Myth #1: Cortisone is not natural.
Facts: Cortisone is a natural hormone that is made in the adrenal glands. A form called cortisol or hydrocortisone is one of the most important hormones in the human body, helping to keep us alive every day.
My conclusion: Cortisol (a.k.a. hydrocortisone) is a natural adrenal hormone of great importance.

Myth #2: Cortisone is dangerous.
Facts: Too much or too little cortisol is dangerous. Having the right amount is necessary to stay alive and healthy. Harvard-trained endocrinologist, William McK. Jefferies, MD, spent the last 50 years of his life making this point. He demonstrated that taking cortisol at levels needed to restore health and metabolism is extremely safe. 1 Many studies have supported this view.2 In fact, when the head of Rheumatology at Emory University reviewed decades of evidence, he concluded that low doses of synthetic cortisone were actually safer and more effective than ibuprofen-type medications.3
My conclusion: Dr. Jefferies was correct. Hydrocortisone is extremely effective for a wide variety of conditions ranging from autoimmune diseases to allergies to chronic fatigue and more. Side effects are generally due to excessive doses or to ignoring deficiencies of other hormones such as thyroid hormone and DHEA.

Myth #3: Cortisone routinely suppresses the immune system.
Facts: Cortisone is necessary for a healthy immune response. Too much or too little can harm the immune system. For example, Prednisone, the most common synthetic form, has only been shown to suppress the immune system at doses greater than 10 mg per day when taken over long periods.4 This equals about twice the dose of hydrocortisone recommended by William McK. Jefferies.
My Conclusion: Only excessive amounts of cortisone suppress the immune system.  Healthy levels are necessary for normal immune function.

Myth #4: There is a perfect way to test for cortisol deficiency.
Facts: Again, there is no such thing as a perfect test. Cortisol is particularly difficult to test because blood levels can vary by the minute. Some people are even resistant to the effects of this hormone.5,6 So, even “normal” levels may not be enough to keep some people healthy. In his book, Dr. Jefferies addresses this difficulty and recommends that a “therapeutic trial” is often the best approach.7 Jefferies is reported to have told his students, “When in doubt, treat the patient.”

My Conclusion: Use appropriate testing, but “when in doubt, treat the patient” and closely monitor for benefits and/or side effects.  Modify or withdraw treatment when it is not helping.

Adrenal References
1.     http://members.aol.com/jefferiesw/
2.    Wein Klin Wochenschr. 2003 Jan 31;115(1-2):6-21.
3.     Arthritis Rheum. 2001 Oct 45(5): 462-7.
4.     Arthritis Rheum. 2001 Oct 45(5): 462-7.
5.     Horm Metab Res. 2007 June;39(6):425-9
6.     J Psychopharmacol. 2006 Jul;20(4Suppl):79-84
7.     Safe Uses Of Cortisol. Third Edition. 2004. by William McK. Jefferies, MD. p 37.