Why Are Intermediate Hormones Being Prescribed Instead of Direct Cortisol Replacements?

Posted on July 19th, 2016

The world of medicine has been directed since 1948 by some very prominent medical brothers that said the use of cortisone acetate may be very damaging for a patient and not indicated, even though endocrine immune levels were not tested.

Today’s medical profession has the ability to test for these imbalances, but unfortunately their medical teaching vectors have  definitely directed them away from the actual use of a cortisol supplement by instead using intermediate hormones, even if the patient has been identified with having a cortisol imbalance.

What I think the medical profession has forgotten is that human and animal patients need to produce at least 30 to 35 ng/dL of daily natural cortisol from their middle layer adrenal cortex, in order to be able to regulate their immune system and survive their environment.

This seems not to be realized just yet by the medical profession.

The human and animal body’s ability to produce natural cortisol from the middle layer adrenal cortex (zona fasciculata), in my opinion, is the Achilles tendon of the body.

What is occurring with the medical profession, because they believe that using a cortisol supplement directly is improper, has gone out of their way to use intermediary hormones that are thought to replace the need to use a cortisol supplement.

Let’s examine where these intermediary hormones come from.

These intermediary hormones occur with the proper enzymatic transfer that is assumed to be present in every patient that is treated with intermediary hormones, but this may not be the case. It needs to be realized that a patient may not have the proper enzymes to make these transfers.

I think what must first be understood is that the endocrine system regulates the immune system, and that the normal production of cortisol is vital for survival, and when it is deficient or defective, many differ diseases may occur.

The day is here when the cause of disease must be identified besides merely trying to treat the effects of disease.

Cortisol regulates the immune system daily, and when the cortisol is broken down by the liver and excreted by the kidneys in a 24 hour period, the hypothalamus is stimulated in a negative feedback mechanism to release its cortico-releasing factor (CRF), which in turn stimulates the pituitary gland to release its ACTH, which causes the middle layer adrenal cortex to respond and release more natural cortisol.

When this happens, the immune system remains regulated and creates the immune protection that is required for the body to survive and remain healthy.

When this does not happen, the inner layer adrenal cortex will respond to the pituitary ACTH, and produce elevated amounts of adrenal estrogen.

The elevated amounts of adrenal estrogen will not only bind the receptor sites for T3 and T4, but will cause the deregulation of the B lymphocyte, which will no longer produce proper antibody protection for the patient, but the elevated adrenal estrogen will cause a deregulation of the T-lymphocyte, which will no longer protect the patient against viruses and molds and fungi, like candida.

Once this deregulation occurs, the immune system will also lose recognition of self-tissue and will cause autoimmune diseases, including cancer and early aging.

Hopefully, realizing this normal, regulatory mechanism is in place, it is time to examine the use of intermediary hormones, even if you as a health care professional are trying to avoid the use of a direct cortisol supplement.

Please realize that intermediary hormones come from cholesterol.

The following is a sequence of intermediary hormones, and with proper enzymatic transfers, will allow these intermediary hormones to progress and reach their final destination, which is usually cortisol.

Without the proper enzymatic transfer cycles, the intermediate hormones cannot complete their enzymatic transfer to prednisolone and finally fund the patients’ bodies need for cortisol.

The following intermediary hormones, need to be considered and determined if they are created, and if they will reach their final destination.

The following, indicates the intermediary, enzymatic progression:

Cholesterol > Pregnenolone > Progesterone > Prednisolone, which funds a cortisol imbalance.

But for this progression to occur, there needs to be complete enzymatic transfer cycles to be present and working.

When there is a deficiency or defect in one or more of these enzymatic transfer cycles, and if a cortisol imbalance has been identified, the cortisol imbalance will not be completed and corrected, and the imbalance will continue.

My clinical studies in animals and in some human patients, has identified a test that will indicate whether the intermediary hormones are actually funding the negative feedback mechanism to the hypothalamic pituitary axis and properly regulating the immune system.

This can be accomplished by measuring the levels of cortisol, total estrogen, total T3 and T4 and IgA, IgM and IgG.   

The following are medical thoughts you may need to think about when considering the use of any intermediary hormone, especially if your patient is suffering from acute allergies, autoimmunity or cancer.

1) If your patient has this endocrine immune imbalance, and you find your intermediary hormones are not working, please consider the fact that your intermediary hormones may not be transferred into active cortisol, because the patient lacks the proper transferring enzymes.

2) If your patient, has elevated cholesterol, please first measure your patient’s cholesterol and cortisol, in order to make sure that your cholesterol lowering drug is also not lowering you patient’s ability to produce cortisol and causing your patient to develop an endocrine immune imbalance.

3) Some patients will be able to process pregnenolone into progesterone, and then into prednisolone, which will fund their cortisol imbalance, but only if their enzyme transfer cycles are present, while other patient cannot respond to this kind of replacement therapy, because the patient does not having the proper transference enzymes in order to complete the cycle into cortisol.

4) DHEA is often prescribed as an intermediary hormone for the production of cortisol, but in reality, if you consult with major published, hormone endocrine cycles, they will indicate that DHEA can either go to more cortisol or to more estrogen.  Therefore, when using DHEA in a patient, it would be best to measure both cortisol and total estrogen before and after using DHEA, to determine if the DHEA is accomplishing the purpose you are using it for.

5) Testosterone is often prescribed, but what needs to be remembered is that the aromatase enzymes in the fatty tissue and other tissues of the body have the ability to transfer testosterone and female androgen into more estrogen.

If you are going to prescribe a testosterone injection or a transdermal for your patient, it is important to first measure testosterone, cortisol, and total estrogen.

If the testosterone level of your patient increases and the cortisol and total estrogen levels stay the same, the supplement is necessary for your patient, and will fund the deficiency you are trying to correct.

However, if the estrogen level increases and the testosterone level does not, supplementing testosterone may only hurt your patient.

Malabsorption of any replacement hormone, whether intermediary and oral, may also depend on whether there is a presence of an IgA deficiency, food allergy or trypsin deficiency.

These are only my thoughts and I hope they will help make a difference for your patient.


Dr. A. J. Plechner