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this is not true, but this might be what most docs think. I will get

clarification on this.

Gracia

Gracia,

You wrote:

>

> what? prednisone is not recommended....

It was just a way of expressing equivalence for people familiar with

prednisone. What was tested was cortisol.

Chuck

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Gracia,

You wrote:

>

> this is not true, but this might be what most docs think. I will get

> clarification on this.

About what I wrote:

>

>> It was just a way of expressing equivalence for people familiar with

>> prednisone. What was tested was cortisol.

Which part is untrue?

It's what the published paper SAID. They looked at long-term low-dose

glucocorticoids (cortisol, oral and inhaled), equivalent in dose to 5 mg

per day of prednisone. Since prednisone is five times as potent as

cortisol, that means they actually used an average of 25 mg of cortisol

per day or an equivalent mix of glucocorticoids. I scaled it the wrong

way last time, but 25 mg per day is still about what you take. It's

still a low dose, a physiologic one. Just read the paper.

Here's the citation and abstract again:

J. K. Saito, J. W. , R. D. Wasnich, and P. D. Ross, " Users of

low-dose glucocorticoids have increased bone loss rates: A longitudinal

study, " Calcified Tissue International 57, #2, 1995.

Abstract Although high doses of glucocorticoids are believed to cause

bone loss, the effects of low glucocorticoid doses are still

controversial. Our study examined the effects of low-dose

glucocorticoids on the rate of bone loss at three appendicular bone

sites. The study population was a cohort of elderly Japanese-Americans,

1094 women and 1378 men. The women were all postmenopausal. At the

baseline examination the mean age of the women was 64 years (range

45–81), and the mean age of the men was 68 years (range 61–82).

Glucocorticoid users (19 women and 21 men) had used oral systemic or

inhaled glucocorticoids on a regular schedule for more than 1 month

(mean use was 2.1 years for the women and 1.9 years for the men).

[Here's the part about dose]

The most common dose was equivalent to 5 mg/day of prednisone; fewer

than 15% of users had taken doses equivalent to 10 mg/day or more.

[Here is what they measured]

Changes in bone mass at the calcaneus, distal radius, and proximal

radius were documented using bone densitometry at 1 to 2-year intervals

over an 8-year period. The initial bone mass of the glucocorticoid users

and controls was similar at the baseline examination. The subsequent

loss rates among females during glucocorticoid use, however, were

approximately double that of the controls. Among males, bone loss rates

during glucocorticoid use were 2–3 times that of controls for the

calcaneus and radius sites. The differences between glucocorticoid users

and controls persisted after adjusting for confounding variables such as

age and use of thiazides and estrogens. We conclude that users of

low-dose glucocorticoids have increased rates of bone loss at

appendicular sites among both elderly women and men.

So, which part is not true, the 1,094 women and 1,378 men, the dosage

equivalence to low dose prednisone, the fact that they used cortisol, or

the fact that they measured bone loss?

Most of the studies I could quickly round up about side effects of low

dose corticosteroids, involve inhalers for asthma patients. My son has

been on these inhalers as part of his post operative lung treatments.

These studies show a number of effects, but particularly bone loss for

doses under 1 mg per day. That is probably another prednisone

equivalent, although they use a number of different corticoids in those

inhalers. Most of these papers are in full text from Medline.

Am. J. Respir. Crit. Care Med., Volume 157, Number 3, March 1998,

S1-S53, " Efficacy and Safety of Inhaled Corticosteroids: New

Developments, " PETER J. BARNES, SØREN PEDERSEN, and WILLIAM W. BUSSE

http://ajrccm.atsjournals.org/cgi/content/full/157/3/S1?ijkey=39d2f9654f4ffece7f\

07c918c434d4f8a0ab3d99 & keytype2=tf_ipsecsha

, P. J.. 1995. Inhaled glucocorticoids for asthma. N. Engl. J.

Med. 332: 868-875.

, P. J., and S. Pedersen. 1993. Efficacy and safety of inhaled

steroids in asthma. Am. Rev. Respir. Dis. 148: S1-S26 .

Reid, I. R.. 1989. Pathogenesis and treatment of steroid osteoporosis.

Clin. Endocrinol. 30: 83-103.

, R.. 1990. Corticosteroids and osteoporosis. Thorax 45: 573-575.

Greenberger, P. A., R. W. Hendrix, R. , and J. S. Chmiel. 1982.

Bone studies in patients on prolonged systemic corticosteroid therapy

for asthma. Clin. Allergy 12: 363-368.

Adinoff, A. D., and J. R. Hollister. 1983. Steroid-induced fracture and

bone loss in patients with asthma. N. Engl. J. Med. 309: 265-268.

Dykman, T. R., O. S. Gluck, W. A. , T. J. Hahn, and B. H. Hahn.

1985. Evaluation of factors associated with glucocorticoid- induced

osteopenia in patients with rheumatoid diseases. Arth. Rheum. 28: 361-368.

Turpeinen, M., and R. Sorva. 1995. Net production of type I collagen in

children with asthma inhaling budesonide (abstract). Am. J. Respir.

Crit. Care Med. 151: A149 .

Konig, P., L. Hillman, C. Cervantes, C. Levine, C. Maloney, B. s,

L. , and S. . 1993. Bone metabolism in children with asthma

treated with inhaled beclomethasone dipropionate. J. Pediatr. 122: 219-226.

Pedersen, S., and F. Hargreaves, editors. 1989. Safety of Inhaled

Corticosteroids. Excerpta Medica, Basel. 40-51.

Wolthers, O. D., B. J. Riis, and S. Pedersen. 1993. Bone turnover in

asthmatic children treated with oral prednisolone or inhaled budesonide.

Pediatr. Pulmonol. 16: 341-346.

Chuck

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Guest guest

I will refrain from cross posting. Thanks. Also thanks for the

continued support and the info in this post.

Venizia

> > ... By the way, can I get in trouble for

> > forwarding this from NTH? I not sure of all the protocol.

>

> Usually, it is only a matter of netiquette to not lift excerpts or

> forward entire posts (or identities) to other lists. For some lists

I am

> on, it is a strict rule, and they will kick you off for doing it. Cross

> posting can be even worse, for then the list manager gets bothered with

> bounced messages. I don't know what the rules are at NTH, but I

would be

> surprised if Ira Fine would care. If he had a rule, he probably would

> have said something by now. I have seen relatively little cross posting

> here, anyway.

>

> As for the details, I have given you peer reviewed studies that show

> that less than physiologic doses, specifically 5 mg per day, DO cause

> measurable side effects if taken long term. A month or less is still

> probably not a problem.

>

> I would ask them for the same level of credibility. Ask them to cite

> literature that confirms their assertions. All you have quoted from

them

> seems to be opinion. As far as I am concerned, everyone here is

> perfectly entitled to trust the opinion of a non-professional over peer

> reviewed research, but I think that could be risky.

>

> Chuck

>

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Venezia, I found this discussion-pasting part of the bottom of the page-rest

is found here

http://boards.webmd.com/webx?THDX@@.897c8e79!thdchild=.897c8e79

Ideally, adrenal insufficiency should be corrected before thyroid hormone

treatment begins. However, the treatment for adrenal insufficiency is the

hormone cortisol (prescription hydrocortisone), a drug with serious and

nasty side effects, and few doctors will prescribe adrenal hormones unless

the deficiency is advanced; moreover, too much cortisol inhibits T4 to T3

conversion (a process by which the thyroid prohormone T4 is converted into

the metabolically active thyroid hormone T3), so it's a catch-22 for hypos

with low adrenals.

One approach is to have adrenal function tested and if necessary, corrected

medically prior to starting thyroid hormone (however, this is rarely done

unless the adrenal problem is advanced enough to.........

_____

From: hypothyroidism [mailto:hypothyroidism ]

On Behalf Of venizia1948

Sent: Wednesday, May 28, 2008 10:31 PM

hypothyroidism

Subject: Re: Cortisol/chuck

Chuck,

I mentioned to him that I had a high cortisol test 2 yrs prior. It

was about 15 points above normal range. All he said was I didn't have

adrenal problems. I do not understand how he would know that other

than the overt symptoms you talk about. I have read that cortisol

numbers can go high and then will go low before one has adrenal fatigue.

Venizia

> > ... So, because I had a hashi attack

> > would that cause adrenal fatigue. I take armour and they say to make

> > sure you do not have adrenal problems before taking it but my doctor

> > never checked when I started it....

>

> Your doctors probably looked for OVERT indications of adrenal failure.

> What Gracia is talking about is so subtle, the tests won't detect it,

> and there are no overt signs. A skeptic would question whether there is

> really anything going on.

>

> Chuck

>

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Dusty,

Thanks so much. This is extremely helpful. I am wondering if the

prescription hydrocortisone they are taking about is the same thing

that Gracia and other on NTH use. Is cortef or isocort the same as

prescription hydrocortisone or are these reduced dosages. People on

NTH swear they are not noticing any side effects. The side effects

can be scary.

Venizia

-- In hypothyroidism , " Dusty " <dusty@...> wrote:

>

> Venezia, I found this discussion-pasting part of the bottom of the

page-rest

> is found here

> http://boards.webmd.com/webx?THDX@@.897c8e79!thdchild=.897c8e79

>

> Ideally, adrenal insufficiency should be corrected before thyroid

hormone

> treatment begins. However, the treatment for adrenal insufficiency

is the

> hormone cortisol (prescription hydrocortisone), a drug with serious and

> nasty side effects, and few doctors will prescribe adrenal hormones

unless

> the deficiency is advanced; moreover, too much cortisol inhibits T4

to T3

> conversion (a process by which the thyroid prohormone T4 is

converted into

> the metabolically active thyroid hormone T3), so it's a catch-22 for

hypos

> with low adrenals.

>

> One approach is to have adrenal function tested and if necessary,

corrected

> medically prior to starting thyroid hormone (however, this is rarely

done

> unless the adrenal problem is advanced enough to.........

>

>

>

> _____

>

> From: hypothyroidism

[mailto:hypothyroidism ]

> On Behalf Of venizia1948

> Sent: Wednesday, May 28, 2008 10:31 PM

> hypothyroidism

> Subject: Re: Cortisol/chuck

>

>

>

> Chuck,

>

> I mentioned to him that I had a high cortisol test 2 yrs prior. It

> was about 15 points above normal range. All he said was I didn't have

> adrenal problems. I do not understand how he would know that other

> than the overt symptoms you talk about. I have read that cortisol

> numbers can go high and then will go low before one has adrenal fatigue.

>

> Venizia

>

>

> > > ... So, because I had a hashi attack

> > > would that cause adrenal fatigue. I take armour and they say to make

> > > sure you do not have adrenal problems before taking it but my doctor

> > > never checked when I started it....

> >

> > Your doctors probably looked for OVERT indications of adrenal

failure.

> > What Gracia is talking about is so subtle, the tests won't detect it,

> > and there are no overt signs. A skeptic would question whether

there is

> > really anything going on.

> >

> > Chuck

> >

>

>

>

>

>

>

>

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Guest guest

welcome to the wacky world of which medical system are we dealing with. ppl

who take cortef love it, but ppl who use allopathic medicine say it is scary.

that is why Jefferies MD wrote his book Safe Uses of Cortisol. this is

why there will be huge lawsuits one day.

gracia

Dusty,

Thanks so much. This is extremely helpful. I am wondering if the

prescription hydrocortisone they are taking about is the same thing

that Gracia and other on NTH use. Is cortef or isocort the same as

prescription hydrocortisone or are these reduced dosages. People on

NTH swear they are not noticing any side effects. The side effects

can be scary.

Venizia

--

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12:25 PM

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Gracia,

I think I am going to pick up that book so I know what I am talking

about with my doctor when after I have that saliva test on the 19th.

I am not disagreeing with you, I am trying to find out what is correct.

Thanks,

Venizia

>

>

> welcome to the wacky world of which medical system are we dealing

with. ppl who take cortef love it, but ppl who use allopathic

medicine say it is scary. that is why Jefferies MD wrote his

book Safe Uses of Cortisol. this is why there will be huge lawsuits

one day.

> gracia

>

> Dusty,

>

> Thanks so much. This is extremely helpful. I am wondering if the

> prescription hydrocortisone they are taking about is the same thing

> that Gracia and other on NTH use. Is cortef or isocort the same as

> prescription hydrocortisone or are these reduced dosages. People on

> NTH swear they are not noticing any side effects. The side effects

> can be scary.

>

> Venizia

>

> --

> Recent Activity

> a.. 14New Members

> Visit Your Group

> Meditation and

> Lovingkindness

>

> A Group

>

> to share and learn.

>

> Health

> Early Detection

>

> Know the symptoms

>

> of breast cancer.

>

> Best of Y! Groups

> Check it out

>

> and nominate your

>

> group to be featured.

> .

>

>

>

>

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

>

>

> No virus found in this incoming message.

> Checked by AVG.

> Version: 7.5.524 / Virus Database: 269.24.4/1476 - Release Date:

5/31/2008 12:25 PM

>

>

>

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Guest guest

why don't you ask janie if she minds if you cross post?

From: venizia1948

Sent: Saturday, May 31, 2008 10:49 AM

hypothyroidism

Subject: Re: Cortisol/chuck

I will refrain from cross posting. Thanks. Also thanks for the

continued support and the info in this post.

Venizia

> > ... By the way, can I get in trouble for

> > forwarding this from NTH? I not sure of all the protocol.

>

> Usually, it is only a matter of netiquette to not lift excerpts or

> forward entire posts (or identities) to other lists. For some lists

I am

> on, it is a strict rule, and they will kick you off for doing it. Cross

> posting can be even worse, for then the list manager gets bothered with

> bounced messages. I don't know what the rules are at NTH, but I

would be

> surprised if Ira Fine would care. If he had a rule, he probably would

> have said something by now. I have seen relatively little cross posting

> here, anyway.

>

> As for the details, I have given you peer reviewed studies that show

> that less than physiologic doses, specifically 5 mg per day, DO cause

> measurable side effects if taken long term. A month or less is still

> probably not a problem.

>

> I would ask them for the same level of credibility. Ask them to cite

> literature that confirms their assertions. All you have quoted from

them

> seems to be opinion. As far as I am concerned, everyone here is

> perfectly entitled to trust the opinion of a non-professional over peer

> reviewed research, but I think that could be risky.

>

> Chuck

>

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Guest guest

I did ask her. She never responded.

Venizia

-- In hypothyroidism , " nancie barnett "

<deifspirit@...> wrote:

>

> why don't you ask janie if she minds if you cross post?

>

>

> From: venizia1948

> Sent: Saturday, May 31, 2008 10:49 AM

> hypothyroidism

> Subject: Re: Cortisol/chuck

>

>

> I will refrain from cross posting. Thanks. Also thanks for the

> continued support and the info in this post.

>

> Venizia

>

>

> > > ... By the way, can I get in trouble for

> > > forwarding this from NTH? I not sure of all the protocol.

> >

> > Usually, it is only a matter of netiquette to not lift excerpts or

> > forward entire posts (or identities) to other lists. For some lists

> I am

> > on, it is a strict rule, and they will kick you off for doing it.

Cross

> > posting can be even worse, for then the list manager gets bothered

with

> > bounced messages. I don't know what the rules are at NTH, but I

> would be

> > surprised if Ira Fine would care. If he had a rule, he probably would

> > have said something by now. I have seen relatively little cross

posting

> > here, anyway.

> >

> > As for the details, I have given you peer reviewed studies that show

> > that less than physiologic doses, specifically 5 mg per day, DO cause

> > measurable side effects if taken long term. A month or less is still

> > probably not a problem.

> >

> > I would ask them for the same level of credibility. Ask them to cite

> > literature that confirms their assertions. All you have quoted from

> them

> > seems to be opinion. As far as I am concerned, everyone here is

> > perfectly entitled to trust the opinion of a non-professional over

peer

> > reviewed research, but I think that could be risky.

> >

> > Chuck

> >

>

>

>

>

>

>

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Guest guest

maybe she did not get it- I would ask her again- I have found that sometimes I

have post twice [ or more] to get a response...

nancie

From: venizia1948

Sent: Sunday, June 01, 2008 5:49 PM

hypothyroidism

Subject: Re: Cortisol/chuck

I did ask her. She never responded.

Venizia

-- In hypothyroidism , " nancie barnett "

<deifspirit@...> wrote:

>

> why don't you ask janie if she minds if you cross post?

>

>

> From: venizia1948

> Sent: Saturday, May 31, 2008 10:49 AM

> hypothyroidism

> Subject: Re: Cortisol/chuck

>

>

> I will refrain from cross posting. Thanks. Also thanks for the

> continued support and the info in this post.

>

> Venizia

>

>

> > > ... By the way, can I get in trouble for

> > > forwarding this from NTH? I not sure of all the protocol.

> >

> > Usually, it is only a matter of netiquette to not lift excerpts or

> > forward entire posts (or identities) to other lists. For some lists

> I am

> > on, it is a strict rule, and they will kick you off for doing it.

Cross

> > posting can be even worse, for then the list manager gets bothered

with

> > bounced messages. I don't know what the rules are at NTH, but I

> would be

> > surprised if Ira Fine would care. If he had a rule, he probably would

> > have said something by now. I have seen relatively little cross

posting

> > here, anyway.

> >

> > As for the details, I have given you peer reviewed studies that show

> > that less than physiologic doses, specifically 5 mg per day, DO cause

> > measurable side effects if taken long term. A month or less is still

> > probably not a problem.

> >

> > I would ask them for the same level of credibility. Ask them to cite

> > literature that confirms their assertions. All you have quoted from

> them

> > seems to be opinion. As far as I am concerned, everyone here is

> > perfectly entitled to trust the opinion of a non-professional over

peer

> > reviewed research, but I think that could be risky.

> >

> > Chuck

> >

>

>

>

>

>

>

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