"Even if physicians suspect cortisol deficiency, they are afraid to prescribe cortisol. They have no experience with
cortisol replacement, but have a lot of experience with the damaging effects of pharmacologic doses of powerful non-natural
“steroids” (e.g. prednisone, dexamethasone). They inappropriately generalize this negative experience to cortisol
supplementation. They believe that any dose of cortisol taken long-term will cause negative effects like Cushing's syndrome.
They are not completely wrong, because they do not understand the importance of DHEA. Oral glucocorticoid therapy, whether
hydrocortisone (HC) or an artificial steroid, suppresses ACTH and therefore DHEA production, thus creating a severe
deficiency of a major anabolic hormone. DHEA is the body's natural cortisol antagonist and prevents many of the
negative effects of cortisol. DHEA has anabolic effects through conversion to estradiol and testosterone within tissues
throughout the body. DHEA is practically unknown to conventional medicine, even though it is the most abundant
steroid hormone in the human body (20 times more abundant than cortisol, 8000 times more than estradiol or
testosterone!). There are thousands of studies detailing its contributions to health and the consequences of deficiency. For
instance, studies show that women on 10mg of prednisone daily start gaining bone mass when given DHEA. Again, it's another
example of the use and misuse of pharmaceutical hormone substitutes causing doctors to overlook the benefits and safety of
balanced hormone restoration. Dr. Lindner prefers sublingual DHEA as it delivers more of the active hormone into the
circulation. People taking cortisol or any artificial steroid must restore their average DHEAS levels to those of a young
person of the same sex: around 200mcg/dL in women, 300mgc/dL in men. This usually takes 10 to 25mg of sublingual DHEA for
women, 25 to 50mg for men. If DHEA is swallowed, the dose needs to be 25 to 50% higher.
Physiological cortisol supplementation accompanied by DHEA, by definition, does not produce any negative effects.
Since HC produces much more fluid retention than the artificial steroids, over-dosing is much easier to detect. A person will
notice fluid retention, weight gain, facial puffiness, higher blood pressure and increased blood sugar. The doctor and patient
simply have to look out for these signs and reduce the dose if they appear. HC is short-acting compared to the artificial steroids--
this also helps avoid overdosing. Dr. Jefferies popularized the ideas that people should take only 20 to 30mg of HC daily.
Conventional medicine gives 20 to 35mg/day to Addison's disease patients. People with central cortisol insufficiency often also
need full replacement doses also since every dose they take further suppresses their already weak ACTH production. Higher
cortisol doses are needed in persons who are replacing their DHEA, as they must, and in those who are taking thyroid
hormone as both of these counteract cortisol strongly. Many people need 40-60mg/day. Cortisol supplementation,
optimized to the lowest dose that provides full clinical benefit, and combined with DHEA replacement, is just good
medical practice. It is more effective and far safer for inflammatory conditions than the alien "steroids" and non-steroidal anti-
inflammatory medicines doctors prescribe every day (e.g. prednisone, methotrexate, Motrin®, Enbrel®, Humira®, Mobic®, etc.)."