Adrenal Fatigue: How to Raise Low Blood Pressure with Steroid Hormones

Low blood pressure is not uncommon in the advanced stages of adrenal fatigue. One way to address low blood sugar is to supplement with an adrenal steroid hormone. In cases of adrenal exhaustion, you may need to include medications as well as steroid hormones in order to help keep your blood pressure in a normal range.

One way to see whether you're responding to any of the meds you’re taking is to check your blood pressure while you're lying, sitting, and standing. Sometimes when you stand up, you may have an abrupt decrease in blood pressure. Dizziness and lightheadedness commonly occur in adrenal fatigue.

If your medications are working, you shouldn't experience dizziness and lightheadedness when standing up and you shouldn't see a difference in the blood pressure readings taken in different positions (sitting, standing). If you do, you need to talk with your healthcare practitioner about modifying your medication dosage.

How to use hydrocortisone as a supplement for adrenal fatigue

If hormonal testing reveals that your adrenal glands can no longer produce adequate amounts of cortisol, you may need to supplement with hydrocortisone. Hydrocortisone is a steroid hormone, normally produced by the zona fasciculata of the adrenal cortex.

If your adrenals are exhausted, you probably aren't producing enough cortisol, so you're probably going to benefit from supplementation. One of the benefits of hydrocortisone is that it can normalize blood pressure as well.

Your options are a prescription medication or an adrenal-based steroid. Hydrocortisone is the most common prescription steroid hormone replacement prescribed. It's taken orally, usually twice a day.

Your healthcare provider determines the hydrocortisone dosing based on your stage of adrenal fatigue, blood pressure, and other symptoms. For example, late stages of adrenal fatigue often require higher doses (and earlier stages, lower doses). A typical, everyday dosing regimen is 5 milligrams in the morning and 2.5 milligrams at night. Your dosing schedule may be different, of course, depending on your individual needs.

If you've been prescribed hydrocortisone, talk with your doctor to find out whether your dose needs to increase in times of severe stress, such as when you're admitted to the hospital for a really bad infection.

Ask whether you need to have the hydrocortisone given intravenously (via the vein) when you're in the hospital. The intravenous hydrocortisone can help you avoid going into adrenal shock while you're being treated for the underlying infection.

How to use fludrocortisones as a supplement for adrenal fatigue

Fludrocortisone (Florinef) is a commonly prescribed steroid hormone. Think of fludrocortisone as working like a synthetic aldosterone. It primarily raises blood pressure by increasing the body's absorption of sodium.

This medication is taken orally. Most healthcare practitioners start with a low dose of 0.1 milligrams per day. This can be increased to be taken twice a day at the same dose.

If tests show that your aldosterone levels (in addition to your cortisol levels) are low, your healthcare practitioner may talk to you about taking an aldosterone substitute like fludrocortisone. It will help raise your blood pressure, but the picture isn't entirely rosy — this medication can have significant side effects that you need to be aware of:

  • Really high bloodpressure: If your blood pressure readings are higher than normal, you may need to talk with your healthcare practitioner about adjusting the dose. You need to monitor your blood pressure on a daily basis.

  • Increased swelling in the legs (edema): If you have a history of congestive heart failure (CHF), this medication may not be a great option, because it can cause salt and water retention. That's bad. The retention of salt and water is the cause of edema.

  • Weight gain: If you're on fludrocortisone, weigh yourself daily. If you see rapid weight gain — more than 2 pounds in two consecutive days — talk with your healthcare provider about adjusting your dose. Weight gain that occurs quickly is often fluid weight (likely the byproduct of salt and water retention).

    The weight gain associated with this medication can increase the risk of developing fluid overload; an example is congestive heart failure (CHF), which is a buildup of fluid in the lungs.

  • Low potassium (hypokalemia): Fludrocortisone can cause urinary excretion of potassium (like high levels of aldosterone would), leading to low potassium levels in the body. If you're taking this medication, your potassium levels likely need to be checked routinely, and you may be asked to supplement with potassium as well.

In addition to fludrocortisone, a natural form of aldosterone is available. It can be difficult to get in the United States, although you may find it in compounding pharmacies. This form of aldosterone is considered natural because it's identical to the human form of aldosterone and is derived from plant sources.

Hearing loss, which may be associated with low levels of aldosterone, can be treated with aldosterone replacement. Just as mineralocorticoid receptors are in the adrenal glands, the same receptors are in the ear. Isn't it amazing how everything in the body is interrelated?

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