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Category Archives: Doctor’s Answers

Drugs That Affect Cortisol

Question:  I’ve read that lots of common medicines and treatments can raise or lower cortisol.  There’s not much mention of the quantity of these meds that affect cortisol though.  Xanax and codeine lower, for example, and Zoloft, Ritalin, St. John’s Wort, alcohol, and even marijuana raise cortisol.  Growth and thyroid hormones are reported to lowerContinue Reading

Exogenous Cushing’s From Past Steroid Use?

Question:  Can I develop exogenous Cushing’s from steroid use that stopped several years ago?  I had a series of injections between 2010-2014 and this year I’ve been noticing some symptoms I suspect are Cushing’s. Answer 1:  The effects of exogenous glucocorticoids can be subtle at first and are generally slowly progressive. It typically takes severalContinue Reading

Confidence in Testing Methods

Question:  Depending on what you read, some sources think the 24 hour urine is the “gold standard” test for Cushing’s, while others think it’s the dexamethasone suppression test.  Some doctors will only start with a blood cortisol test, and a lot of resources I’ve read say that this is an almost worthless test.  How canContinue Reading

Fertility After Hypophysectomy / Hypopituitarism

Question:  My pituitary gland was removed, so now I replace a lot of hormones.  I didn’t have a period for awhile, but once I changed my doses of estrogen and progesterone, now I have one like clockwork every month.  I’m still in my 30s.  Is it possible for me to become pregnant? Answer:  The pituitaryContinue Reading

Personalized Hydrocortisone Dosing

Question:  I recently attended a meeting with other adrenal insufficiency patients and was surprised to find out that some of them had personalized dosing of hydrocortisone and were taking smaller but more frequent doses, some 4x a day.  I’ve been taking two daily doses for years but the idea of having a small third doseContinue Reading


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