How my low cortisol is dragging me down...


New Member
Sep 9, 2013
Hello everyone! I have been reading Ray Peat's work in the last month or two, and have found the posters on this website to be helpful and sincere, so thank you. I've been perusing Ray Peat's articles and interviews in hope of finding some advice that I could apply to my situation, but I am still confused.

I'm a 28 year old Australian woman, have severe Crohn's disease and have spent the last couple of years in hospital a lot, including several surgeries that removed my colon, which has settled things down greatly. 

I have incorporated Peat's dietary ideals lately and I have found eating a high proportion of reduced fat milk and pulp free OJ fantastic for my altered digestive system! Nutritious and low fibre foods suit me very well. 

My main stumbling block now is that after taking a corticosteroid for so long (prednisolone), I seem to have become dependent on it as my adrenal glands have been suppressed by this medication. I have had this tested whilst in hospital twice and the cortisol response was low - this is not "adrenal fatigue", but drug induced adrenal insufficiency. I have been told that I can reduce my dosage slowly, but no matter how slowly I wean this drug I remain unwell; becoming progressively becoming more exhausted, with 'brain fog', sleeping problems, muscle soreness and migraine headaches.

I am seeing endicrinologist to help with this, I'm frustrated with the possibility of being dependent on a steroid replacement for good. Most people in this situation don't have to, they recover after some months. It seems that my overall stamina is still very low, even when taking a physiological replacement dose or slightly higher.


Feb 20, 2013
Welcome to our forum
Prednisolone is usually prescribed to manage inflammation. If you do not have inflammation you
will not be needing this. Adrenal insufficiency is not a big problem if you have other protective hormones to
take care of your stress and inflammation. Ray Peat thinks if we strengthen our anti stress hormonal system
of thyroid, progesterone, DHEA, pregnenolone etc we can avoid reliance on stress hormones like
estrogen, cortisol, adrenal, TSH. serotonin etc. Stress hormones do its job at the cost of causing
damage to our body. Your condition is bit more unique than most people.
I think you will get more useful help by having a consultation with Ray Peat.
You can email him directly if he is not busy he might answer your email.


The Law & Order Admin
Jan 4, 2012
Welcome to the forum. :welcome

Low metabolism is dragging you down. I took high doses of prednisone for many a years and I am sure that was a huge part of crashing my metabolism.

Ray Peat said:
While hypothyroidism makes the body require more cortisone to sustain blood sugar and energy production, it also limits the ability to produce cortisone, so in some cases stress produces symptoms resulting from a deficiency of cortisone, including various forms of arthritis and more generalized types of chronic inflammation.


Aug 11, 2013
Hi Delune,

My husband was on prednisone (a precursor to prednisolone) and although it temporarily was a miraculous drug in the long run turned into a nightmare drug for him. When we found out that it lowered the immune system and was actually making his condition worse (autoimmune condition caused by Lyme disease), he decided he wanted off the drug right away. He thought he could do it cold turkey even though all of my reading indicated it had to be done slowly. Well, he ended up in worse shape and ended up having to increase his dose. To make a long story short, corticosteroids have to be weaned slowly even if they're not doing you any good. What worked best for my husband was to alternate his dose. If he was at 20 mg, one day he would take 20 mg and the next 15 mg. He would do this for at least 10 days and if he felt fine he would then lower it again. Once you start getting down to the lower dosage, you have to go even slower. By 10 mg, you should only be reducing by 1 mg at a time and at 5 mg you reduce by .5 mg. Slowly but surely eventually wins the race.


Dec 21, 2012
I think your thyroid has been suppressed by cortisone.
Thyroid is necessary to stimulate adrenals.
When you suspend cortisone, as your thyroid is not working enough, yours adrenal are not stimulated to produce cortisol.

Probably, using a bit of thyroid hormones you could stimulate the adrenals to produce hormones.
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