Cortef side effects

I know some people have said there are no side effects from Cortef and that it's probably my dose is too low, but I now have at least 10 of the side effects listed on the prescription information website. These also all start within minutes of taking a dose (I'm currently taking 25mg). I get headaches, become extremely thirsty, heart pounding, very dizzy and weak, feel like I'm going to pass out. I just got new thyroid labs as well as a metabolic panel to check my sodium and potassium, but I won't know those results for another 2 weeks. In the meantime, I'm getting very scared and wonder if I should just stop taking the Cortef and find another way to raise my cortisol. Maybe my body just doesn't like it. It's also not the fillers, as the only two I'd have an issue with are corn starch and lactose and neither of them would cause these symptoms. I've also gained about 5 pounds in the last couple weeks, all in my stomach, and I'm eating less food than before because I have no appetite.

[rumpled]

I would say your dose is not that low - it is a replacement dose. How are you taking it?

As such, you cannot just *stop* as that is dangerous. You could taper back. You can change how you take it - such as time of dosing and how you break it up.

What does your doctor or pharmacist say?

[Sunshine_67]

I'm taking 10mg when I wake up (around 5 or 6am), then 7.25mg 4 hours later, 5mg 4 hours later and 2.5mg at bedtime.

I haven't talked to my doc yet. I see him in 1 1/2 weeks. My pharmacist is a naturalist and doesn't believe in HC, so he won't be of any help. I'm starting to sonder if maybe it's the lactose or corn starch that's causing acid reflux and causing the problems. There's corn starch in my thyroid meds and I don't have a problem with it, so maybe it's the lactose. I can't imagine lactose causing problems with the brain though, but if it's causing severe acid reflux, that would cause the breathing problems and lead to being dizzy. I don't know, just speculating.

[rumpled]

Do you have lactose intolerance? Does cornstarch in any other form bother you?

I only know a few people that take cortef at night. A few of my buddies *need* a tiny boost at night to sleep - most people find it interferes. A normal body (check the ranges) has the bulk in the morning and tapers thru the day to next to nothing by late night. That is why you should be highest at your 8am testing, and have really low midnights.  Most people I know take the bulk in the morning, and a small amount between 2-4pm.

The problem could also just be completely unrelated to the medication. That is also a possibility. Perhaps you need florinef? What are your sodium and potassium readings - or renin and aldosterone? Low BP can make you dizzy. Reflux - seen a stomach doc?

[kevieb]

I take 30 mgs of hydrocortisone---20 in the morning and 10 around noon------though I usually forget the noon dose and end up taking it somewhere between noon and 2 pm.   It has never caused me to gain any weight.

I also have severe reflux----but i have had it long before i had any cortisol problems--at least that I was aware of.  My reflux does not cause me breathing problems, although I know it can cause breathing problems for some people if they aspirate or if they get esophageal spasms.

What kind of breathing problems are you having?  Have you only had the reflux problems since you started cortef?

[Sunshine_67]

I am lactose intolerant, but I haven't had any stomach issues like I do when I eat dairy. I get some inflammation from corn and a test showed that corn reacts the same way gluten does in my body (I'm gluten intolerant), but there's corn starch in my thyroid meds and it doesn't seem to bother me and when I eat corn all it seems to do is cause some sinus inflammation. I do seem to get worse by the afternoon and evening, so maybe it's the time of day I'm taking the Cortef? I think I may need florinef. I have noticed since I started taking it that I'm a lot more thirsty and my heart pounds hard sometimes (not fast, just hard). I read low potassium can cause that. I recently got new labs done, checking sodium and potassium, but I won't get those results for another couple weeks when I see my doctor.

The breathing problems I have are that I feel like my airways are tightening and I cough a lot, like I can't get enough air. Then I start feeling lightheaded. Sometimes it goes away when I take digestive enzymes. I've seen a GI doc and had many tests done and I have no problems with my stomach or esophagous so it must be a chemical problem I guess.

I was only taking a small amount at night because another board said to take it according to the body's rhythm, not your labs.

I think the reflux might be from slow digestion due to low thyroid. I have had that issue before and it causes shortness of breath for me. I've been having to take a lot of digestive enzymes lately, but I don't always have them with me.

My body has never responded to medication like it does everyone else even when my labs show I need to take something, so who knows what's wrong. It's very frustrating to keep playing these guessing games.

[rumpled]

The thing is that larger doses of HC - or stronger forms are what are given for breathing issues - it is an anti-inflammatory. So it would be strange to cause a breathing issue.

You can dose according to a rhythm - but if you dose according to an abnormal rhythm you can have more side effects. I had an abnormal rhythm with my Cushing's - my body is ruined from the nightly dosing of cortisol. So I prefer to dose according to a normal, not an abnormal - if that makes sense? Also they are finding the body does store - so there is usually a little left around until you reach crisis and hopefully you can read your body to avoid that.

I can understand the meds not reacting like everyone else - it runs in my family - even my grandfather said our DNA must be counter-clockwise!

[Sunshine_67]

My doc told me to take all my HC by 11:00am so I don't know what's the right way to take it. I do know when I take even 2.5mg at night, I don't sleep well.

Yes, that's why I've been thru 23 doctors in 5 years and no one still knows exactly what's wrong with me. I don't follow everyone else or fit into their "box", so they give up. I actually had one doc tell me the only way she knew how to treat me is to see what works for everyone else, and then do the opposite for me. I don't know why my body rejects everything that's supposed to be good for it. Lactose and corn both do cause some inflammation for me, but I can't see those little pills having so much in it that it would cause major problems. I can't afford to get my meds compounded right now though.

I wish I would have never started taking thyroid meds 5 years ago. Even though I was hypothyroid and needed to be on them, somehow it has triggered something that has thrown my entire body out of whack.

[kevieb]

I'm sorry---but I'm having a little trouble following what you are trying to tell us.  You said you have severe reflux--but then you said you have seen a GI and had many tests run that showed you have no problems with your stomach or esophagus----if you have SEVERE reflux---it's going to show up with a scope and biopsies.  I have severe reflux and it causes my esophagus to get inflammed and to narrow-----3 times I have had something called a shotzky's ring which has to be fractured.  I have had to have my esophagus dilated 3 times.

Severe reflux would require you to be on a proton pump inhibitor.  If reflux was causing esophageal spasms, the PPi would most likely take care of that and stop the breathing problems---if you feel like it is reflux causing it.

If you think you have slow digestion because of low thyroid, then you are probably not on enough thyroid medication---which could possibly be the cause of alot of your problems.  If you are low thyroid and low cortisol---you need to make sure they are in balance with each other---you also may need to have a whole endocrine work-up done to see what other  hormones might be out of whack.

It also couldn't hurt to have vitamin and mineral levels checked---when some of those get too low or too high they can cause a bunch or weird symptoms.

I'm curious as to what kind of test they did that told you that your body reacted to corn the same way it reacts to gluten.   How do you react to gluten, and how did you discover that you were gluten intolerant?

I have 3 children with celiac disease---but there is a very specific test for celiac disease.

I quite often don't react to medications like other people do, either.

If you are eating foods that you know you have a problem with--that could be causing you problems.

What type and dosage of thyroid medication are you on?

Also, one more thing you might consider-----get another pharmacist.  I have never heard of a pharmacist who is a naturalist.  A pharmacist should know that a person who needs hydrocortisone needs it because their body is not making enough of it's own----he would be totally irresponsible to not believe in it and not know about it because he didn't believe in it.

[Sunshine_67]

I apologize for my poor memory, but I have trouble remembering yesterday right now with my brain fog. I do recall now that GI doc saying I did have a very small hiatel hernia and some reflux, it just hasn't caused any damage. I do believe the low thyroid is causing the reflux because when my levels were higher, I don't remember having these problems. Could be that when everything runs too slow, even food doesn't get digested fast enough. I don't have many times when the food comes back up, it's more just a tightening in my airways and a lot of coughing that sometimes goes away after I take digestive enzymes.

I don't have celiac's, but I"m gluten intolerant. I have Hashimoto's and gluten was also causing nodules on my thyroid and high antibodies. Once I stopped eating gluten, the antibody level went down and the nodules went away. The test I had done for corn was thru SpectraCell. It specifically tests gluten free type grains to see if your body treats them like gluten. I'm also sensitive to amaranth, tapioca and a couple other gluten free grains. When I I've eaten corn though, all I notice is that it makes me tired and causes some sinus inflammation. I've never had an issue like this from eating corn or dairy. I almost feel like the Cortef is affecting my heart in some way. I keep having moments when my heart pounds really hard and I get extremely tired and lightheaded, then it goes away after a while.

I'm on NP Thyroid at 90mg. I know that's too low since my last labs were very low. I see my doc next week so I hope he'll increase the dose. My hair, skin and eyes are very dry and I'm extremely constipated, so part of me also wonders if I have toxins floating around since I can't get them out of my body.

The pharmacist I use is a compounding pharmacist and certified in nutrition. He's all about holistic treatments, which is why he doesn't like hydrocortisone. He doesn't know my levels are as low as they are, so I'm sure he'd be ok with me taking it, he just prefers to try a more natural approach first.

I already know my female hormones are out of whack, but I haven't been able to find a good doc who knows the right way to test and treat for them. Blood tests aren't accurate for estrogen, but for some reason even the holistic docs are only using that instead of saliva or urine. I think it's an insurance thing since blood tests are always covered.

[Sunshine_67]

For some reason my body just isn't liking Cortef. I just took 2.5mg at bed and I now have acid reflux and severe heartburn. I ate food with it and took Betaine and nothing helped. I take it during the day and it suddenly makes me really dizzy and feel weird and by 5pm I'm so weak and tired I feel like someone has drugged me. I've tried posting on the yahoo board but all they do is ask for labs and if you don't get them done by the company they like, they blow you off. They never actually answer any questions. I'm so frustrated!!!

[Buckupnow]

Low cortisol causes weak muscles which cause hiatal hernias to develop.  Reflux is a symptom of both adrenal insufficiency and the hernia.  I've read that everybody on thyroid meds and hydro also need to take DHEA and possibly progesterone.  Low cortisol = stomach problems and reflux.   I used to have a pounding heart ....also caused from low cortisol, but as the thyroid meds and other hormones are coming into balance after taking for 6+ months I am feeling better and many symptoms are gone.

[christine120]

are you taking cortef for adrenal fatigue? I am having severe adrenal fatigue plus pain in my stomach and itching to all food. But aparently i have no allergies. I just did the siliva test and i am waiting for my results but my guess is i have no or low cortisol so i am going to be staring cortef soon. can anyone tell me if this is safe especially since i already have a thin stomach lining and pain from eating food.

[christine120]

are you taking cortef for adrenal fatigue? I am having severe adrenal fatigue plus pain in my stomach and itching to all food. But aparently i have no allergies. I just did the siliva test and i am waiting for my results but my guess is i have no or low cortisol so i am going to be staring cortef soon. can anyone tell me if this is safe especially since i already have a thin stomach lining and pain from eating food.

[geokatgrl]

I had similar issues when I was on a higher dose of Cortef. I tapered my dose down to 15mg, and that seemed to help some. I have wondered for a while if I should have started it at all, but my adrenals were flatlined on my saliva cortisol.

I highly recommend Dr. Lam's new book on Adrenal Fatigue Syndrome. Great information, and good advice on adrenal and hormone support. It has answered a lot of questions for me. You can also get much of the information free from his website.

[Buckupnow]

I have AI from taking a prescription of Prednisone....it shut down my adrenal glands.  I was dying.