Hydrocortisone
| Hydrocortisone | |
|---|---|
 | |
| Formula | C21H30O5 |
| Class | |
| Administration | Oral, topical, injectable |
| Solubility | |
| Legal status | Prescription only (oral/injectable); OTC low-dose (topical) |
| Brand names | Cortef, Solu-Cortef, Cortaid (topical) |
| Bioavailability | ~90% oral |
| Recommended dose | |
| Upper limit | |
| LD50 | |
| Ray's verdict | Depends on context Chemically identical to the body's own cortisol; replacement-dose use for genuine adrenal insufficiency is a different situation from excess/chronic elevation |
Hydrocortisone is the pharmaceutical name for cortisol itself, not a synthetic analog like prednisone, but the same molecule the adrenal glands produce. It is used as low-dose replacement therapy for adrenal insufficiency (Addison's disease), as an anti-inflammatory at higher doses, and topically for skin conditions.
Peat's framework
[edit]Ray Peat's writing on cortisone treats the adrenal glands' own output as something the body should generally need only in small, situational amounts, linking chronic excess directly to inadequate progesterone:[1]
The adrenal glands use it to produce their anti-stress hormones, and when there is enough progesterone, they don't have to produce the potentially harmful cortisone.
In a progesterone deficiency, we produce too much cortisone, and excessive cortisone causes osteoporosis, aging of the skin, damage to brain cells, and the accumulation of fat, especially on the back and abdomen.
Replacement-dose hydrocortisone for someone whose adrenal glands genuinely underproduce is restoring a normal level, not creating the excess Peat described; the distinction is dose and indication, not the molecule itself. Using it to push cortisol above normal, or long-term at anti-inflammatory doses, reproduces the same risks as chronic stress-driven excess.