314 miles in 9 days and the meds that made it possible

When a person has adrenal insufficiency, they are unable to produce:  cortisol, aldosterone, DHEA, testosterone (women), progesterone (some women).  If you can't maintain a good blood sugar, blood pressure and muscle mass, you can't do much.  Sometimes, people die from lack of cortisol and aldosterone.

I replace all of these hormones and thyroid hormones.  Replacing hormones while on a long run is challenging.  Knowing how to replace them takes study of medical journals, understanding of human physiology and listening to other's experiences.  Next, there's a LOT of trial and error.  Years of it.

Most of my pills are round and white.  Quite annoying because they all look the same after they've been in a back pack for a week and have been jiggled around for 250+ miles.  Good thing I can tell some apart by taste or I'd be pretty screwed taking DHEA instead of hydrocortisone.

The first three days, I did what I've done in training runs:

• 10 mg HC, .1 mcg florinef (I usually take .075 but splitting the pills that little was too much work), 12.5 mcg T3, 12.5 DHEA and probiotics
• One hour into running, I took 5 mg HC and 2 salt supplements/hour, T3 at regular times (11 am and 2:30 pm),  6.25 DHEA at 11 am also
• The last dose of T3 and DHEA were questionable because the pills crumbled up and I couldn't tell what they were for certain.
• On the really rainy day, I only took one sodium supplement/hour
• 100 mcg of T4

On the third day, I started having trouble with nausea, crying and inappropriate muscle soreness.  The third night a light bulb went off in my head, I was under replaced!  The fourth through ninth day, I took 10 mg of HC/hour for a total of 100 - 150 mg/day.  I needed it.  I did have some trouble sleeping but I do whenever I get a lot of exercise and also did on the first three nights when I was taking 50-75 mg of HC so I don't think it was the HC.

When I had my breakdowns on the road, it was almost always due to needing to eat and needing more HC.

I was very careful to stay hydrated.  On the hot days, I drank about two gallons of water.  No Gatorade.  I didn't want to drink hot Gatorade, it was just not appealing to me.  I had a few Icees.  One root beer and one gingerale.  Ice water was a treat.

If I had to do this all over again, I'd start out my adventure with 10 mg/hour of HC.  For any race under two days in duration, I'd stick to 5 mg/hour.

I was also careful to eat when I was hungry during and after the race.  When I finished my other multiday run, which was half the distance, I returned home feeling very hypothyroid.  After doing some research, I discovered that the body needs food post race to stay out of the hypothyroid state.  During my international travels immediately post race, I didn't eat much because I was too dumb to convert my money into Euros so I had no money to eat.  I bought a huge bar of chocolate and that's all I had for about 24 hours.  Gross.  I suffered when I returned home.  I took the eating thing to heart and have not felt hypo.  

If you've got any questions, please ask.