Cortisone and Prednisone Taper

September 23, 2006

I just did a 5 days Prednisone taper starting at 20mg/day to try to

relieve accumulated fatigue. Before that I was taking 25mg Cortisone

Acetate/day divided in 4 doses of 6.25mg. After the taper I resumed

my Cortisone Acetate dosage but I will try to get it down to 12.5

mg/day or lower if possible. For Andy's opinion on adrenal supression

check post number 7064.

By the way I use Cortisone Acetate instead of hydrocortisone since it

is less irritating for my stomach. In the equivalence table 20mg

hydrocortisone (Cortef) = 25 mg Cortisone Acetate. Dr. Jefferies uses

20mg Cortisone Acetate so maybe I should try to aim more toward 20mg.

My doctor wants to test my adrenal reserve.

In his book Safe Uses Of Cortisol by McK. Jefferies

He uses Corticotropin (synthetic ATCH) for testing adrenal response

However in on 's Principle of Internal Medicine the test is

done with

Cosyntropin (Rx name:Cortrosyn)

My doctor wants me to take the Cortrosyn test to verify my adrenal

reserve or else he won't prescribe Cortisone Acetate anymore.

I don't really want to take this test since I'm already stressed

enough and I'm trying to build adrenal reserve not use it all for a

test. I don't know what you think or if anyone has had this test done?

ph

September 23, 2006

>

> Cortisone and Prednisone Taper

>

> I just did a 5 days Prednisone taper starting at 20mg/day to try to

> relieve accumulated fatigue. Before that I was taking 25mg Cortisone

> Acetate/day divided in 4 doses of 6.25mg.

How long have you been taking this? Has it helped to relieve your

symptoms?

After the taper I resumed

> my Cortisone Acetate dosage but I will try to get it down to 12.5

> mg/day or lower if possible. For Andy's opinion on adrenal supression

> check post number 7064.

>

> By the way I use Cortisone Acetate instead of hydrocortisone since it

> is less irritating for my stomach. In the equivalence table 20mg

> hydrocortisone (Cortef) = 25 mg Cortisone Acetate. Dr. Jefferies uses

> 20mg Cortisone Acetate so maybe I should try to aim more toward 20mg.

>

> My doctor wants to test my adrenal reserve.

>

> In his book Safe Uses Of Cortisol by McK. Jefferies

> He uses Corticotropin (synthetic ATCH) for testing adrenal response

>

> However in on 's Principle of Internal Medicine the test is

> done with

> Cosyntropin (Rx name:Cortrosyn)

>

> My doctor wants me to take the Cortrosyn test to verify my adrenal

> reserve or else he won't prescribe Cortisone Acetate anymore.

>

In the 's group that I follow the people say that the ACTH stim

test is not accurate if the person has been on Cortef (or most other

replacements) for a period of time. They say that the person can be

switched to dexamethasone for the test, but no one has been able to

explain why to me.

Did you notice in Jefferies " Safe Uses of Cortisol " book he gave

several reasons why he still treated people with a therapeutic trial

of cortisol if there stim test was 'normal' and that symptom relief is

enough to justify treatment (my words, I'd have to go look at the book

to see exactly what he said).

> I don't really want to take this test since I'm already stressed

> enough and I'm trying to build adrenal reserve not use it all for a

> test. I don't know what you think or if anyone has had this test done?

>

I haven't had the test done. When I was prescribed cortef I was in so

much pain that it would have been inhumane to withhold treatment (it

wasn't all that humane for the previous doctors to ignore my pain).

I feel the same way as you do. I need to avoid stress not go through

the stress of testing when I already know that I really need

replacement cortisol. The ACTH stim test is designed to pick up

primary 's disease. 's disease is extreme adrenal

failure. Some estimates are 80-90% loss of adrenal function. The

test is not designed to pick up on the adrenals that haven't quite

reached the high failure point yet, but almost. It also isn't

designed to pick up on pituitary or hypothalmus problems.

I have been following 's groups and find that there are lots

and lots of people who have had full blown 's crises (yes,

sometimes several) in emergency rooms but don't get prescribed

cortisol because they fail the ACTH stim test.

If it is the pituitary or hypothalmus that is not functioning

(secondary) then there are other tests that would have to be done to

see where the problem is. The insulin stress test is one. In Andy's

Amalgam Illness book he says that that test would cause more oxidative

stress. That is exactly what we don't need when the poor old system is

struggling as it is. The insulin stress test also comes with the risk

of putting the person into insulin shock.

The standard tests that are used to diagnose 's disease are not

good enough to be used to make treatment decisions. Unfortunately,

most doctors and most endocrinologists don't even know this.

J

> ph

>

September 23, 2006

>

> Cortisone and Prednisone Taper

>

> I just did a 5 days Prednisone taper starting at 20mg/day to try to

> relieve accumulated fatigue. Before that I was taking 25mg Cortisone

> Acetate/day divided in 4 doses of 6.25mg.

How long have you been taking this? Has it helped to relieve your

symptoms?

After the taper I resumed

> my Cortisone Acetate dosage but I will try to get it down to 12.5

> mg/day or lower if possible. For Andy's opinion on adrenal supression

> check post number 7064.

>

> By the way I use Cortisone Acetate instead of hydrocortisone since it

> is less irritating for my stomach. In the equivalence table 20mg

> hydrocortisone (Cortef) = 25 mg Cortisone Acetate. Dr. Jefferies uses

> 20mg Cortisone Acetate so maybe I should try to aim more toward 20mg.

>

> My doctor wants to test my adrenal reserve.

>

> In his book Safe Uses Of Cortisol by McK. Jefferies

> He uses Corticotropin (synthetic ATCH) for testing adrenal response

>

> However in on 's Principle of Internal Medicine the test is

> done with

> Cosyntropin (Rx name:Cortrosyn)

>

> My doctor wants me to take the Cortrosyn test to verify my adrenal

> reserve or else he won't prescribe Cortisone Acetate anymore.

>

In the 's group that I follow the people say that the ACTH stim

test is not accurate if the person has been on Cortef (or most other

replacements) for a period of time. They say that the person can be

switched to dexamethasone for the test, but no one has been able to

explain why to me.

Did you notice in Jefferies " Safe Uses of Cortisol " book he gave

several reasons why he still treated people with a therapeutic trial

of cortisol if there stim test was 'normal' and that symptom relief is

enough to justify treatment (my words, I'd have to go look at the book

to see exactly what he said).

> I don't really want to take this test since I'm already stressed

> enough and I'm trying to build adrenal reserve not use it all for a

> test. I don't know what you think or if anyone has had this test done?

>

I haven't had the test done. When I was prescribed cortef I was in so

much pain that it would have been inhumane to withhold treatment (it

wasn't all that humane for the previous doctors to ignore my pain).

I feel the same way as you do. I need to avoid stress not go through

the stress of testing when I already know that I really need

replacement cortisol. The ACTH stim test is designed to pick up

primary 's disease. 's disease is extreme adrenal

failure. Some estimates are 80-90% loss of adrenal function. The

test is not designed to pick up on the adrenals that haven't quite

reached the high failure point yet, but almost. It also isn't

designed to pick up on pituitary or hypothalmus problems.

I have been following 's groups and find that there are lots

and lots of people who have had full blown 's crises (yes,

sometimes several) in emergency rooms but don't get prescribed

cortisol because they fail the ACTH stim test.

If it is the pituitary or hypothalmus that is not functioning

(secondary) then there are other tests that would have to be done to

see where the problem is. The insulin stress test is one. In Andy's

Amalgam Illness book he says that that test would cause more oxidative

stress. That is exactly what we don't need when the poor old system is

struggling as it is. The insulin stress test also comes with the risk

of putting the person into insulin shock.

The standard tests that are used to diagnose 's disease are not

good enough to be used to make treatment decisions. Unfortunately,

most doctors and most endocrinologists don't even know this.

J

> ph

>

September 23, 2006

>

> Cortisone and Prednisone Taper

>

> I just did a 5 days Prednisone taper starting at 20mg/day to try to

> relieve accumulated fatigue. Before that I was taking 25mg Cortisone

> Acetate/day divided in 4 doses of 6.25mg.

How long have you been taking this? Has it helped to relieve your

symptoms?

After the taper I resumed

> my Cortisone Acetate dosage but I will try to get it down to 12.5

> mg/day or lower if possible. For Andy's opinion on adrenal supression

> check post number 7064.

>

> By the way I use Cortisone Acetate instead of hydrocortisone since it

> is less irritating for my stomach. In the equivalence table 20mg

> hydrocortisone (Cortef) = 25 mg Cortisone Acetate. Dr. Jefferies uses

> 20mg Cortisone Acetate so maybe I should try to aim more toward 20mg.

>

> My doctor wants to test my adrenal reserve.

>

> In his book Safe Uses Of Cortisol by McK. Jefferies

> He uses Corticotropin (synthetic ATCH) for testing adrenal response

>

> However in on 's Principle of Internal Medicine the test is

> done with

> Cosyntropin (Rx name:Cortrosyn)

>

> My doctor wants me to take the Cortrosyn test to verify my adrenal

> reserve or else he won't prescribe Cortisone Acetate anymore.

>

In the 's group that I follow the people say that the ACTH stim

test is not accurate if the person has been on Cortef (or most other

replacements) for a period of time. They say that the person can be

switched to dexamethasone for the test, but no one has been able to

explain why to me.

Did you notice in Jefferies " Safe Uses of Cortisol " book he gave

several reasons why he still treated people with a therapeutic trial

of cortisol if there stim test was 'normal' and that symptom relief is

enough to justify treatment (my words, I'd have to go look at the book

to see exactly what he said).

> I don't really want to take this test since I'm already stressed

> enough and I'm trying to build adrenal reserve not use it all for a

> test. I don't know what you think or if anyone has had this test done?

>

I haven't had the test done. When I was prescribed cortef I was in so

much pain that it would have been inhumane to withhold treatment (it

wasn't all that humane for the previous doctors to ignore my pain).

I feel the same way as you do. I need to avoid stress not go through

the stress of testing when I already know that I really need

replacement cortisol. The ACTH stim test is designed to pick up

primary 's disease. 's disease is extreme adrenal

failure. Some estimates are 80-90% loss of adrenal function. The

test is not designed to pick up on the adrenals that haven't quite

reached the high failure point yet, but almost. It also isn't

designed to pick up on pituitary or hypothalmus problems.

I have been following 's groups and find that there are lots

and lots of people who have had full blown 's crises (yes,

sometimes several) in emergency rooms but don't get prescribed

cortisol because they fail the ACTH stim test.

If it is the pituitary or hypothalmus that is not functioning

(secondary) then there are other tests that would have to be done to

see where the problem is. The insulin stress test is one. In Andy's

Amalgam Illness book he says that that test would cause more oxidative

stress. That is exactly what we don't need when the poor old system is

struggling as it is. The insulin stress test also comes with the risk

of putting the person into insulin shock.

The standard tests that are used to diagnose 's disease are not

good enough to be used to make treatment decisions. Unfortunately,

most doctors and most endocrinologists don't even know this.

J

> ph

>

September 24, 2006

>

> How long have you been taking this? Has it helped to relieve your

> symptoms?

>

About 1 year. I stopped for 2 month this summer when I was feeling

better but I crashed because I did too much exercise in one day (bad

move) and I'm back to square 1. One bad day is enough to put me in

shock for 6 month to a year, I must be extra careful with stress and

exercise.

Yes it does help with my symptoms, cortisone is a good thing to have

when you are near death.

>

> In the 's group that I follow the people say that the ACTH

stim

> test is not accurate if the person has been on Cortef (or most other

> replacements) for a period of time. They say that the person can be

> switched to dexamethasone for the test, but no one has been able to

> explain why to me.

>

> Did you notice in Jefferies " Safe Uses of Cortisol " book he gave

> several reasons why he still treated people with a therapeutic trial

> of cortisol if there stim test was 'normal' and that symptom relief

is

> enough to justify treatment (my words, I'd have to go look at the

book

> to see exactly what he said).

>

I wish my doctor would understand, I will ask to see an endo to try

to convince him but it is still precious energy spent for nothing

more than their own protection not mine.

Do you think a lawyer could help me get the medication I need? Just

asking...

ph

September 24, 2006

>A possible alternative is to try prednisolone

> (which only has to be taken once a day).

In their wisdom the powers that be will not let us have prednisolone

in Canada (as far as I can tell - they may change their minds from day

to day). I was getting in for a while by prescription and then

suddenly I had to go off of it cold turkey..... I was having some

cognitive problems not long after I stopped (like walking against red

lights, in front of moving traffic, sheesh).

We don't seem to be allowed DHEA in Canada either.... or vitamin K....

or acetyl l carnitine.... Probably lots of others.

Someone correct me if I'm wrong.

J

> >

> > Cortisone and Prednisone Taper

> >

> > I just did a 5 days Prednisone taper starting at 20mg/day to try to

> > relieve accumulated fatigue. Before that I was taking 25mg Cortisone

> > Acetate/day divided in 4 doses of 6.25mg. After the taper I resumed

> > my Cortisone Acetate dosage but I will try to get it down to 12.5

> > mg/day or lower if possible. For Andy's opinion on adrenal supression

> > check post number 7064.

> >

> > By the way I use Cortisone Acetate instead of hydrocortisone since it

> > is less irritating for my stomach. In the equivalence table 20mg

> > hydrocortisone (Cortef) = 25 mg Cortisone Acetate. Dr. Jefferies uses

> > 20mg Cortisone Acetate so maybe I should try to aim more toward 20mg.

> >

> > My doctor wants to test my adrenal reserve.

> >

> > In his book Safe Uses Of Cortisol by McK. Jefferies

> > He uses Corticotropin (synthetic ATCH) for testing adrenal response

> >

> > However in on 's Principle of Internal Medicine the test is

> > done with

> > Cosyntropin (Rx name:Cortrosyn)

> >

> > My doctor wants me to take the Cortrosyn test to verify my adrenal

> > reserve or else he won't prescribe Cortisone Acetate anymore.

> >

> > I don't really want to take this test since I'm already stressed

> > enough and I'm trying to build adrenal reserve not use it all for a

> > test. I don't know what you think or if anyone has had this test done?

> >

> > ph

> >

>

September 24, 2006

>A possible alternative is to try prednisolone

> (which only has to be taken once a day).

In their wisdom the powers that be will not let us have prednisolone

in Canada (as far as I can tell - they may change their minds from day

to day). I was getting in for a while by prescription and then

suddenly I had to go off of it cold turkey..... I was having some

cognitive problems not long after I stopped (like walking against red

lights, in front of moving traffic, sheesh).

We don't seem to be allowed DHEA in Canada either.... or vitamin K....

or acetyl l carnitine.... Probably lots of others.

Someone correct me if I'm wrong.

J

> >

> > Cortisone and Prednisone Taper

> >

> > I just did a 5 days Prednisone taper starting at 20mg/day to try to

> > relieve accumulated fatigue. Before that I was taking 25mg Cortisone

> > Acetate/day divided in 4 doses of 6.25mg. After the taper I resumed

> > my Cortisone Acetate dosage but I will try to get it down to 12.5

> > mg/day or lower if possible. For Andy's opinion on adrenal supression

> > check post number 7064.

> >

> > By the way I use Cortisone Acetate instead of hydrocortisone since it

> > is less irritating for my stomach. In the equivalence table 20mg

> > hydrocortisone (Cortef) = 25 mg Cortisone Acetate. Dr. Jefferies uses

> > 20mg Cortisone Acetate so maybe I should try to aim more toward 20mg.

> >

> > My doctor wants to test my adrenal reserve.

> >

> > In his book Safe Uses Of Cortisol by McK. Jefferies

> > He uses Corticotropin (synthetic ATCH) for testing adrenal response

> >

> > However in on 's Principle of Internal Medicine the test is

> > done with

> > Cosyntropin (Rx name:Cortrosyn)

> >

> > My doctor wants me to take the Cortrosyn test to verify my adrenal

> > reserve or else he won't prescribe Cortisone Acetate anymore.

> >

> > I don't really want to take this test since I'm already stressed

> > enough and I'm trying to build adrenal reserve not use it all for a

> > test. I don't know what you think or if anyone has had this test done?

> >

> > ph

> >

>

September 24, 2006

> I wish my doctor would understand,

It's possible that he might learn to understand.... possible. After

all, he did prescribe the cortisone acetate. Perhaps copying a small

number of pages from Jefferies book might help. I find that some

doctors will read, if given just a little bit of very interesting

stuff, with the important points highlighted......

Be sure to take a bit of cortisol just before you go in to advocate

for yourself. Convincing doctors has to fit under the big stress

category.

I will ask to see an endo to try

> to convince him but it is still precious energy spent for nothing

> more than their own protection not mine.

Trouble is, endos generally don't understand how to treat adrenal

insufficiency.

The doctor who first prescribed cortef for me actually told me NOT to

bother going to an endo.

> Do you think a lawyer could help me get the medication I need? Just

> asking...

>

I actually think that it's a good idea to talk to a lawyer and find

out what your rights are and how best to advocate for yourself.

Another possibility would be to talk to someone in the College of

Physicians and Surgeons (if you can catch one that sounds reasonable).

I phone them up every once in a while to ask about the rules.

You may have better luck finding a doctor in Ontario, if you are ok

with travelling.

There are lists of practioners at Teitelbaum's website. These doctors

should be familiar with the use of physiological doses of cortisol.

You could always phone and ask the receptionists.

https://www.endfatigue.com/

J

>

> >

> > How long have you been taking this? Has it helped to relieve your

> > symptoms?

> >

> About 1 year. I stopped for 2 month this summer when I was feeling

> better but I crashed because I did too much exercise in one day (bad

> move) and I'm back to square 1. One bad day is enough to put me in

> shock for 6 month to a year, I must be extra careful with stress and

> exercise.

>

> Yes it does help with my symptoms, cortisone is a good thing to have

> when you are near death.

>

> >

> > In the 's group that I follow the people say that the ACTH

> stim

> > test is not accurate if the person has been on Cortef (or most other

> > replacements) for a period of time. They say that the person can be

> > switched to dexamethasone for the test, but no one has been able to

> > explain why to me.

> >

> > Did you notice in Jefferies " Safe Uses of Cortisol " book he gave

> > several reasons why he still treated people with a therapeutic trial

> > of cortisol if there stim test was 'normal' and that symptom relief

> is

> > enough to justify treatment (my words, I'd have to go look at the

> book

> > to see exactly what he said).

> >

>

> I wish my doctor would understand, I will ask to see an endo to try

> to convince him but it is still precious energy spent for nothing

> more than their own protection not mine.

>

> Do you think a lawyer could help me get the medication I need? Just

> asking...

>

> ph

>

September 25, 2006

>>One issue is that Hg-poisoned people often have fungal/yeast issues.

>>Depending on how bad these are steroids will be contraindicated.

>This idea comes from the use of pharmacological doses of steroids.

True, but in my case I get all the side effects at physiological

dosing too. I'm not a big fan of allopathic medicine, but one thing

they do right IMHO is the very serious attitude docs have to steroids.

Also the side effects sheets you get with steroids are compulsory

reading IMHO.

>Too little or too much cortisol impairs immunity. Just the right

amount (physiological dose) helps the immune system.

Agree, but its more complex than that - e.g. when I took steroids I

managed to end my frequent colds which I'd had for several weeks, but

my fungal infection got a lot worse.

> Have you ever been prescribed steroids, what kind, at what dose, and

what happened.

They are freely available over the internet so I didn't need

prescription. Dose: everything between 2.5mg h/c to 20mg. And the

equivalent in prednisolone (up to 5mg).

Side effects I got a lot of what is listed on the sheet. Basically it

increased the virulence of my fungal infection (steroids apparently

increase the respiratory rate of fungus). I also got psychic

derangement, even at low doses - it affected my personality big time.

I got water retention. I got joint problems. If its listed on the

sheet I got it.

I will say that I seem to be an extreme case, and most seem to do ok

on steroids. Part of my problem (other than severe yeast) is that I

don't metabolise steroids well - they stay in my system a lot longer

than they are supposed to (presumably sulfation problems?). H/C can

stay in my system 24 hours, and prednisolone for a couple of days.

> In their wisdom the powers that be will not let us have prednisolone

> in Canada (as far as I can tell - they may change their minds from day

> to day). I was getting in for a while by prescription and then

> suddenly I had to go off of it cold turkey.....

>I was having some

> cognitive problems not long after I stopped (like walking against red

> lights, in front of moving traffic, sheesh).

Ouch!

> We don't seem to be allowed DHEA in Canada either.... or vitamin K....

> or acetyl l carnitine.... Probably lots of others.

DHEA is officially not allowed in the UK either, though it can be

easily obtained via the net. I'm also sure *everything* is available

down at the local bodybuilding gym.

I can't even begin to imagine on what grounds they would ban

carnitine. Are they afraid people will get too clever and wise up to

the govnment?

.

September 25, 2006