Protocols for Low Cortisol and Adrenal Exhaustion (Stage 2 and 3)

If you have not yet read my previous posts on the adrenals/protocols for adrenal exhaustion, please review the below posts to get the most out of this article:

• Understand How Excess or Deficient Cortisol Levels Affect Your Health

• Protocols for Low Cortisol and Adrenal Exhaustion Stage (1)

In stage 2 or 3 adrenal exhaustion, your cortisol levels are below normal on more than one time window (see test below), have low DHEA levels, and a poor cortisol to DHEA ratio.

The above adrenal stress profile shows depressed cortisol levels in the morning, noon and afternoon.  The DHEA-S average is on the low side of normal – pushing the cortisol to DHEA ratio out of normal.

What are the symptoms of the client above?

• Troubles getting out of bed

• Does not start to “feel normal” until about 7:00pm

• Feelings of impending doom

• Reduced Sex Drive

• Anxiety

• Feels like passing out much of the time

• Frequently has trouble getting to sleep at night

• Has troubles with too much stimulation (like going shopping at IKEA for example)

What hormone is primarily responsible creating the above symptoms?

• Excess Adrenaline – In conditions of low cortisol, adrenaline is secreted in excess in attempt to signal the adrenal glands to produce cortisol.  The theory with adrenal fatigue is that both cortisol and adrenaline production gets dis-regulated.

General Protocols for the above client after considering:  Symptoms, adrenal stress results and blood lab test profile results.

Please Note: No one should implement a protocol without the professional guidance of a qualified physician.  This general protocol is to educate you and your doctor on what drugs, supplements, diet and lifestyle changes can help you recover from adrenal exhaustion/adrenal fatigue.

Protocol (Stage 3) Adrenal Exhaustion:

• In the above situation (unless major life stressors can be reduced) medical drugs may be carefully administered.

Hydrocortisone

Please note:  Taking hydrocortisone is a last resort if you are truly “burnt out” (yet do not have Addison’s Disease, and should be carefully supervised by your physician.  Everyone is individual and will respond differently to this drug.  Theoretically, most people produce around 40 milligrams of cortisol per day and of course some of that is metabolized by the body.  Low dose hydrocortisone is safe for a short period of time and gives the adrenals a chance to rest and recover.  Prednisone however, works on a slightly different pathway and has the ability to shut down the adrenals (dose dependent and length of time on the drug dependent).  Hydrocortisone does also have the ability to shut down the adrenal glands given enough dose and duration as well (it’s just not as potent as prednisone)

Take 10mg in the morning and 5mg at lunch.  Do not take hydrocortisone past 2pm.  I prefer Hydrocortizone in generic form because it is an old drug – runs about $15.00 and is likely cheaper than your co-pay.  You can buy the name brand Coref, but I would try the generic first.

In using hydrocortisone treatments, it may be necessary to adjust your dosage every 3-7 days as your body adapts to the drug.

After using hydrocortisone for 2-3 months you may talk to your doctor about backing off the dosage and combining your protocol with licorice.  Licorice increases the half life of cortisol which decreases your need for hydrocortisone.

Pregnenelone

Take 5-20mg of pregnenelone per day.  In high stress states, pregnenelone is stolen to make more cortisol.  In stage III adrenal fatigue pregnenelone and DHEA is often low.  Pregnenelone is a precursor to DHEA – you may not need to take supplemental DHEA because it can theoretically be restored through pregnenelone supplementation.  For more information about the detailed steroidal hormone pathways as it relates to pregnenelone and cortisol Click Here

DHEA

Take 5-10mg of DHEA per day.  DHEA Dehydroepiandrosterone is produced by the adrenal glands (men) and the adrenal glands/ovaries (women).  DHEA is often depleted in the latter stages of adrenal exhaustion and is important to bring back up to normal levels.  I would suggest including DHEA in your blood profile test in addition to the saliva for increased accuracy.  DHEA improves your ability to adapt to stress – be sure to boost it if it is low.

Licorice

As noted earlier, licorice increases the half life of cortisol.  Take 2ml of  licorice root extract in tincture form when backing down on your hydrocortizone.  Also, you could take licorice in pill form.  I highly recommend a licorice product that I use.

Please reference my previous post on adrenal fatigue for a few tips on restoring adrenal gland function through diet, exercise and lifestyle changes.

Adin’s Final Thoughts:

If you are an individual who has multiple stressors, and do not have the option to significantly “back off the gas pedal of life”, then a synthetic medical boost may be your best option.  The medical approach should be applied only for a certain window of time and not to be used as a band-aid so you can keep overworking and pushing yourself! When you are on hydrocortisone and or pregnenelone/DHEA, please make the necessary healthy nutrition and lifestyle choices so you can fully recover.

Below is a sitemap of my other articles on adrenal fatigue:

http://siliconvalleyfit.com/excess-or-deficient-cortisol/

http://siliconvalleyfit.com/protocols-for-low-cortisol-and-adrenal-exhaustion/

http://siliconvalleyfit.com/protocols-for-low-cortisol-and-adrenal-exhaustion-stage-2-and-3/

http://siliconvalleyfit.com/yet-another-case-study-of-adrenal-fatigue/

http://siliconvalleyfit.com/how-to-test-your-cortisol-levels/

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