1. Weakness and fatigue — especially in the afternoon (this symptom is so prevalent that if it is not there, hydrocortisone deficiency is probably not there either)
2. Decreased coping ability — “My plate is so full I feel like I won’t be able to keep up!”
3. Hypoglycemia & carbohydrate craving
4. Mood swings
5. Headaches, especially if they occur in the late morning or afternoon
7. Allergies (almost certainly present in cases of severe allergies)
8. Adrenalin tide or “panic attacks” — tachycardia, dry mouth, perspiration, nausea, light headedness, breathlessness, trembling, “out of control”
A good starting dose is 10 mg taken twice daily. Make sure you take it in the morning and early afternoon. That’s when your body will respond to it the best. Review 7-10 days and increase the dose up to 20mg bd x 7-10 days.
If there is still no response, then something is being missed. This might be a thyroid deficiency, or perhaps a vitamin deficiency
If you do improve, then continue replacing the hormone while correcting the stressors that caused the depletion. About half of the people that need hydrocortisone will be able to stop it after two to three months of treatment. This is because, in many cases, the combination of taking the hormone and reducing the stress load will enable your adrenal glands to renew themselves.
However, many people have adrenals that were just not built for all of the stressors that they face in this modern world we live in. This is especially true in the case of severe allergies. In these cases, you’ll need hydrocortisone treatment on a continuous basis. Use the lowest dose of hydrocortisone that you need to feel great, and have your doctor check your fasting ACTH level. As long as it is greater than 10 pg/ml, you are in a good range.