When does Hydrocortisone kick in?

[misme38]

I was diagnosed with low cortisol levels which I have had for  at least 7 yrs. Suffer from extreme fatigue so if I work out of do something like go out of town, it makes me 2 weeks to recover.  Same with surgery, cannot tolerate general anesthesia, will come out vomiting. My muscles ache, I have sinus issues, foggy mind, I feel like someone" unplugged" me lol and I need to rest or feels like my body shuts down. Started therapeutic yoga and I eat a pretty organic and clean diet, take lots of supplements. I am on hydrocortisone 5mg 3 times day. My reverse T3 is high so doctor wants to give me thyroid meds after cortisol levels increase. I've only been on the hydrocortisone for a little over a week. When does it kick in_

[rumpled]

24 hour testing is a good test - but one is not... enough. It can also be mishandled. You may not have kept it cold and the lab may have have not as well, and other stuff happens....

If you have testing for sodium and potassium - that is also indicative if you have AI. AI is a salt wasting disease so Na and K are off at least some times.

The symptoms can be... general so perhaps you don't have it?

[Foggy2]

You should see an endocrinologist.  You may have Secondary Adrenal Insufficiency (SAI).  HC (hydrocortisone) is still the treatment, and your dosing sounds appropriate.  But they should have done a stim. test on your prior to starting the HC.  It is true that treating your thyroid won't work completely until the adrenal is fully under control, but an endo. MD can at least start the process of working you up and start some kind of treatment rather than leave it completely untreated.  You most likely need a bunch of labs done as well.  Start looking for a Board Certified Endo., even if you have to travel a bit to get treated.  And get copies of your medical records; have all your labs Cc'd to you from now on as well.

[misme38]

Thank you kindly for your answer. Good question, I don't believe my internist did those tests just morning cortisol, 24hr saliva cortisol tests which was under 1 in mornin. I know next to nothing about low cortisol, I was told 7 yrs ago based on saliva tests and  treated by a naturopathic doctor, rest and supplements and didn't do any other meds or tests simply because it got too expensive.  Felt ok then steadily worse over the yrs. My dosing is as follows, 5mg at 7am, 5mg at noon, half a tablet st 4pm.I'm,a bit skeptical about all this because I already suffer from Sjogrens, interstitial cystitis and untreated low thyroid. I have read up on addison's which I tested negative for thank God. Seems I'd be in a crisis if I did have true adrenal insufficiency and perhaps s is maybe it's just low from stress .I prefer to see an actual endocrinologist who will order those tests you mentioned.

[rumpled]

Hydrocortisone is a fast acting med - which is why it also used in time of crisis.

So, it should kick in quickly and last a short while, up to 6 hours. Which is why it is the preferred replacement as you can use it to better imitate a normal body.

Your dosing schedule IMHO is not consistent with a normal body. A normal body has the highest levels in the morning with a decrease in the afternoon declining to near nothing by midnight. This cycle repeats daily. Did you have a stim test, and abnormal sodium levels?