Ask a Neurologist
22.11.2008 - CHRONIC FATIGUE; HYDROCORTISONE v/s PROVIGIL?
- Question:
Hi there
Whilst I’d been experiencing "hell" (continuing damaging episodes & decreasing functionality) since my first A.D.E.M episode early Oct ’05, which included hearing loss in one ear, blurred vision, vertigo (spent 1 month in a Rehab facility to learn to balance, walk, etc), an RRMS diagnosis had only been confirmed recently - Aug ’08.
Betaferon therapy has now commenced (this week).I’ve been taking Hydrocortisone (HC) (20mg/day as per physiological dosage at times to match circadian rhythms) for the past year, according to Dr William Jefferies’ research for Chronic Adrenal Fatigue (confirmed on Saliva, as well as Hair, testing); the HC has been quite effective, for without which, I battle just to get out of bed in the morning!
My Betaferon nurse has suggested Provigil as an option (?) though?
However, I am also Hypothyroid (antibodies >1,300) and, having read a research paper on Provigil, wondered whether this would be a good idea in my case?
What other alternatives are there, or would it be appropriate to continue with the HC route?Any advice and suggestions would be highly appreciated!
Thanks for the assistance ...
Best Rgds
Snaz- Reply:
-
After you’ve been starting Betaferon it will take 2-3 months until the drug is definitely effective. During that period I would suggest to continue hydrocortisone. After 3 months you are advised to lower the dose hydrocortisone 20, 15, 10, 5, 0 within the next 3 months. To my opinion you are not in need of hydrocortisone after Betaferon works optimally.
The drug provigil/modafinil is known. It’s only to prevent fatigue. It does not influence the use of hydrocortisone or betainterferon at all.
- Consultant:
- Dr E.A.C.M. Sanders, neurologist