Rifampin and adrenals

Hey all-

I recently started rifampin for bartonella. My doctor suggested taking hydrocortisone 10mg during the treatment. I have read a few articles showing that rifampin can induce adrenal crisis and I assume this is why she prescribed.

I have noticed I have less energy while on rifampin but was skeptical to take hydrocortisone since its a steroid and I don't want it to suppress my immune system.

Anyone have any insight on rifampin and adrenals?

Having less energy is probably just a herx.

Symptoms of cortisol deficiency include peeing a lot (salt loss), feeling nervous but tired, sleep disruption, constipation/diarrhea (endorphin effect). Also my blood tests tended to show low B12 and increased homocysteine (as a result of increased epinephrine production).