Hi Gilla
I want to start by saying that a lot of ladies in peri and beyond have some degree of adrenal (HPA) dysfunction.
Many are unaware of it and put everything down to sex hormone imbalance.
Anxiety is a key issue with HPA dysfunction, but unfortunately can be a symptom of both high and low cortisol, so the only way to know is to test.
What we don’t know is what your cortisol/Dhea was like earlier in the year and post covid infection, so it is difficult to pinpoint an actual cause.
In fact one potential cause now is you recently stopped low dose steroids, and the negative feed back loop might not yet had time to readjust.
Or it could just be an ongoing stress response to your chronic Urticaria.
So, morning cortisol should be at the very top of the range.
Noon should be upper quarter, lower part.
Late afternoon should be midrange.
Bedtime should always be at the bottom of the range.
Dhea and cortisol should work in balance with each other. As cortisol goes up, Dhea goes down.
When cortisol falls, Dhea makes a last ditch attempt to rise…then falls.
This is what I think is happening to you with your pm rise in Dhea.
Low cortisol can result in reduced cellular absorption of certain hormones, reduced thyroid receptor response, and low pregnenolone, progesterone and aldosterone. Testosterone along with Dhea levels fall with declining cortisol levels, but which comes first is highly individual.
Clinical manifestations can include estrogen dominance symptoms (relative to progesterone) and blood volume/pressure issues.
So what to do about it???
Of course, the obvious stress reduction, rest, relaxation techniques are paramount, along with regular meals, do not skip breakfast (which should be high in protein- eggs a good choice) and adequate sea salt twice a day.
But bigger guns than this are often needed.
It really depends Gilla on how you would like to proceed?
The best solution is to work with either an endocrinologist or a good functional practitioner (the disadvantage here though could be that they are unable to prescribe).
That said an endocrinologist will often jump straight in with the big guns and prescribe hydrocortisone, which is often not necessary if you have adequate pregnenolone and progesterone throughout the month.
I have had low cortisol issues for a number of years and have been able to get on top of it without using HC.
There are a few supplements that are very good for low cortisol. Namely, vitamin c(don’t start too high and the B vitamin Pantethine. Also I have used Thorne adrenal Cortex (don’t use glandulars) with good success.
It’s also important that you avoid, for now, supplements that can lower cortisol, such as Phosphatidylserine, zinc and holy basil. All good supplements and I actually take zinc now with my evening meal, but not good for you right now.
Lastly, there are two good books I would like to recommend-
‘Stop the Thyroid Madness’ which has 2 excellent chapters on adrenal dysfunction
and
‘A Practitioners Guide to Physiologic Bioidentical Hormone Balance’
My cortisol and Dhea nose dived after getting covid in May, this doesn’t happen to everyone, it depends how good your reserves are and in some people they actually increase. The only way I could tell was by testing yet again. After Christmas when I tested they were pretty good. So you can see how quickly things can change.
It’s awful to have to deal with so much all at once Gilla, but take heart, as knowledge is power and will help you win through.
Please let me know if there is anything you wish me to clarify.
M x
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Topic: HRT and Histamine issues / Urticaria / DHEA and Cortisol (Read 54793 times)