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08/19/2008 19:27
herro
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Well, hoping someone out there has heard of this. my endo said new research shows that replacement doses for cortisol should be lower. iwas taking hydrocortisone-20 mg in am and 10mg in pm. now i take 7 1/2 am, 5mg noon and 5 mg pm. i feel like crap!!! so tired, no energy, no strength. have wanted to just lie in bed and do nothing for few hrs a day. and i sweat way too much...my clothes get soaked, sweat drips down my face, i have to sit in front of a fan to get cool. it is not hot flashes. when i had surgery 6/07 i was hot like this for about 3 mths. my skin feels cold but i am hot. drs kept telling me it was hot flashes last yr. i am almost 2 yrs post menopause. i will get really thirsty and drink couple glasses and then feel like i am going to vomit. am too tired to research right now....

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11/28/2008 16:58
bob3bob3
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Hi there!

Yes I have kind of. You may have seen some other posts from me about determining the right dose.

From what I understand the 25-30mg seems to have been a best guess historically that in some circumstances may be excessive. The problem is of course the one of osteoporosis. You also cant use a large single dose of HC as it decays to quickly. You are trying to match your body's natural cycle.

What is missing from the equation is that there is no sound way to determine exactly what you need and when you need it. The cortisol you need is cell bound, not blood so it is near impossible to measure. Blood tests can be used to determine failure but not the right dose. (Unlike a vitamin pill for example cortisol doesn't just "go away" if you take excess) Electrolyte tests too seem to be good at proving a disaster but not how well you are replacing.

I have an article my endo sent me dated March08 that is a little lengthy to get into here. It does talk about a variety of dose sizes from 5mg 3x daily, 10mg morning, 5 in afternoon, 20mg single dose and 15-25mg broken up into 2 or 3. Quite a lot of variation from different "authors". Perhaps this is the one yours is talking about.

Keep in mind too that cortisol is a resource that you will use in varying amounts from day to day. I even read an article that advocates an extra 5mg if you are likely to have a stressful day at work! You also use more if you exercise more or are of large mass (like me!) I use to take more steroid the day before I rode my bicycle to work (I was using Dex) but that drug made me hungry all the time!

My suggestion for what it is worth is to experiment with the dose yourself. Maybe 10/7.5/5 rather than 7.5/5/5. If you have been on 20/10 it can hardly be any worse than what it use to be..

Also, on reading the article mentioned and talking to my endo he said there isn't enough research/info out there to positively determine what the right dose is. I use fatigue, breathing issues and dehydration to determine if I am too low. On the other side if I get to angry I know I have taken too much! Buffering my morning dose with food sometimes helps to iron out the angry peak! My problem too is that I am one of those people that feel really good after any HC dose so I have to be careful not to take it for recreational reasons!!!

If I sweated like you have mentioned I would assume an electrolyte issue born from lack of cortisol. I however being a male don't have experience in PM hormone disturbances that you may need to consider as well

Hope this helps

Cheers Bob (East Texas)

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