TREATMENT DATABASE

Hydrocortisone is the pharmaceutical name for cortisol, a glucocorticoid hormone excreted by the adrenal cortex in response to stress, inflammation, and low blood sugar levels.

Cortisol is produced in the outer layer of the adrenal gland, known as the adrenal cortex. The release of cortisol is controlled by the hypothalamus, which secretes corticotropin-releasing hormone (CRH) to the pituitary gland, which in turn releases adrenocorticotropic hormone (ACTH). ACTH is carried by the bloodstream to the adrenal glands, where cortisol is then released.

Cortisol has numerous effects on body functions, including reduction of inflammation, maintenance of sodium and potassium balance, and regulation of blood sugar. Cortisol also has profound effects on protein and carbohydrate metabolism. Because cortisol can suppress the immune system (specifically the proliferation on T cells), hydrocortisone is used medically to treat inflammatory conditions such as rheumatoid arthritis, lupus, and allergies.

USES IN ME/CFS :  Several studies have confirmed that treatment with low-dose hydrocortisone increases energy levels and stamina in ME/CFS patients. In 1999 Cleare et al found that in a group of 32 ME/CFS patients treated with 5-10 mg of cortisol daily for a month, energy levels were significantly improved. In a subsequent study published in 2001, Cleare also found that low-dose cortisol restored normal adrenal responses to CRH in ME/CFS patients.

Some doctors include low-dose hydrocortisone (Cortef) as part of their ME/CFS protocols. In a 2008 study of 500 patients, Dr. Holtorf found that 5-15 mg a day of time-release hydrocortisone resulted in an overall improvement in 94% of his patients.

However, not all clinicians agree that treatment with hydrocortisone is beneficial. Cortisol can be an immune system suppressant and, in cases in which the immune system is already compromised, its effects could be disastrous. Clinicians who are critical of hydrocortisone's usefulness as a ME/CFS treatment point out that glucocorticoids are best used as a short-term treatment for severe allergic reactions. Long-term use may exacerbate the disease process.

The fact that some patients have high, rather than low, levels of cortisol indicates that tests should be performed prior to embarking on this treatment.

Treatment rating for Hydrocortisone