Instructions for Patients taking Cortef

Cortef (hydrocortisone, cortisol) is a hormone made in the adrenal gland. It is prescribed in physiologic doses (doses made by the adrenal gland under normal conditions) for symptoms of low cortisol or adrenal insufficiency. Symptoms of cortisol deficiency include:

  • Fatigue, especially in the afternoon
  • Stress
  • Sugar/Salt cravings
  • Low blood sugar
  • Allergies, asthma, sinusitis
  • Chemical sensitivity
  • Aches, pains (especially neck and back)
  • Muscle stiffness, Joint pain, Arthritis
  • Hives, itching, skin sensitivity, reaction to bug bites
  • Weak immune system, repeated infections, pneumonia
  • Low blood pressure, low fluid volume (dehydrate easily)

It is important to understand the difference between a physiologic replacement dose of hydrocortisone and a pharmacologic dose of steroids. Cortef is usually prescribed in 5 to 10 mg tablets given two to three times daily for a total daily dose of 15-20 mg. This dose does NOT have the side effects of ‘steroid therapy’.

A physiologic dose (up to 20 mg per day) of cortef does NOT cause:

  • Bone loss
  • Weight gain
  • Elevated glucose, sugar cravings (a normal level of cortisol regulates blood sugar)
  • Anxiety, sleep disturbances
  • Thinning skin, easy bruising
  • Suppress the immune system
  • Suppression of endogenous adrenal production (it takes 40 mg of cortef to suppress your natural cortisol production)

Wichers 99, Jodar 03, McConnell 02, McK.Jefferies 96

This is important for you to understand because you will receive information from the pharmacy when you pick up your prescription that describes the ‘side effects’ of steroids. Some health care providers are not aware of the difference between therapeutic replacement doses of cortef and ‘steroids’.

Cortisol is your body’s natural anti-inflammatory hormone and is much safer than Vioxx ®, Celebrex ®, and Mobic® which can cause serious side effects, including death.

Cortef 5 mg may be taken three times daily with meals. Some people prefer to take it twice daily, 10 mg in the morning and 5-10 mg around 4 pm. Because cortisol is a natural hormone it will not interfere with taking any other medication. If you develop a respiratory infection or go through a period of extreme stress you may need to temporarily increase your dose of cortef (up to 20 mg four times daily).

Recommended Reading
Safe Uses of Cortisol 2 nd Edition by William Mck. Jefferies, M.D., FACP
Adrenal Fatigue by James Wilson, N.D., D.C., Ph.D. Adrenal Fatigue
Hormone Balance Data section username: research password: bhrt

(Cortisol folder /Mck Jefferies article)