Owen Fonorow
“That cortisone and cortisol are normal hormones of the adrenal cortex implies that in physiologic dosages they must be safe. ”
– William Mck Jefferies. 2004. Safe Uses of Cortisol.
“Our hypothesis is that common symptoms of disease result from low blood levels and tissue levels of the adrenal hormone cortisol.”
– Owen R. Fonorow, Vitamin C Foundation
Medical doctors are taught that symptoms of disease appear in response to an infection; or, when no pathogen is found, that our own body attacks itself through, for example, an autoimmune response. This author has an entirely different opinion based on several years of experience with a diagnosis of adrenal insufficiency. When cells are deprived of cortisol, those deprived cells initiate an inflammatory response. We experience pain, we swell, we produce mucous and other fluids. The medical assumption is that there is an infection behind these symptoms.
Think of our trillions of individual cells as fish feeding in a red ocean. These fish must communicate with other fish, and they require a myriad of substances, including vitamins, minerals, amino acids, sugars, hormones, etc. Cells have more than one “mouth,” openings on cell membranes called receptors. Different receptors are used to “feed” on different substances. While not every cell requires every available substance, all cells have receptors for the all-important natural anti-inflammatory hormone cortisol.
The new theory is that the lack of cortisol triggers a cascade of events causing inflammation. Evidence suggests that the availability of cortisol is the signal that all is well, and the lack of cortisol rapidly ignites the series of metabolic events we think of as an immune response. Few doctors know that cortisol is the only hormone we cannot live without, so that if we are deprived of cortisol for a day or two, we die painfully. In the extreme, the complete breakdown of our tissue’s ability to obtain cortisol leads to a potentially lethal condition called sepsis.
Cortisol – Villain or Hero?
Medicine and its followers believe that the steroid cortisol is basically evil and must be handled with care. Doctors are not taught that cortisol and its bioidentical equivalent, hydrocortisone, are natural, or that the other functional look-alikes, such as prednisone, are an invention of man. The basis for the fear that cortisol and other glucocorticoids are dangerous is rooted in antiquated research from a time when doctors had no idea how much cortisol our cells required. In the beginning, the “fish” were woefully overfed. With no knowledge of proper dosing, early patients were given 100-150 mg or more of prednisone (the functional equivalent of over 500 mg of hydrocortisone)! We now know that the safe maximum sustainable dosage is 40 mg of hydrocortisone or 10 mg of prednisone.
The old studies are still used to scare doctors, and the new studies deliberately confuse readers by combining results for “glucocorticoids” together, as if the natural and unnatural are equivalent. This misrepresentation is at least part of the reason the pharmaceutical industry maintains its status as the largest for-profit industry in the world.
Adrenocorticotropic Hormone (ACTH, Corticotropin)
The adrenal cortex, a major portion of a small gland that rests above our kidneys, produces various hormones, including its most important: cortisol. It is interesting that cortisol is produced on-demand. Cortisol levels in the blood are controlled by a complex hormonal signaling system in the brain. The adrenals respond to adrenocorticotropic hormone (ACTH or corticotropin) from the anterior pituitary. ACTH is secreted in response to a corticotropin-releasing hormone from the hypothalamus.
Cortisol blood levels are not constant throughout the day. The amount of cortisol measured in the blood generally increases in the morning to a peek around noon and then declines during the afternoon into evening. Under normal conditions and when the human is healthy, the brain’s daily request for cortisol leads to an amount released into the bloodstream within a narrow range, typically 40 mg, regardless of body weight.
A stress may create a need for more cortisol than usual. Perhaps schools of “fish”—or tissues—eat more than their fair share, creating an overall cortisol deficiency. Deprived fish start complaining with signals of pain to the brain, and they may even start growing more mouths—cortisol receptors—to help them capture their fair share.
Brain cells are “fish” too. They decide to signal their brethren adrenal “fish” that something is wrong and that more cortisol is required. “Boys,” the brain communicates through the second hormone, “the other fish (cells) are complaining out there! They are hungry and they aren’t getting their daily cortisol. Tissues are inflaming! Adrenals, get cracking!” Failure in this hormonal brain signaling can also affect cortisol availability.
While this stress is usually caused by an injury or by doing battle with an invading pathogen and infection, the new idea is that the increased need creates a localized deficiency of cortisol. The mere lack of cortisol is what marshals the body’s response.
How Do We Know How Much Cortisol the Adrenals Make?
After the Mayo Clinic received the Nobel Prize for discovering the chemical structure of cortisol in the 1950s, Merck synthesized it, and William Mck Jefferies, MD, became the resident who administered the very first doses of Merck hydrocortisone to patients in an arthritis ward. At that time, no one knew what dose to use; and over time, Dr. Jefferies became the world expert. “Cortisol is the only essential hormone,” Jefferies informs us. “We can do without every other hormone for long periods, but if we are without cortisol, even for a single day or two, we die.”
The budding science of the late 1950s and 1960s pointed to female hormones (estrogens) accelerating the growth of breast cancers. During this period, well-meaning doctors completely removed the adrenal glands of breast cancer patients (Jefferies 2014). After these adrenalectomy procedures, doctors discovered that the adrenal glands produce more hormones than they initially suspected. They also discovered that the hormone cortisol was so important that its absence would lead to death within 24-48 hours.
The experiments with breast cancer patients (minus their adrenal glands) determined that 40 mg daily of cortisol (as hydrocortisone, the bioidentical equivalent of cortisol) kept the cancer patients alive and in reasonably good health. The fish were happy; they didn’t seem to care whether their favorite food (cortisol) came from Merck pharmaceuticals or the body’s own adrenal glands.
Cortisol and the Flu
Over the years, Dr. Jefferies and his team made a little-known discovery that the flu virus begins the infection by attacking the brain’s HPA axis signaling, which turns off the adrenal function, which stops the production of cortisol ( Jefferies 2004). The common symptoms of the flu, which manifests in fever, chills, shakes, flushing, pain, and vomiting, are caused by the body’s inability to produce cortisol in response to the viral attack. These symptoms are evidence supporting our cortisol theory.
Dr. Jefferies recommended 100 mg of oral hydrocortisone at the onset of the flu, then tapering to 50 mg on day 2, and so on. This protocol avoids nearly all flu symptoms. Linus Pauling also wrote that taking vitamin C in high doses might stop or mitigate the severity and duration of the flu. High concentrations of vitamin C are needed by the adrenals, which leads to the question: Could taking vitamin C to combat the flu have a connection with the adrenals and cortisol? Jefferies poses this question in his book as well.
Sepsis
It is known that fishes’ mouths (cortisol receptors) can become plugged and gagged, preventing them from eating their favorite food. Technically, the receptors become oxidized. What if all the mouths of most or all of the fish become gagged and unable to “eat” cortisol, even if some is present in the blood?
Sepsis is a body-wide infection that leads to frequent hospital deaths. Thanks to professor Paul Marik MD, we now know that a little fish food (cortisol) with vitamin C—a powerful antioxidant –opens up the mouths of the fish by un-oxidizing their cortisol receptors. Using Marik’s protocol of vitamin C, hydrocortisone, and vitamin B1 (thiamine), fish are enabled to eat their favorite food, which is being amply supplied, and the human recovers in a few hours. Otherwise, 1,000 to 1,500 people die every day from sepsis in hospitals and medical centers.
This begs the question, what about adrenal fish? What if the adrenals’ cells aren’t able to eat their required fish food because their own mouths are oxidized? What happens to the body’s supply of cortisol then?
Effect on Blood Sugars
Cortisol is a glucocorticoid, which means it promotes the release of glucose from the liver into the bloodstream. The answer as to why the release of cortisol raises blood sugars seems self-evident. We evolved such that if our fish are hungry and complaining, an immune response would soon be required. Cell division requires energy, so the immune system fish will require a strong supply of glucose to fuel their impending immune-cell division.
As mentioned, the early findings that glucocorticoids can harm the immune response were based on work with the man-made substances at dosages far above what the body produces for itself. Dr. William Mck. Jefferies, whose work focused on natural hydrocortisone, reports that at the safe dosages (less than 40 mg of hydrocortisone), the immune response in his patients was not impaired, and he reports evidence that higher dosages protected against infection.
Lack of Cortisol Creates Other Hormone Imbalances
Sometimes, the brain may request more food than some people’s adrenals can provide to its customers. Pain isn’t being reduced, so signals keep coming to and from the brain; and in desperation, the brain may resort to sending signals to other departments of the adrenal cortex (Where is the cortisol?). The the production of other adrenal hormones can be stimulated. This is one reason why DHEA hormone production may also decline.
Dr. Jefferies found that DHEA supplementation could be very helpful to his patients for the same reasons: it helps to quiet the brain. Jefferies’ book contain case studies of young women patients in puberty, with small breasts, whose breasts grew to normal size on a physiologic dosage of hydrocortisone.
Adrenal Exhaustion
The case studies in Jefferies’ book illustrates that symptoms of insufficient cortisol often begin in the fifth decade of life, usually weeks or months after a stressful event. Case after case illustrates the benefits of resting the adrenal glands by supplementing a safe physiological dose of the bioidentical hydrocortisone. A safe Merck dose to rest the adrenal fish is between 10 to 30 mg of hydrocortisone.
This protocol helps avoid adrenal exhaustion and quiets the brain. The adrenal factories will have extra capacity and will be ready to produce more cortisol on demand should something major happen…when a migraine rages! The adrenal fish are ready to go into maximum fish-food production (cortisol) and respond.
If we take too much, e.g., say greater than 40 mg of hydrocortisone (10 mg of prednisone), for too long, the adrenal production shuts down. The adrenal fish become lazy, the brain is quiet, the adrenal fish go to sleep: “Stop the vendors. We don’t need supplies. Let’s take a vacation.” This is called shutting down the adrenals, but other hormones continue to be made if they can. The human becomes dependent on Merck until the factories can re-open.
Since 2011, the author has a secondary adrenal insufficiency, meaning the factory still works, but became faulty due to a series of stresses. The author’s adrenal insufficiency condition is such that he only has a 25 percent adrenal production capacity for cortisol. It’s as if seventy-five percent of his adrenal manufacturing plant has been incinerated (75% of the fish that make cortisol may have been killed). This author’s endocrinologist prescribed 30 mg of cortisol as hydrocortisone per day, more in the morning, in keeping with the body and mind’s natural rhythm. With his own 25 percent production and 75 percent from Merck, his fish are happy; and he feels and looks normal. Life is good.
When a major stress strikes, the author doesn’t have the normal way to feed the fish extra food. Mayo, Merck, and his endocrinologist ride in to save the day, with fish food to be taken orally. The symptoms subside and all is well on a high fish-food diet. High doses of cortisol flood the red ocean. At the right dosage, fish can be happy in 30 minutes for the next 6-8 hours. The liver not only knows how to handle cortisol, our liver “fish” require the same food as well.
Experimental Evidence – Lack of Cortisol Induces a Wide Range of Symptoms
The author had major dental work to remove abcesses and bone infections, which resulted in an abdominal abscess thought to be an infected hernia mesh. Along the way to surgical removal of the mesh, he contracted influenza type A. These stresses created an unusual need for exogenous cortisol, which an endocrinologist determined from hospital observation to be 60 mg every 8 hours, or 180 mg per day by vein.
The author was unable to sleep for three weeks on this dosage of hydrocortisone. Other physicians then feared he was over medicated, and they deprived him of all medications, including hydrocortisone for a 24-hour period in a hospital setting. This “experiment” occurred on April 27, 2018 and resulted in the following symptomology. This record began approximately 12 hours into the 24 hours of deprivation: at 4:30 am after prescription meds were removed around 5 pm the previous day.
Headache
Eye Pain
Neck Pain
Back Pain
Sore Throat
Back Shoulder Pain
Shakes
Lower Rib Pain
Cough
Trembles
Dull Ache under Eyes
Mouth, Feet Hurt
Cramp Left Abdomen under rib
Right Side of Throat Sore
Chesty Cough Worsening
Loss of Consciousness
Feeling like Blacking Out
Toothache
Pain Inside Mouth, Teeth on Either Side
Yawning Hurts Abdomen
Sore Throat Getting Worse
Neck Swelling
Hard to Swallow
Harder to talk – Sore Throat
Right Chest Pain
Pain in Lower back, both sides, during breathing
Dizziness
Lips Chapped
Tremors/Shakes
Hand Tremors (6:30 a.m.)
Chest Pain While Coughing
Pain Behind Teeth
Cough with Mucous Erupts with Talking
Dull Headache Back of Head Between Ears
Sore Throat were “Tonsils” (were) part of Throat
Shortness, Difficulty Taking Breaths, Hard to Expand Lung
The experience, at least a 75% lack of daily cortisol, reinforced the idea that symptoms do not have to develop from a disease but will develop entirely and predictably from a lack of cortisol.
Aren’t Symptoms a Good Thing?
If symptoms are the result of an infection, they are a good thing. Even so, doctors with the knowledge presented here can prescribe patients enough of the good fish food that will eliminate symptoms and complaints, even if there is a virus afoot attacking the body.
This begs the question: Would it be preferred to have no symptoms, no fluids, no mucous, no cough, and to breathe normally, even if under a full-blown attack of viral pneumonia? Not even have to go to a doctor or hospital? Most people will have normal or low levels of cortisol, so the symptomology will begin; however, it is this author’s bias that most people who are diagnosed with pneumonia are diagnosed from symptoms caused by unhappy fishes. Higher cortisol helps resolve, not cause, infections. This author wonders, as we age and make less of our own cortisol, if there is even an infection most of the time?
Final Thoughts
Jefferies’ Safe Uses of Cortisol, 3rd edition, is a monumental book containing a wealth of deep knowlege. In my opinion, this book should be read by all physicians. Unfortunately, not only has this information been kept away from most physicians, they are taught to fear cortisol, potentially the most powerful implement in their medical arsenal.
This author believes that if doctors routinely prescribed patients hydrocortisone at the onset of symptoms, their patients would feel no pain or have no apparent illness in 12 to 24 hours. The Jefferies’ 100 mg protocol at the onset of infection, tapering off daily by 50% would control all symptoms. Unfortunately, most people cannot get their doctors to provide long-term prescriptions for natural fish food in the proper dosages.
Published April 22, 2023
©Fonorow, 2019
About the Author
Owen Fonorow graduated from the United States Air Force Academy, class of 1976, and served as an officer in the United States Air Force, strategic air command. Owen has his master’s in computer science (Arizona), master’s in business administration (Wyoming), and dual-doctorates in naturopathy (Chatworth College, Costa Rica). In 1996, Owen founded the nonprofit Vitamin C Foundation, along with his brother Michael S. Till, Sr.
Owen has since written more than thirty articles, and these papers have been published in assorted alternative medical journals, including Townsend Letter, Nexus New Times, Life Extension Foundation magazine, American Naturopathic Medical Association Monitor, and The Bolen Report. Many of the themes in these articles have been incorporated in his best-selling book, Practicing Medicine Without A License? The Story of the Linus Pauling Therapy for Heart Disease. His second book, The Great Suppression of American Alternative Medicine, is available online.