Optimal Hydrocortisone Replacement Dosing
Journal of Clinical Endocrinology & Metabolism (2009)
Physiologic replacement (15 to 25mg/day) improved fatigue, anxiety, and quality of life vs historical higher doses.
Hydrocortisone
Oral tablet (5mg)Available in all 50 statesMarketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
hormones
HydrocortisoneHydrocortisone
Pharmaceutical form of cortisol, the primary endogenous glucocorticoid. Cornerstone replacement therapy for adrenal insufficiency. Used at physiologic doses (15 to 25mg/day divided) to match normal cortisol production.
Identical to endogenous cortisol
Life-saving in adrenal crisis
Short half-life allows circadian dosing
Multiple formulations available
No commitment · HSA/FSA eligibleNo commitment · HSA/FSA eligible
How it works
Mechanism of action
Binds glucocorticoid receptors in virtually every cell, regulating carbohydrate, protein, and lipid metabolism; modulating immune responses; and maintaining vascular tone. At physiologic doses replaces normal adrenal output.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
Clinical evidence
The research behind Hydrocortisone.
Safety profile
Monitoring & safety information.
Commonly reported side effects
- Weight gain (supraphysiologic doses)
- Insomnia (if dosed late)
- Mood changes
- Increased appetite
Less common but serious risks
- Adrenal crisis if doses missed during illness
- Cushing's syndrome with excess dosing
- Immunosuppression
- Osteoporosis (chronic excess)
Generally not appropriate for
- Systemic fungal infections (supraphysiologic doses)
- Live vaccines during immunosuppressive doses
Typical monitoring
- Morning cortisol and ACTH stimulation test
- Blood glucose/HbA1c
- DXA (long-term)
- Blood pressure
- Electrolytes
FAQ
Quick answers.
Pharmaceutical form of cortisol, the primary endogenous glucocorticoid. Cornerstone replacement therapy for adrenal insufficiency. Used at physiologic doses (15 to 25mg/day divided) to match normal cortisol production.
Identical to endogenous cortisol. Life-saving in adrenal crisis. Short half-life allows circadian dosing. Multiple formulations available.
Common side effects include: weight gain (supraphysiologic doses), insomnia (if dosed late), mood changes, increased appetite. Most side effects are dose-dependent and may resolve with continued use or dose adjustment.
Pharmaceutical form of cortisol, the primary endogenous glucocorticoid. Cornerstone replacement therapy for adrenal insufficiency. Used at physiologic doses (15 to 25mg/day divided) to match normal cortisol production.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.