Re: OT RE:ACTH stim testing

[Guest guest]

>

> > I don't think those of us taking the 5 mg 4 times daily are too

concerned

> about it. Of course, I " m a 230 pound male, and I'm sure there are

115 pound

> females taking the same dosage.

agreed. and again, i think my initial alarm started when i realized

the one size fits all H/C protocol could be dangerous for me.

>

>

> >

> A very limited amount of people do well on small doses.

This is probably right in many cases...but I'm mindful that

Peatfield does say start with 2.5...and only over a couple of weeks

work up as needed.

>

> This may or may not be relevant. For one thing you say " steroids "

cause....

> Well, what kind of steroid?

I need to check more on this..this was the 2nd place i've seen that

said nighttime dose suppresses morning production....but I still

don't quite understand how this works.

cindi

[Guest guest]

my understanding from conversion charts...that it's 20% weaker, and

a shorter 1/2 life than H/C.

The top maintenance dose of cortisone acetate for addisons is 37.5,

with it listed as 12.5 - 37.5 as a usual maintenance dose.

37.5 acetate would be equivalent to about 45 mg. of H/C, not 20 - if

i have calculated this correctly.

cindi

>

>

> hydrocortisone IS pretty much equal to cortisone acetate. It

is just dosed differently. Cort acetate dose would be 37mg=20mg

cortef. My BB doc asked me which one I liked best, and I said I

guess I like cortef best. But they work the same.

> Gracia

>

>

>

>

>

> Recent Activity

> a.. 26New Members

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[Guest guest]

lordy, i had that calculation wrong...too early in the morning..

if H/C is 20% stronger than cortisone acetate..then 37.5 cortisone

acetate would be equal to 30 mg. of H/C. geez...

cindi

> >

> >

> > hydrocortisone IS pretty much equal to cortisone acetate. It

> is just dosed differently. Cort acetate dose would be 37mg=20mg

> cortef. My BB doc asked me which one I liked best, and I said I

> guess I like cortef best. But they work the same.

> > Gracia

> >

> >

> >

> >

> >

> > Recent Activity

> > a.. 26New Members

> > Visit Your Group

> >

[Guest guest]

>From: " cindi22595 " <cindi22595@...>

>

>agreed. and again, i think my initial alarm started when i realized

>the one size fits all H/C protocol could be dangerous for me.

Yes, but I think Jeffries profiled the typical low adrenal patient as being

a tall, thin, blonde female which likely implies a relatively low weight for

his dosing.

Skipper

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[Guest guest]

>From: " cindi22595 " <cindi22595@...>

>This is probably right in many cases...but I'm mindful that

>Peatfield does say start with 2.5...and only over a couple of weeks

>work up as needed.

I'm not checking the book right now, but this is what he said in his paper -

" The Treatment

You will be given hydrocortisone 10mgm, which is the natural form, to take

in a

dose appropriate to your needs. Half a tablet three or four times a day is

usual, later to be increased, if required. Hydrocortisone has the problem of

very rapid uptake by the system, and it needs to be given every four hours,

at

least. This creates practical problems for many patients, and we use more

often,

Deltacortril, or Prednisolone. 2.5mgm is usually given to start with,

increasing

to 5mgm after a few days. Rarely, a total dose of 7.5mgm may be required. "

So he started with 15-20 mg of Hydrocortisone or 2.5 mg of Prednisone, which

is equivalent.

Skipper

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[Guest guest]

>From: " cindi22595 " <cindi22595@...>

>I also am not sure if we can take his articles and apply them to all

>other AF cases Without hypo. It would just seem needing to get

>thyroid hormone in to you and needing the H/C for that might be a

>little different protocol from non-hypo AF.

>Cindi

No, but then Jeffries book about " Safe Uses of Cortisol " is about adrenal

insufficiency, and not hypothyroidism. So, that would apply to long term

treatment, not the temporary AF caused by low thyroid.

Skipper

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[Guest guest]

>From: " cindi22595 " <cindi22595@...>

>

>yea...it is ironical.

>

>For me, Gracia...if i had a diagnosis of 's...the calculated

>full replacement replacement dosage for me IS 20 mg. And if I took

>the 30 mg. that is recommended to some folks (citing peatfield), I'd

>soon be developing Cushing's from over replacement.

>So in my case...and perhaps because i'm thinner...it really matters.

Thinner than someone you don't know?

Since you've made up your mind that 20 mg is full replacement for you and

enough to suppress your adrenals, why don't you just take 10 mg?

Also, does that formula for the calculation take into consideration the

effect of the Florinef which most 's patients take? If you have

Florinef, you need less HC.

I'm not so sure what's so hard about this. Or, are you just trying to

convince us our amount is wrong?

Skipper

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[Guest guest]

maybe...but height counts as much in the current formula as weight -

even though i think it's apparent Jefferies wasn't using the Dubois

formula to calculate replacement doses. He does cite his own work

as the reference for his replacement dose...and ya know, i'd love to

find a copy of the study of his he references.

But replacement doses really wasn't his specific area of research

either i guess...he was more about what less than full replacement

doses can do for an individual...although in reading the cases, I

can't help but wonder if some cases were just unidentified as yet on

the way to 's folks. I think the research since him has fine-

tuned the message a bit, but I don't think that distracts in any way

from his valuable research.

You might find the discussion on the Dubois formula

interesting...scroll down to the end:

http://jjco.oxfordjournals.org/cgi/content/full/33/6/309

cindi

-- In iodine , " Skipper Beers " <lsb149@...> wrote:

>>

> Yes, but I think Jeffries profiled the typical low adrenal patient

as being

> a tall, thin, blonde female which likely implies a relatively low

weight for

> his dosing.

[Guest guest]

in agreement...although he does mention autoimmune disease...and also

the protocol improving cell uptake of thyroid hormone (receptor

resistance)in his book...intriguing uses for H/C i think.

cindi

>>

> No, but then Jeffries book about " Safe Uses of Cortisol " is about

adrenal

> insufficiency, and not hypothyroidism. So, that would apply to long

term

> treatment, not the temporary AF caused by low thyroid.

[Guest guest]

steph,

interestingly, i went to the site today...and the adrenal pages have

been revised recently even from a recent revision (which clarified

peatfield basically meant months, not lifetime)....so I think if you

take a look again at their adrenal info as revised...the message has

evolved. I'm so glad - the info looks good now.

Cindi

>

> Cindi,

> I am curious (as I can certainly relate to the adrenal issues.) Are

you

> taking Armour? Do you ever go to _www.stopthethyroidmadness.com_

> (http://www.stopthethyroidmadness.com) ? There is a huge amount of

adrenal info there and

> they are very pro HC.

[Guest guest]

I thought Jefferies said that 35-40mg was NOT what the body produced,

but what was required to provide the body with a replacement dose. He

then concluded that it was likely a digestion/availability issue -

that only 60% of the cortisone taken was available.

Sharon

> But replacement doses really wasn't his specific area of research

> either i guess...he was more about what less than full replacement

> doses can do for an individual...although in reading the cases, I

> can't help but wonder if some cases were just unidentified as yet on

> the way to 's folks. I think the research since him has fine-

> tuned the message a bit, but I don't think that distracts in any way

> from his valuable research.

[Guest guest]

>From: " cindi22595 " <cindi22595@...>

>But replacement doses really wasn't his specific area of research

>either i guess...he was more about what less than full replacement

>doses can do for an individual...although in reading the cases, I

>can't help but wonder if some cases were just unidentified as yet on

>the way to 's folks.

Of course they were. Isn't 's usually recognized first when someone

shows up in the ER in adrenal crises?

I think the research since him has fine-

>tuned the message a bit, but I don't think that distracts in any way

>from his valuable research.

If it's so fine tuned, why are you having difficulty?

>

>You might find the discussion on the Dubois formula

>interesting...scroll down to the end:

>http://jjco.oxfordjournals.org/cgi/content/full/33/6/309

I couldn't figure it out. Seemed to be talking mainly about cancer or BMR.

Skipper

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[Guest guest]

that is correct...and i always talk in terms of the oral h/c dose...it

gets too confusing otherwise. and most articles/abstracts do the

same...refering to the oral h/c..exogeneous, not endogeneous.

but the body makes around 10 mg. of h/c....i had that in one of the

references.

cindi

>

> I thought Jefferies said that 35-40mg was NOT what the body produced,

> but what was required to provide the body with a replacement dose. He

> then concluded that it was likely a digestion/availability issue -

> that only 60% of the cortisone taken was available.

[Guest guest]

lol.

well...actually i was only having difficulty when i was talking with

a small group of folks who couldn't get past " what is a replacement

dose " ...since talking it out some with you and on a adrenal fatigue

forum, i'm very comfortable with all the info.

On the DuBois formula...body surface is also used to individual

doses for anti-cancer agents so as not to over treat. since it is

also used for addison's doses, i thought the discussion in that

article of how it evolved is interesting. I had wondered where it

came from. This excerpt shows the formula for addisons in regards

to body surface area:

Found this sources specific info on adrenal insufficiency

replacement:

Glucocorticoid replacement therapy: Patients with adrenal

insufficiency should be treated with hydrocortisone, the natural

glucocorticoid. The hydrocortisone daily dose is 25-30 mg (10-15 mg

per meter square body surface area) and can be given in two to three

divided doses. A longer-acting synthetic glucocorticoid such as

prednisolone, prednisone or dexamethasone, may be employed but

should be avoided. because their longer duration of action may

produce manifestations of chronic glucocorticoid excess such as loss

of lean body mass and bone density and gain of visceral fat. The

usual oral replacement dosages are 5-7.5 mg of prednisolone or

prednisone or 0.25-0.75 mg of dexamethasone once daily.

Cindi

>

> >From: " cindi22595 " <cindi22595@...>

>

> >

> I think the research since him has fine-

> >tuned the message a bit, but I don't think that distracts in any

way

> >from his valuable research.

>

> If it's so fine tuned, why are you having difficulty?

>

> >

> >You might find the discussion on the Dubois formula

> >interesting...scroll down to the end:

> >http://jjco.oxfordjournals.org/cgi/content/full/33/6/309

>

> I couldn't figure it out. Seemed to be talking mainly about

cancer or BMR.

>

> Skipper

>

> _________________________________________________________________

> The next generation of Search—say hello!

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us & FORM=WLMTAG

>

[Guest guest]

So, if this is correct then Jefferies might agree that 21-24mg is

what the body makes for itself, the theoretical replacement dose, so

to speak? And he gave 35-40mg as the actual replacement dose to get

that effect?

But you are saying that new research suggests that 12-15mg is what

the body makes and 20-25mg is what is needed to get that effect? Or

did I get this wrong?

And while we are on the topic of efficiency of cortisol meds, is

there any research that looks at the

efficiency/digestibility/availability of the different types, e.g.,

hydrocortisone, cortisol, and cortisol acetate?

Sharon

> that is correct...and i always talk in terms of the oral h/c

dose...it

> gets too confusing otherwise. and most articles/abstracts do the

> same...refering to the oral h/c..exogeneous, not endogeneous.

>

> but the body makes around 10 mg. of h/c....i had that in one of

the

> references.

> cindi

>

> > I thought Jefferies said that 35-40mg was NOT what the body

produced,

> > but what was required to provide the body with a replacement

dose. He

> > then concluded that it was likely a digestion/availability

issue -

> > that only 60% of the cortisone taken was available.

>

[Guest guest]

sorta.

i think there are probably two important things to remember when

looking at jefferies work.

first, since his work....they have developed better ways to assess

what the body actually makes. i don't think that info should be

disregarded. remember back in the 40s when they first started with

this, they were using 100 mg. plus...and they didn't know all the

adverse side effects. this has all has evolved over the last 1/2

century in that they do know now the adverse side effects of over-

replacement. so although his figures may be slightly off, it

doesn't negate the importance of the message at all.

second, jefferies did work with cortisone acetate...and although he

said that cortisol was equal...what we do definitely know now is

that hydrocortisone is 20% stronger than cortisone acetate. That's

why with h/c, addison's folks don't need 4x a day dosing. H/C lasts

longer in the body. So i think that information should also be

applied to Jefferies work to see if it 3x a day dosing with H/C is

more appropriate.

but to answer your question...mostly yes..with an average

replacement dose being 20-25 mg....but this can vary according to

height and weight somewhat.

As to your other question...there is some info that talks about

which is more suppressive (the stronger ones like prednisone) and of

course the longer action in the body of h/c over cortisone

acetate...but so far, i haven't run across exactly what you're

asking about. Peatfield, however, does indicate that higher doses

may be needed because of digestive/absorbtion issues with the

digestive tract. Since hypo and adrenal problems tend to cause

digestive issues....one might speculate that a higher dose might be

needed initially, and then lowered as those issues resolved.

cindi

since Jefferies time, they have developed better studies

>

> So, if this is correct then Jefferies might agree that 21-24mg is

> what the body makes for itself, the theoretical replacement dose,

so

> to speak? And he gave 35-40mg as the actual replacement dose to

get

> that effect?

>

> But you are saying that new research suggests that 12-15mg is what

> the body makes and 20-25mg is what is needed to get that effect?

Or

> did I get this wrong?

>

> And while we are on the topic of efficiency of cortisol meds, is

> there any research that looks at the

> efficiency/digestibility/availability of the different types,

e.g.,

> hydrocortisone, cortisol, and cortisol acetate?

>

> Sharon

>

> > that is correct...and i always talk in terms of the oral h/c

> dose...it

> > gets too confusing otherwise. and most articles/abstracts do the

> > same...refering to the oral h/c..exogeneous, not endogeneous.

> >

> > but the body makes around 10 mg. of h/c....i had that in one of

> the

> > references.

> > cindi

> >

>

> > > I thought Jefferies said that 35-40mg was NOT what the body

> produced,

> > > but what was required to provide the body with a replacement

> dose. He

> > > then concluded that it was likely a digestion/availability

> issue -

> > > that only 60% of the cortisone taken was available.

> >

>

[Guest guest]

it bears mentioning that this is variable...you see it anywhere from

15 to 35....

i tend to like the actual formula i found that calculates a " safe "

replacement dosage without side effects:

http://www.endotext.org/adrenal/adrenal14/adrenal14.htm

Side effects occur only with supraphysiologic doses of

glucocorticoids and not with proper replacement, which is equivalent

to 12 to 15 mg of hydrocortisone/ m2 body surface area per day (7).

Major complications are unlikely with short-term treatment (less

than 2 weeks) with high doses of glucocorticoids, although sleep

disturbances and gastric irritation are common complaints, and

depression, mania, or psychosis, may be infrequently precipitated

(7, 20-22). On the other hand, many side effects are associated with

chronic daily administration of pharmacologic amounts of

glucocorticoids (Table 2) (10, 11). These side effects include the

development of varying degrees of Cushing's syndrome manifestations

during therapy and secondary adrenal insufficiency (adrenal

suppression) after discontinuation of treatment. Growth retardation

is one of the major side effects of chronic daily glucocorticoid

therapy in children ( 23, 24).

cindi

----In iodine , " cindi22595 " <cindi22595@...> wrote:

>

> > but to answer your question...mostly yes..with an average

> replacement dose being 20-25 mg....but this can vary according to

> height and weight somewhat.

[Guest guest]

>From: " cindi22595 " <cindi22595@...>

>lol.

>well...actually i was only having difficulty when i was talking with

>a small group of folks who couldn't get past " what is a replacement

>dose " ...since talking it out some with you and on a adrenal fatigue

>forum, i'm very comfortable with all the info.

Well, it's likely the dose that suppresses the adrenals could be variable,

which is why checking the ACTH occassionally is a good idea. It may be that

20 mg a day will keep some patient's adrenals from working on a stress free

day. But, even if it does, how many stress free days are there, and does

the normal amount of stress in one's life escalate the cortisol production

enough times during the day that it keeps the adrenals active enough not to

atrophy? Just driving to work for most people probably escalates the

adrenaline levels, which in turn causes a cortisol response.

There are a lot of varibles to consider.

Skipper

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[Guest guest]

>From: " cindi22595 " <cindi22595@...>

If I used your formula correctly, it means I should get 27 - 33 mg per day,

which is more than I take.

A 5', 115 pound female should take 18-22 mg which is in the range that

agrees to Dr. Jeffries..

I found a calculator for the formula at http://tinyurl.com/zslxc, I plugged

in 12 and 15 mg to get the actual dosage, once it calculated the body

surface area..

So, based on this, unless I don't understand the formula or the calculator,

it supports Jeffries contention of 20 mg per day is OK for most people.

Skipper

>it bears mentioning that this is variable...you see it anywhere from

>15 to 35....

>i tend to like the actual formula i found that calculates a " safe "

>replacement dosage without side effects:

>

>http://www.endotext.org/adrenal/adrenal14/adrenal14.htm

>

>Side effects occur only with supraphysiologic doses of

>glucocorticoids and not with proper replacement, which is equivalent

>to 12 to 15 mg of hydrocortisone/ m2 body surface area per day (7).

>Major complications are unlikely with short-term treatment (less

>than 2 weeks) with high doses of glucocorticoids, although sleep

>disturbances and gastric irritation are common complaints, and

>depression, mania, or psychosis, may be infrequently precipitated

>(7, 20-22). On the other hand, many side effects are associated with

>chronic daily administration of pharmacologic amounts of

>glucocorticoids (Table 2) (10, 11). These side effects include the

>development of varying degrees of Cushing's syndrome manifestations

>during therapy and secondary adrenal insufficiency (adrenal

>suppression) after discontinuation of treatment. Growth retardation

>is one of the major side effects of chronic daily glucocorticoid

>therapy in children ( 23, 24).

>

>cindi

>

>

>----In iodine , " cindi22595 " <cindi22595@...> wrote:

> >

> > > but to answer your question...mostly yes..with an average

> > replacement dose being 20-25 mg....but this can vary according to

> > height and weight somewhat.

>

>

>

>

>

>

>Iodine

[Guest guest]

agreed - it absolutely is variable...i kept researching this subject

and about the only thing even slightly definitive is 10 mg. and less

taken in the morning probably will not suppress ones own adrenals.

after that, it's sorta a crap shoot. like i mentioned earlier, i'm

sure this is the reluctance of physicians to use sub or full

physiological doses...although i certainly think their reluctance

hurts us. Supression is okay if not prolonged, etc. I can look at

my own daughter who has seasonal allergies and asthma...and I

think...hmm....5 mg. of h/c in the AM may help that during her

trouble months I think.

There is some literature out there thought that says every other day

dosing significantly reduces the risk of adrenal suppression....and

also some literature on just stress dosing. I went into my research

endeavor thinking the subject was going to be cut and dried, and

it's not at all. In fact I think researching it has contributed to

my own possible AF. :-(

Cindi

>

> >From: " cindi22595 " <cindi22595@...>

>

>

> Well, it's likely the dose that suppresses the adrenals could be

variable,

> which is why checking the ACTH occassionally is a good idea. It

may be that

> 20 mg a day will keep some patient's adrenals from working on a

stress free

> day. But, even if it does, how many stress free days are there,

and does

> the normal amount of stress in one's life escalate the cortisol

production

> enough times during the day that it keeps the adrenals active

enough not to

> atrophy? Just driving to work for most people probably escalates

the

> adrenaline levels, which in turn causes a cortisol response.

>

> There are a lot of varibles to consider.

>

>

>

> Skipper

>

> _________________________________________________________________

> The next generation of Search—say hello!

> http://imagine-windowslive.com/minisites/searchlaunch/?locale=en-

us & FORM=WLMTAG

>

[Guest guest]

???? why? your history screams adrenal. I am a 5' 2" female, actually not sure how much I weigh, let's say 140, and I take the same dose as Skipper. Where have you heard that low dose cortisol is dangerous?

Maybe you need to ask peeps who have taken it.

Gracia

>> > I don't think those of us taking the 5 mg 4 times daily are too concerned > about it. Of course, I"m a 230 pound male, and I'm sure there are 115 pound > females taking the same dosage.agreed. and again, i think my initial alarm started when i realized the one size fits all H/C protocol could be dangerous for me. > > > > > A very limited amount of people do well on small doses. This is probably right in many cases...but I'm mindful that Peatfield does say start with 2.5...and only over a couple of weeks work up as needed. > > This may or may not be relevant. For one thing you say "steroids" cause.... > Well, what kind of steroid? I need to check more on this..this was the 2nd place i've seen that said nighttime dose suppresses morning production....but I still don't quite understand how this works. cindi

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[Guest guest]

you are really wrong here. Try asking someone who takes cortef how long it lasts. They will be glad to tell you.

I was on a adrenal group. The peeps on that group were sooooo sick and confused, then someone would post something very confusing and sort of authoritative from Tish from NTH, and peeps got way more confused. I had to unsub from the group, no one was getting well at all.

You are perpetuating this confusion!

Gracia

sorta. i think there are probably two important things to remember when looking at jefferies work. first, since his work....they have developed better ways to assess what the body actually makes. i don't think that info should be disregarded. remember back in the 40s when they first started with this, they were using 100 mg. plus...and they didn't know all the adverse side effects. this has all has evolved over the last 1/2 century in that they do know now the adverse side effects of over-replacement. so although his figures may be slightly off, it doesn't negate the importance of the message at all.second, jefferies did work with cortisone acetate...and although he said that cortisol was equal...what we do definitely know now is that hydrocortisone is 20% stronger than cortisone acetate. That's why with h/c, addison's folks don't need 4x a day dosing. H/C lasts longer in the body. So i think that information should also be applied to Jefferies work to see if it 3x a day dosing with H/C is more appropriate. but to answer your question...mostly yes..with an average replacement dose being 20-25 mg....but this can vary according to height and weight somewhat. As to your other question...there is some info that talks about which is more suppressive (the stronger ones like prednisone) and of course the longer action in the body of h/c over cortisone acetate...but so far, i haven't run across exactly what you're asking about. Peatfield, however, does indicate that higher doses may be needed because of digestive/absorbtion issues with the digestive tract. Since hypo and adrenal problems tend to cause digestive issues....one might speculate that a higher dose might be needed initially, and then lowered as those issues resolved. cindi

..

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[Guest guest]

but that's calculating a Full replacement dose.

so then the question becomes...if folks think that 1/2 of a

replacement dose (20 mg. of the 40 mg. jefferies cited) is the

correct sub-replacement dosage for AF, etc...you would then have to

divide the 27-33 by 2 to get that 1/2 sub-replacement dosage.

And in my own case, with a full replacement dose for me being around

20 mg....If I took the standard 20 mg., I'd be fulling replacing

with absolutely no adrenal reserve for stresses - in essence, i've

become an addison's patient. in comparison, it would be more

prudent for me to take 10 mg. for AF.

Now, I think if you throw hypo into the analysis....it could change

the standard 1/2 replacement protocol. Peatfield's protocol with

higher doses for this is probably fine for a few months while

someone's adrenals recover. Even normal adrenals get weakened from

hypo...although the stats are that about 25% of the hashi's folks

will also have antibodies to the adrenals.

cindi

>>

> If I used your formula correctly, it means I should get 27 - 33 mg

per day,

> which is more than I take.

>

> A 5', 115 pound female should take 18-22 mg which is in the range

that

> agrees to Dr. Jeffries..

>

> I found a calculator for the formula at http://tinyurl.com/zslxc,

I plugged

> in 12 and 15 mg to get the actual dosage, once it calculated the

body

> surface area..

>

> So, based on this, unless I don't understand the formula or the

calculator,

> it supports Jeffries contention of 20 mg per day is OK for most

people.

>

[Guest guest]

FYI Broda Foundation actually recommneds prednisolone (Deltacortril) over cortef! according to a person who called there. Hertoghe uses both but says there is a difference--cortef is best used for mental complaints like depression. DHEA is also good for depression.

You don't want to onit the 4th dose of cortef, believe me.

gracia

lol. well...actually i was only having difficulty when i was talking with a small group of folks who couldn't get past "what is a replacement dose"...since talking it out some with you and on a adrenal fatigue forum, i'm very comfortable with all the info. On the DuBois formula...body surface is also used to individual doses for anti-cancer agents so as not to over treat. since it is also used for addison's doses, i thought the discussion in that article of how it evolved is interesting. I had wondered where it came from. This excerpt shows the formula for addisons in regards to body surface area:Found this sources specific info on adrenal insufficiency replacement:Glucocorticoid replacement therapy: Patients with adrenal insufficiency should be treated with hydrocortisone, the natural glucocorticoid. The hydrocortisone daily dose is 25-30 mg (10-15 mg per meter square body surface area) and can be given in two to three divided doses. A longer-acting synthetic glucocorticoid such as prednisolone, prednisone or dexamethasone, may be employed but should be avoided. because their longer duration of action may produce manifestations of chronic glucocorticoid excess such as loss of lean body mass and bone density and gain of visceral fat. The usual oral replacement dosages are 5-7.5 mg of prednisolone or prednisone or 0.25-0.75 mg of dexamethasone once daily.Cindi

..

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[Guest guest]

i agree my history screams adrenal. not questioning that.

at your height/weight, the upper end of your full replacement dose

is around 23 mg.

Now here's the thing...when you went on H/C, it's probably because

you were Not functioning at 100%....you could have been functioning

at 70% (16 mg.) or less and thus 20 mg. really made you feel better.

But has taking that much H/C strengthened or weakened your

adrenals? And at that type of dose, I'd want to stress dose for

something like dental work or maybe even a brisk walk...because

natural adrenal reserve (storage) has been drastically reduced.

The theory is, of course, that resting them strengthens them. But as

Chris's link from SSTM points out, there doesn't seem to be much

evidence of that. So it's a real possibility that some AF folks

really do just need full replacement? I guess it depends on adrenal

damage done.

But I don't see how most folks taking a full replacement dose is

necessarily the best thing for their adrenals. If they are weak,

they might want a different protocol to bring them up to 100%

functioning instead of shutting them down and hoping they will

bounce back.

Cindi

> >

> > > I don't think those of us taking the 5 mg 4 times daily are

too

> concerned

> > about it. Of course, I " m a 230 pound male, and I'm sure there

are

> 115 pound

> > females taking the same dosage.

>

> agreed. and again, i think my initial alarm started when i

realized

> the one size fits all H/C protocol could be dangerous for me.

> >

> >

> > >

> > A very limited amount of people do well on small doses.

>

> This is probably right in many cases...but I'm mindful that

> Peatfield does say start with 2.5...and only over a couple of

weeks

> work up as needed.

>

> >

> > This may or may not be relevant. For one thing you

say " steroids "

> cause....

> > Well, what kind of steroid?

>

> I need to check more on this..this was the 2nd place i've seen

that

> said nighttime dose suppresses morning production....but I still

> don't quite understand how this works.

> cindi

>

>

>

>

>

>

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