Medrol Vs. Hydrocortisone

[health4life24]

I'm having major problems metabolizing HC (Cortef) way too fast. I can take 10 mg of HC and feel really good for about 45 min. & then it wears off quickly. It's causing some major ups & downs and I need to figure out if I need to switch to a longer acting corticosteroid like Medrol.

I have read though about the potential long term use of Medrol & some of the nasty sides associated with it. I'm also not sure if I want to put myself at risk for life time dependency if it permanently shuts down cortisol production. I'm hoping one day I can recover fully and if I should either really up my dosage of HC (would probably need around 50 mg a day the way I'm metabolizing it to feel stable)

I'm also wondering if anyone has experience with a sustained release version of HC & if that's a viable option. So, my options are to up my HC to a much higher dosage or switch over to Medrol. I'm trying to figure out the best course of action and if the risk & potential sides are worth switching over to Medrol. Does anyone have an opinion on what would be safer? High dosage HC throughout day versus one single dosage of Medrol? What's the safer option? Any opinions on sustained release HC, does it work? For those taking Medrol that have taken HC in the past, do you feel good & are you experiencing any bad side effects?

[BALifter]

Sounds to be like you are WAY overusing corts. Why not get down to the bottom of the issue of the pain? I think you are digging a deeper hole.

[health4life24]

Sounds to be like you are WAY overusing corts. Why not get down to the bottom of the issue of the pain? I think you are digging a deeper hole.

Wow, thanks for the insights...that really helps me out. I have adrenal/thyroid issues confirmed through one of the best specialist around (Dr. Marianco). Do you think I like sitting around feeling like crap all day? No, I don't. I'm trying to be proactive trying to get back to the road to wellsville. I was prescribed HC which works, but I'm metabolizing it too fast. I just wanted to hear opinions on those that were in the same boat that have switched over to Medrol. Is that so hard?

[MrBigPR]

Medrol has serious side effects when used long term. I wouldnt go that route.

[health4life24]

Medrol has serious side effects when used long term. I wouldnt go that route.

Compared to HC? I'm just talking about replacement dose, nothing too crazy. I have heard that 20% of people metabolize HC too fast & need to switch over to Medrol. I'm currently taking about 20 -25 mg of HC a day, but having major ups & downs because it wears off so quickly.

[engival]

why not dose differently?

2.5mg every few hours?

[LeanGuy]

Be careful going by symptoms only, have you done a 4x cortisol test to show that its actually dropping out? These are not drugs to play around with (as I pop my 2.5mg HC afternoon dose)

[health4life24]

Be careful going by symptoms only, have you done a 4x cortisol test to show that its actually dropping out? These are not drugs to play around with (as I pop my 2.5mg HC afternoon dose)

No, have not done that yet. That's a good idea, just don't have the cash right now. I'm confident though that it's my adrenals because I feel good on HC, it just doesn't last long enough. I'm trying 5mg about every 2 hours...about 45 minutes in it starts to wear off quickly. I'm staying like at half a grain Armour because of this. If the HC was more stable, I would slowly increase on Armour if I could.

I'm actually slowly weaning off the HC because it obviously isn't working for me. I'm taking DHEA along with some other adrenal supplements while I'm doing this. I probably need to go back to baseline and figure out where I need to go from there.

[JanSz]

No, have not done that yet. That's a good idea, just don't have the cash right now. I'm confident though that it's my adrenals because I feel good on HC, it just doesn't last long enough. I'm trying 5mg about every 2 hours...about 45 minutes in it starts to wear off quickly. I'm staying like at half a grain Armour because of this. If the HC was more stable, I would slowly increase on Armour if I could.

I'm actually slowly weaning off the HC because it obviously isn't working for me. I'm taking DHEA along with some other adrenal supplements while I'm doing this. I probably need to go back to baseline and figure out where I need to go from there.

Make sure that you have:
DHEAs(500-640)mcg/dL------------------major player, 95% time overlooked

post #87
Jan's BloodTest April13/2007

MESO-Rx - View Single Post - alternatives to HC

Hypopituitary Support
Equivalent maximum doses (do not take pregnenolone
or any other adrenal supplement that breaks down
into cortisol with these)

cortisone acetate 37 1/2 (weak, not recommended)
hydrocortisone 30 mg
cortef 30 mg
prednisone 7 1/2 mg
prednisolone 7 1/2 mg
triamcinolone 6 mg
methylprednisolone 6 mg
**dexamethasone 1 mg
betamethasone 0.8 mg

*Isocort max dose 8 pellets-is said to have 2 1/2 mg of
cortisol per pellet, so 8 pellets is 20 mg of cortisol.

**info sources can range from
1 mg dex = 6 mg medrol = 30 mg Cortef
to
1 mg dex =16 mg medrol=80 mg Cortef.
In my experiance with dex (your experiance may differ),
I've found the equivalents to be closer to
1 mg dexamethasone=
40 mg Prednisone
32 mg Medrol
160 mg Cortef/HC.

***1 mg medrol =1/32 mg dexamethasone
***6 mg medrol = 6/32 mg dexamethsone

***Dexamethasone should not be used alone, but in
combination with Medrol no more than 50% dex/50% medrol.
============================== ================

The relative mineralcorticoid potencies of different steroids

Human Aldosterone 300
Fludrocortisone Acetate (Florinef) 150
Deoxycorticosterone acetate 20
Cortisol/hydrocortisone 2
Cortisone 2
Prednisone 1
Prednisolone 1
Methylprednisolone 0.5
Triamcinolone 0
Dexamethasone 0
Betamethasone 0

These figures are rough estimations
============================== ===========================

Glucocorticoid* Potencies of Different Steroids

deoxycorticosterone acetate************ 0
Human Aldosterone *********************** 0.3
cortisone acetate*********************** ***** 0.8
hydrocortisone**************** *************** 1.0
prednisone******************** ***************** 4.0
prednisolone****************** **************** 4.0
triamcinolone***************** *************** 5.0

methylprednisolone************ *********** 6.0
* Fludrocortisone acetate (florinef) **** 12
betamethasone***************** ********** 24 - 30
dexamethasone***************** ************ 32

*potency is locked up for most people, few actually
experiance a significant amount.A rare few
need to lower their cortisol therapy by up to 1/3.

These figures are rough estimations
============================== ================

Glucocorticoid half lives

cortisone acetate 30 minutes (weak, not recommended)
cortisone (oral) 0.8 - 8 hours
hydrocortisone 1 -8 hours
cortisone (IM) 1.3 -18 hours
prednisone 16 -36 hours
prednisolone 18 - 36 hours
triamcinolone 18- 36 hours
methylprednisolone 18- 36 hours
dexamethasone 36 - 54 hours
betamethasone 36- 54 hours

These figures are rough estimations.

Corticosteroid converterCorticosteroids conversion calculator (hydrocortisone, dexamethasone, prednisone, methylprednisolone, betamethasone

[health4life24]

Thanks Jansz,

I'm currently taking about 200mg of DHEA. For whatever reason, my body really needs it and it makes me feel much better. I did a Rhein's and my DHEA was double the top of the range (this was before taking dhea or anything else).

I have no idea why my body needs such a high amount. My LH & FSH are rock bottom, even though Test has been decent. I have to wonder if allot of that DHEA is being converted to Test because I suspect a sluggish pituitary. This in turn has probably put stress on adrenals over time causing adrenal fatigue.

I've pretty much weaned off HC because it wasn't working that well because it wore off so quickly. I only stress dose when I really need it. I'm wondering if adrenals would recover if I went on TRT to put stress off adrenals, or if it's too late for my adrenals & I need to go on Medrol anyway. I'm going back to baseline until I can approach with extreme caution.

[JanSz]

Thanks Jansz,

I'm currently taking about 200mg of DHEA. For whatever reason, my body really needs it and it makes me feel much better. I did a Rhein's and my DHEA was double the top of the range (this was before taking dhea or anything else).

I have no idea why my body needs such a high amount. My LH & FSH are rock bottom, even though Test has been decent. I have to wonder if allot of that DHEA is being converted to Test because I suspect a sluggish pituitary. This in turn has probably put stress on adrenals over time causing adrenal fatigue.

I've pretty much weaned off HC because it wasn't working that well because it wore off so quickly. I only stress dose when I really need it. I'm wondering if adrenals would recover if I went on TRT to put stress off adrenals, or if it's too late for my adrenals & I need to go on Medrol anyway. I'm going back to baseline until I can approach with extreme caution.

I use 400mg DHEA/day

Test blood
desired DHEAs(500-640)
take as much DHEA as need to get there.
============================== =========================
Do not use more than 30mg Cortef (or equivalent dose of Medrol)
cortef 30 mg---->methylprednisolone (Medrol) 6 mg

half lifes
hydrocortisone 1 -8 hours
methylprednisolone 18- 36 hours
============================== =========================

If you have a decent TotalTestosterone but low LH, FSH
Check what is your actual BAT(BioAvailableTestosterone)
or
FreeTestosterone (using chart not a test)
if you need boost, you may need just HCG.

To heal adrenals you need good sleep, DHEAs and decent testosterone.
.
.