T Nation

Cortef Causing Anxiety

I have been on cortef for the last 2+ months and it is causing me a lot of problems. I was on 10 mg a day for the first month, then 20 mg a day for the second month. All is has done so far was made me feel very nervous (anxiety) and took away almost all my concentration towards anything I do, along with just overall feeling awful. For example, I can barely work and my job doesnâ??t even require that much thinking. And writing this post is very difficult, etc. It seems like the more I take, the worse I feel.

Since starting the medication, it is the worst I have ever felt in my life.

The one positive is that it raising my testosterone a little bit. My test went from 150 to 290 on 10 mg day for a month. However, all the negatives with taking the medication far outweigh this positive.

I have recently cut back to 10 mg a day, but I canâ??t even tolerate that. I also have added 30 mg of armour about 4-5 days ago, which does not seem to be helping either.

I am completely lost as far as my treatment goes and am looking for some guidance.

My current plan with my doctor is to add thyroid meds and this he thinks will help me feel better. I am only on 30 mg of armour, but feel worse than before. He also wants to me to stay on the cortef until my TSH drops, but I am going to have to figure out a way to do this. I cannot tolerate the cortef and will either have to stop taking it or combine it with something so that I can take it. So far combining it with 30 mg of armour is not working.

My labs after 10 mg a day on cortef were:

Tsh 2.9 .4-4.5
TT4 8.7 4-12
T4free 1.1 .8-1.8
T3free 371 230-420
TT3 155 97-219

My labs after 20 mgs were:

Tsh 3.1 .4-4.5
TT4 6.7 4-12
T4free 1.0 .8-1.8
T3free 334 230-420
TT3 156 97-219

The results of the second test was not what my doctor was hoping for and said it indicated that I may have something called thyroid resistance. Before I started the cortef medication, my TSH was around 3.8. Since my tsh dropped almost a point after taking 10 mg of cortef for a month, we thought it would drop further to around 1.5-1.9 on 20 mg a day, but it actually went up to 3.1.

I am not sure how taking cortef is supposed to affect your thyroid labs, but I came across something saying how it might right raise your T4 levels and lower your T3 levels. If someone could be provide me with some info on this and how it might affect your tsh, that would be great.

I have a few questions and would really appreciate any help you could give me.

Please keep in mind that I am weigh around 300 pounds so I may or may not need a higher dose of certain medicine.

Here are a few scenarioâ??s that I could to choose to take in the next coming weeks or months. Please let me know what you think is best or please provide an alternate one.

  1. I could stop taking the cortef and just try increasing the armour dose and see if that helps.

Pros: Stopping the cortef might reduce my anxiety and I will overall feel better. Also, I will get a chance to see how I react to just thyroid meds. Could be good or bad.

Cons: My adrenals will not be supported and testosterone might go lower.

  1. Increase my armour dose and stay at around 5-10 mg of cortef and see how I feel.

Pros: I still would be on some kind of adrenal support and I could see how I react to the combination of higher thyroid dose along with cortef.

Cons: I probably will still have a big problem with anxiety at 5-10 mg and this is something I am trying to avoid.

  1. I could try taking some kind of anti-anxiety pill or a beta blocker or something that would allow me tolerate the cortef medication.

Pros: I have read about people with addissons and others who take cortef and it causes them a lot of anxiety, but they take some kind of anti-anxiety pill or something else to alleviate the anxiety and improve quality of life.

Cons: I really do not want to go this route because I feel if your body is reacting a certain way to something, it is natural and for me to try and mask this negative reaction to cortef seems pretty risky.

  1. I ask my doctor to bump my thyroid dose to a fairly high level to see if that has a positive effect. Not sure exactly how high, but I know 30 mg of armour for a 300 pound man canâ??t be that much.

Pros: I was reading about thyroid resistance, and if it looks like I may have it in some way, then the only treatment I have read about is a high dose of thyroid meds.

Cons: I am hesistant to rush into a fairly high dose of thyroid meds at first and would rather work my way up. But if it may help, then I think it is worth a shot.

I did not indicate this earlier, but basically my entire endocrine is shot and we are trying to fix it.

Probably the most important question I have for you is.

What do I do if I cannot feel that much better trying to fix my adrenals and thyroid?

I do not even want to think about that happening because it makes sense that thyroid meds should work in my case. And also my testosterone was raised from the cortef. I am hoping that I will just have to find a good balance of thyroid and cortef to make me feel better, but you never know.

Also, if you know anything about cortef or thyroid meds or thyroid/adrenal issues causing people a lot of anxiety please let me know. I have read the having either high or low of thyroid/adrenals could produce a lot of anxiety, but have not seen that much info on this subject.

If you think you have an idea of what is causing my anxiety or how it is happening in my case, please let me know. Thank you for your help.

Hey man, not sure how mcuh info i can offer…but i can offer an experience?

at the moment my dad is suffering from a similar kind of thing, adrenal glands are shot to bits from years of stress and his ability to produce cortisol is very reduced.

From his experences, id say the more you can do naturally the better. Using natural substances to help the body. He found that simply using drugs to bump up levels of hormones simply led to other health problems and esculations of existing problems.

“Also, if you know anything about cortef or thyroid meds or thyroid/adrenal issues causing people a lot of anxiety please let me know. I have read the having either high or low of thyroid/adrenals could produce a lot of anxiety, but have not seen that much info on this subject.”

So yeah you are on the right track there, its a very important aspect of your bodies physiological health, and my advice (i have no medical knowledge of the subject past a basic understanding) would be to look into alternatives if the medication is making you feel worse.

Some people are know as over-responders regardless of body weight to certain compounds. The “nervous” sensation you are having is from the cortef “over” stimulating the adrenals, but you already know that. Trying to get your thyroid under control before you get your adrenal fatigue fixed is going to be very difficult.

You don’t mention you take any supplements; you don’t possible take anything that contains calcium within four hours of taking your thyroid meds, do you? If so, stop now as calcium inhibits the uptake of T4.

As far as going “natural” there is a great product that is not “made in the lab” named “Isocort”. Isocort is made from freeze dried adrenal gland and also contains a few herbs and are 5 mg tablets, but they are not same as cortef in any way. (I know I take both) The dosage for Isocort is up to 8 tabs a day and a 240 tab bottle (30 day supply) costs about $30.00 online.

Here is another way to support your adrenals without getting anxiety from the now stimulated adrenals using hydrocortisone.
You might find Isocort to be the answer to your problem, and since the actual dosage of each tablet is very small you can fix your adrenals w/o the nasty side effects you now experience.