Saturday, March 30, 2013

Alternative Medicine for Adrenal Insufficiency/HPA Axis Suppression

I got this comment on an old post the other day:

"My husband is a physician suffering from all sorts of complications after a year on Prednisone including two taper attempts--the first nearly killed him with an adrenal crisis. You definitely need an endocrinologist working with you and insist on being monitored closely with blood work done frequently. Does anyone have any thoughts or suggestions on home to go the alternative route in conjunction with conventional medicine? "

Having done a lot of alternative or integrative medicine stuff to try and support my recovery, I feel I can say, the short answer to your question is, no, there isn't really an alternative route for steroid induced adrenal insufficiency.

The best 'natural' treatments for HPA Axis Suppressoin are things like taking lots of B vitamins as well as C. You should also monitor your blood pressure and salt food for low blood pressure. It's also important to keep sugar on hand for low blood sugar.

Don't ever leave home without some form of salt and sugar. If you can keep blood sugar and blood pressure stable you can avoid a lot of bad adrenal ju-ju.(Ju-ju being not digging yourself into a pit where conditions are ripe for an adrenal crisis.)

Plus, you should sleep as much as possible. And don't try to exercise until you can handle regular activities of daily living (i.e. work, cleaning house, running errands all the usual stuff you couldn't do while in the depths of adrenal insufficiency). You might not be able to tolerate exercise for up to a year or longer, depending on how resilient your system is (or isn't as the case may be).

I think some people are just really sensitive to adrenal suppression and don't come back like the text books say they should. And it sucks. All you can do is ride it out.

If you go the alternative route, be careful. Likely the first thing they'll want to do is hook you up with a Meyer's Cocktail via IV. Every alternative doctor has a different recipe and some of them add steroids to the mix, which might not be such a good idea for those of us trying to recover adrenal function.

Alternative medicine likes to 'rest' the adrenals by giving patients steroids and using a diagnosis of Adrenal Fatigue. Sometimes the doses are as high as 40mg which will not stimulate your HPA axis to function. In fact, it will further suppress it! Some alternative patients have found my blog because the steroids they were given left them suppressed. They weren't necessarily insufficient to begin with, but all the 'resting' of their adrenal system ensured they ended up that way.

The most effective treatment alternative medicine has to offer adrenal suppression patients is bio-identical hormone replacement...if blood work shows you need it. In my case, I had low progesterone and replacing that has made the biggest difference out of anything I've tried (ostensibly because it is one of two precursors to cortisol production). However, not everyone will have low levels of hormones.

Regarding the difficulties with tapering...Any time tapering steroids is a disaster that means you're not going low or slow enough.   Too few physicians understand this 'law of tapering steroids'. It's not an area of medicine they know. They still think adrenal stuff is rare or that steroid induced adrenal stuff follows all the 'rules' of their medical textbooks.

Based on my experience and that of other patients, the ideal taper is to drop the dose by only 1 or 1/2 mg every taper. You don't taper again until you feel okay at the new dose.

Also, try to switch to hydrocortisone with its shorter half-life. Take all your doses before noon and then nothing after (you might have to work up to this). Once you adjust to it, the shorter half-life will support recovery whereas prednisone's 24 hours+ half life impedes it. (Note: Don't try to taper until you've fully adjusted to the switch from prednisone to hydrocortisone. Be advised, switching steroids can be rough...some level of misery is unavoidable, but shouldn't last more than ten days.I ended up alternating between prednisone and hydrocortisone for a while until my body could handle the change in half-life.)

If you are struggling with a steroid taper, please check out the forums links that show up when you go to leave a comment on my blog posts. Those patients know what they are talking about and are an invaluable resource.

1 comment:

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Thanks for your comment. I read all comments and do my best to respond to questions, usually in a new post.

If you have adrenal issues and want to connect with other patients the following message boards are wonderful resources: