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Author Topic: cortisol/prednisone/aldosterone/DHEA/adreanals  (Read 2416 times)

Mr.L

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cortisol/prednisone/aldosterone/DHEA/adreanals
« on: July 11, 2019, 04:31:11 pm »
When I first started TRT, about 3 years ago, I had my DHEA tested. It was in the 70's and was too low. I started supplementing with a prescription DHEA and left it at that. I think it helped me but I started it at the same time as TRT so cannot pin that down. The doctor suspected that I have low aldosterone as well because of low BP and frequent urination and I am not sure what else. I did have it tested and I think the number was 8. I do not know the range but he never said I needed to treat it so I assume it was fine. Recently, and several years ago I had to take predisone. First it was for Polymyositis and the more recent time it was for a chest infection. I felt pretty great both times. This last time I was taking 60mg and that was a bit much and caused some trouble sleeping but I had boundless energy. Well I only took it for a week and now I am back to having no energy again.
From what I understand your adrenal glands make DHEA, cortisol, and aldosterone. If I had low DHEA and the doctor suspects low aldosterone would it not stand to reason that I might have some cortisol problems? And if I felt so good taking the Prednisone would that testify to that a little or does it just make everyone feel like superman regardless? Lastly, is there a feedback loop that can get shut down if you take DHEA?   
« Last Edit: July 11, 2019, 09:11:39 pm by Mr.L »

HRT Guru

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #1 on: July 11, 2019, 06:03:34 pm »
How would one treat Aldosterone? (rhetorical). What I would rather see you trying here is going high enough in the hormonal cascade with Pregnenolone, that should roll down the the hormonal cascade to everything below it. Huge assumption that your body is going to convert it to the downstream portion. I'm not a DHEA fan as I believe it *can* aromatase very easily in some forms and for some guys.
Adrenal Fatigue isn't a recognized medical condition, it's usually can be pinned down to herbs, and minerals like salt there's good homebrew sorts of things you can explore in that way.
Cortisol FYI is a saliva test taken in 4 times over 24hrs, should not be a blood serum test, it's rather expensive test if paying it out of pocket.

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #1 on: July 11, 2019, 06:03:34 pm »


Mr.L

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #2 on: July 11, 2019, 06:49:28 pm »
"How would one treat Aldosterone? (rhetorical)." I don't understand. Can you not treat it? I do take extra salt. Also I do take preg/dhea that Dr. has prescribed.

Cataceous

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #3 on: July 12, 2019, 12:41:52 am »
How would one treat Aldosterone? (rhetorical). ...

Fludrocortisone, brand name Florinef.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 60, Ht: 5'10", Wt: 154 lbs
Protocol: 3.2 mg TE subQ qd, 2.4 mg TP subQ qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #3 on: July 12, 2019, 12:41:52 am »


HRT Guru

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #4 on: July 12, 2019, 01:44:47 pm »
How would one treat Aldosterone? (rhetorical). ...

Fludrocortisone, brand name Florinef.

Great post.

Mr.L

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #5 on: July 16, 2019, 07:22:16 pm »
This thread dies awful fast... ::)

Joe Sixpack

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #6 on: July 17, 2019, 03:50:42 am »
I don't recall that supplementing DHEA has a negative feedback loop for cortisol.  But many people report that TRT has a suppressing effect on cortisol.  Happened to me for sure.  Since you are on TRT, it is easily possible that you are having low cortisol due to this suppression.  As the GURU mentioned, testing is pretty much the only way to know for sure.  But I suspect that your positive experience w/ prednisone is a pretty good indicator that you are low.  If you had normal or high natural cortisol, I suspect the pred would make you feel anxious or otherwise sub-par. 

The trouble w/ taking prednisone or other cortico-steroids is that they suppress your natural cortisol output.  So if you take it long term, coming off of it is difficult.  Most docs wouldn't give it to you long term anyway.  excess cortisol is harmful in many ways.... blood sugar/diabetes, cardiovascular disease, etc. 

Age: 55, Ht: 5'08", Wt: 155 lbs
Protocol: 25 mg T Cyp + 25 IU HCG M,W,F + 2 clicks T Cream + 15mg DHEA + 15mg Pregnenalone daily.
12/2018 test results: TT: 1054 ng/dL (264-916), FT: 17.2 pg/mL (7.2-24), E2: 21.6 pg/mL sensitive (8.0-35.0)

cujet

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #7 on: July 19, 2019, 06:31:03 pm »
I'm currently taking 10 prednisone to combat extreme fatigue. My blood test cortisol is always low or low-normal. The highest I've ever seen my AM cortisol levels is 10 mcg/dl. Sometimes, in the 4's. Normal AM should be 10 to 20, or even as high as 30 at some labs. With 6 being the absolute low limit.

Whether I use T or not, my cortisol remains low. Prednisone helps immensely. It's about an 80% improvement.
58 years old
Autoimmune Hashimoto's, near zero natural T production
Cause: severe mononucleosis in my early 30's
Weight 235 and climbing despite eating far less
Height 5' 10"
180mg NPthyroid (natural desiccated pigs thyroid)
Labs (Oct 2017) , my T=730, TSH 0.03, T3+T4 mid-range normal.
Prednisone 10mg/day (no ACTH, dangerously low cortisol)
 
10% compounded creme. T=725, which feels just right.

Mr.L

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #8 on: July 19, 2019, 07:04:55 pm »
I'm currently taking 10 prednisone to combat extreme fatigue. My blood test cortisol is always low or low-normal. The highest I've ever seen my AM cortisol levels is 10 mcg/dl. Sometimes, in the 4's. Normal AM should be 10 to 20, or even as high as 30 at some labs. With 6 being the absolute low limit.

Whether I use T or not, my cortisol remains low. Prednisone helps immensely. It's about an 80% improvement.

do you have any side effects?

Mr.L

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #9 on: July 19, 2019, 07:06:04 pm »
I don't recall that supplementing DHEA has a negative feedback loop for cortisol.  But many people report that TRT has a suppressing effect on cortisol.  Happened to me for sure.  Since you are on TRT, it is easily possible that you are having low cortisol due to this suppression.  As the GURU mentioned, testing is pretty much the only way to know for sure.  But I suspect that your positive experience w/ prednisone is a pretty good indicator that you are low.  If you had normal or high natural cortisol, I suspect the pred would make you feel anxious or otherwise sub-par. 

The trouble w/ taking prednisone or other cortico-steroids is that they suppress your natural cortisol output.  So if you take it long term, coming off of it is difficult.  Most docs wouldn't give it to you long term anyway.  excess cortisol is harmful in many ways.... blood sugar/diabetes, cardiovascular disease, etc.

Yeah that's no good. I do not want to deal with more side effects if I do not have to...

Joe Sixpack

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #10 on: July 20, 2019, 02:35:41 am »
I'm currently taking 10 prednisone to combat extreme fatigue. My blood test cortisol is always low or low-normal. The highest I've ever seen my AM cortisol levels is 10 mcg/dl. Sometimes, in the 4's. Normal AM should be 10 to 20, or even as high as 30 at some labs. With 6 being the absolute low limit.

Whether I use T or not, my cortisol remains low. Prednisone helps immensely. It's about an 80% improvement.
Do you have any idea what your cortisol levels are when you take the pred?
Age: 55, Ht: 5'08", Wt: 155 lbs
Protocol: 25 mg T Cyp + 25 IU HCG M,W,F + 2 clicks T Cream + 15mg DHEA + 15mg Pregnenalone daily.
12/2018 test results: TT: 1054 ng/dL (264-916), FT: 17.2 pg/mL (7.2-24), E2: 21.6 pg/mL sensitive (8.0-35.0)

cujet

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #11 on: July 20, 2019, 05:08:44 pm »


do you have any side effects?

No side effects that I can tell. Prev symptoms were rapid exercise intolerance and extreme fatigue, 6x naps/day. Example: unable to walk 1000 feet without sitting down for a time. Muscles just won't work.

10 pred is roughly a cortisol replacement dose for Adrenal insufficiency for a man my size.

I simply go from being sub-human to 80% normal.

I now have to come off of the pred for some ACTH/Adrenal stimulation testing. I'm not happy about it, because the doc keeps pulling me off pred, leading to a return of symptoms. So, we have not optimized the dose and checked levels.
58 years old
Autoimmune Hashimoto's, near zero natural T production
Cause: severe mononucleosis in my early 30's
Weight 235 and climbing despite eating far less
Height 5' 10"
180mg NPthyroid (natural desiccated pigs thyroid)
Labs (Oct 2017) , my T=730, TSH 0.03, T3+T4 mid-range normal.
Prednisone 10mg/day (no ACTH, dangerously low cortisol)
 
10% compounded creme. T=725, which feels just right.

Mr.L

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #12 on: July 21, 2019, 03:20:51 pm »


do you have any side effects?

No side effects that I can tell. Prev symptoms were rapid exercise intolerance and extreme fatigue, 6x naps/day. Example: unable to walk 1000 feet without sitting down for a time. Muscles just won't work.

10 pred is roughly a cortisol replacement dose for Adrenal insufficiency for a man my size.

I simply go from being sub-human to 80% normal.

I now have to come off of the pred for some ACTH/Adrenal stimulation testing. I'm not happy about it, because the doc keeps pulling me off pred, leading to a return of symptoms. So, we have not optimized the dose and checked levels.

Well at least you know what works to make you feel better right. Good luck and thanks for the response.

Mr.L

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #13 on: July 21, 2019, 03:22:16 pm »
I don't recall that supplementing DHEA has a negative feedback loop for cortisol.  But many people report that TRT has a suppressing effect on cortisol.  Happened to me for sure.  Since you are on TRT, it is easily possible that you are having low cortisol due to this suppression.  As the GURU mentioned, testing is pretty much the only way to know for sure.  But I suspect that your positive experience w/ prednisone is a pretty good indicator that you are low.  If you had normal or high natural cortisol, I suspect the pred would make you feel anxious or otherwise sub-par. 

The trouble w/ taking prednisone or other cortico-steroids is that they suppress your natural cortisol output.  So if you take it long term, coming off of it is difficult.  Most docs wouldn't give it to you long term anyway.  excess cortisol is harmful in many ways.... blood sugar/diabetes, cardiovascular disease, etc.

I have worried about the side effects. I am not sure this is my problem. I'll follow up with some labs I suppose. Thanks

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Re: cortisol/prednisone/aldosterone/DHEA/adreanals
« Reply #13 on: July 21, 2019, 03:22:16 pm »