“Safe Uses of Cortisol” by William Jeffries, is a most authoritative literature on low-dose hydrocortisone. Dr. Jeffries devoted his entire career to researching and developing a low-dose hydrocortisone protocol for people with CFS, FM, arthritis, post-viral syndrome, mononucleosis, HPA axis dysfunction, hypoglycemia, and many other conditions including infertility. He found even marginal adrenal insufficiency can have big effects.
Cortef / hydrocortisone has the same molecular structure as our body’s natural cortisol. Prednisone and most of the other synthetic “souped-up” products that are often prescribed are on average about 4 x more potent than cortisol. Each pharmaceutical company had to come up with their own unique molecular formula so they could get a patent and get in on this market. Supplementing with these drugs can be very problematic on a long-term basis.
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, Cushings syndrome, immune suppression 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 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 on 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.
I was very fortunate 30 years ago to be "accidentally" cured of a very long bout of post-viral chronic-fatigue syndrome. I'd actually given up on doctors for this but an aggressive "cortisol" treatment combining hydrocortisone injecttion/prednisone pills for ASTHMA unexpectedly wiped out 11 CFS symptoms in four days. I became my own researcher, finding Dr. Jefferies's small testbook in our University medical library. I had a phone conversation and some mail correspondence with the great doctor and continued small daily prednisone doses for years, gradually tapering to zero. Jefferies would routinely try 20mg. hydro. with CFS patients, half of a normal cortisol output and equal to 5mg. prednisone which I found accidentally to be my typical dose. Not only alleviated every/ symptom, including total insomnia/irritable bowel/tachycardia/joint pain/light sensitivity/brain fog, but also restored normal blood-sugar levels which previously were extremely low (fasting especially).