Summary of Post
Here I give part of the Protocol specifically for Hydrocortisone to get you started. Much effort and time has gone into writing this Protocol, which is original content put to the test by myself and also used by hundreds of other readers with whom I have shared it.
Is this Protocol for you?
This Protocol should be useful to you if you have been on steroids long-term (more than 6 months). If you have been taking steroids for only a few months, you should be able to taper much faster (following your doctor's advice) and won't need this Protocol.
The Protocol can be adapted to Prednisone, although in my experience it is easier to wean off Hydrocortisone due to its shorter biologic half-life. (To wean off Prednisone, divide the dosages by 4 or use a handy corticosteroid conversion calculator). To facilitate weaning if you are on dexamethasone or corticosteroids with longer biologic half-lives, first switch to prednisone, then if possible, to hydrocortisone.
Is this Protocol for you?
This Protocol should be useful to you if you have been on steroids long-term (more than 6 months). If you have been taking steroids for only a few months, you should be able to taper much faster (following your doctor's advice) and won't need this Protocol.
The Protocol can be adapted to Prednisone, although in my experience it is easier to wean off Hydrocortisone due to its shorter biologic half-life. (To wean off Prednisone, divide the dosages by 4 or use a handy corticosteroid conversion calculator). To facilitate weaning if you are on dexamethasone or corticosteroids with longer biologic half-lives, first switch to prednisone, then if possible, to hydrocortisone.
I have successfully tapered quicker than given in the Protocol, by drastically decreasing stress and increasing rest (read about my lifestyle changes HERE). It really depends on your body and how well you listen to it. I welcome you to email me or leave a comment on my blog if you have any questions and I will get back to you, usually within a day or two. I get half a dozen emails weekly and take time to consider and respond to each one. In return for my time, please do consider leaving me a tip ('Tip Jar' button on right side bar).
Testimonial from a reader
"I, for one, have never gotten any useful advice in the doctor's office about weaning off prednisone. I think the effort a writer puts into a useful piece of information is certainly worth the price of a copay to the doctor's office or the copay on a prescription." (Sandy M., New Mexico)
IMPORTANT: Consult a
licensed health care provider before embarking on this regimen or using any
supplement in combination with, or in lieu of any Rx drug.
About Hydrocortisone and Cortisol
Hydrocortisone
(HCT) is an important, potent and potentially dangerous Rx drug.
Once you take 20-40 mg per day, your adrenal cortex stops producing its own
cortisol altogether. Cortisol is the adrenal hormone that HCT and other
corticosteroids (prednisone, dexamethasone, etc) simulate. The adrenal cortex may stop producing cortisol when a person is taking 20 mg a day of HCT, while for another person, natural cortisol production may stop when that person is taking 40 mg a day of HCT. Every person is different but the point remains - put in enough
of the (synthetic) corticosteroids and the body will halt its own production of the real
thing. Dexamethasone and prednisolone have a much longer biologic half-life than HCT and suppress
the adrenal glands for a longer period of time.
If you have
been on HCT a long time (more than 5 years), at doses of more than 20 mg/day
your adrenal cortex may be badly
damaged. Cortisol, the natural corticosteroid produced by the adrenal cortex,
is necessary for survival. If the adrenal cortex is permanently damaged you
will have to take HCT or a similar drug indefinitely. Ask your doctor about the synacthen test to
see how well (or if) your adrenal glands are working.
Before Starting the Protocol
1. I assume you will start your weaning at a dose of 40 mg per day (STEP 1,
see ‘The Protocol’ below). For most of you, this is your ‘maintenance dose’,
i.e., the minimum dose you take to stay symptom-free. Most people are able to
take fairly large reductions in dose above STEP 1. If you are taking 60 mg per
day, you will need to cut down your dose gradually, until you are at 40 mg,
before starting this Protocol. If you are currently on 25 mg, start at STEP
4. Start your weaning at the
corresponding STEP for your current dose.
2.
You should be on a relatively ‘clean’ diet (i.e., no caffeine, other stimulants, recreational
drugs, etc.) Relatively ‘clean’ lifestyle (i.e., nonsmoking, no alcohol at
this time, etc.). You should also identify all sources of stress in your life (e.g., relationship, emotional, physical, lack of sleep) and implement changes to minimize this stress. The aim here is to reduce the ‘overhead’ on the body
system and enhance both the speed and extent of your success. For more details
on lifestyle changes, please read Adrenal Fatigue: The 21st Century Stress Syndrome
by Dr James Wilson (I review the book HERE). I don’t get commissions from Dr Wilson if
you buy his book! I actually reviewed it after I had successfully weaned off
HCT myself through trial and error, and it would have helped me hugely if I had
his book earlier. It’s all there, so please read it!
by Dr James Wilson (I review the book HERE). I don’t get commissions from Dr Wilson if
you buy his book! I actually reviewed it after I had successfully weaned off
HCT myself through trial and error, and it would have helped me hugely if I had
his book earlier. It’s all there, so please read it!
3. HCT is available in 10 mg tablets. Use a pill cutter to split a tablet down
to 1/8 size (0.125 mg).....
4.
5.
6.
(the remaining three Notes can be found in the full Protocol, see below)
THE PROTOCOL
4.
5.
6.
(the remaining three Notes can be found in the full Protocol, see below)
THE PROTOCOL
STEP 1. Take your routine dose of HCT daily for two weeks. Take it at the same time every day. Make sure you are stable.
STEP 2. After two weeks, reduce your dose by 5 mg You are now at 35 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.
STEP 3. After 7-10 days of STABILITY, drop 5 mg. You are now at 30 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.
STEP 4. After 7-10 days of STABILITY, drop 5 mg. You are now at 25 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.
STEP 5. After 7-10 days of STABILITY, drop 5 mg. You are now at 20 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.
STEP 6. After 7-10 days of STABILITY, drop 2.5 mg. You are now at 17.5 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.
NOTE: CHANGE IN DROP QUANTITY.
STEP 8. After 7-10 days of STABILITY, drop 2.5 mg. You are now at 12.5 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.
STEP 9. Things often start to get dicey from here on out. At about 12 ± mg, your body has to start producing its own corticosteroids. This is where you start "stretching" or "pulsing".........
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xo Gracie
