give me.
    ~~Trying to Regain my Health


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