Doctor insights on:
Glucocorticoid Taper For Adrenal Insufficiency
Which is the better steroid replacement, prednidone or cortef (hydrocortisone)? For secondary adrenal insufficiency.
I like Cortef (hydrocortisone) best: For adults it's a personal preference, but Hydrocortisone (cortef (hydrocortisone)) gives more physiologic steroid hormone replacement. Doses much easier to adjust, though trade-off is taking 3 times/day because 1/2 life is shorter than prednisone. Prednisone is much stronger than Hydrocortisone so it's easier to get cushingoid taking it, especially because dose can't be manipulated as finely as with cortef (hydrocortisone). ...Read moreSee 1 more doctor answer
Chronic adrenal insufficiency. You may consult this site for more information on this topic. http://www.mayoclinic.org/diseases-conditions/addisons-disease/home/ovc-20155636 For good health - Have a diet rich in fresh vegetables, fruits, whole grains, milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Drink enough water daily, so that your urine is mostly colorless. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco, alcohol, weed or street drugs in any ...Read more
Can Beconase (beclomethasone) reduce adrenal androgens? I have salt wasting congenital adrenal hyperplasia. Thank :-)
Yes and no: They are often, and incorrectly, used interchangeably. Hypocortisolism is low cortisol, no matter what the cause. Hypoadrenalism is a general term which does not specify which hormone or hormones are low. Adrenal insufficiency means a deficiency in all adrenal hormones, but is incorrectly used to refer to low cortisol levels. Pituitary deficiency can cause low cortisolare you now properly confused. ...Read more
No: No it should not if the tapering is done properly. ...Read more
Schmidt's: If a person is discovered to be severely hypothyroid, it is dangerous to treat it aggressively until it's been determined that adrenal insufficiency (as in schmidt's) is not also present. The jump-start that the body gets when the thyroid replacement kicks in can kill the person if there's not enough adrenal cortisol . If i've misunderstood your question, please forgive me. ...Read more
For patients with partial adrenal insufficiency, does hydrocortisone replacement of 20-30 mg daily cause iatrogenic cushings given that the pituitary and adrenals still function to some degree?
Depends: It really depeds what you mean by cushings. You may get some of the characteristics..Weight gain, immune dysfunction, but the classic physical signs are likely absent. The dose of 20-30 mg of hc is actually a bit above the "physiologic " dose of hc that would be similar to what the adrenals normally produce. As a result, the pituitary/adrenal are essentially shut down. ...Read moreSee 1 more doctor answer
Adrenal cortex: The adrenal cortex makes lots of hormones. Very important are cortisol and aldosterone which help maintain life and salt balance. Addison's disease is caused by adrenal cortex damage rendering it unable to make these hormones anymore, mostly autoimmune cause in us. Patients often have a bronzed look. Hydrocortisone replacement is a lifesaving necessity. Fludrocortisone may also become necessary. ...Read more
Stimulation Test: Cortisol levels vary widely between individuals, and by time of day and are affected by illness. So random levels may not be helpful. A stimulation test with an injection of Cortrosyn to make the adrenals release cortisol is used. Blood is drawn just before, and 30 and 60 minutes after the Cortrosyn injection. Stimulated levels above 18-20 usually indicate normal adrenal function. ...Read moreSee 1 more doctor answer
I have adrenal insuff (long term steroids/crohn's) am tapering off dex but can't get below 0.25 mg. Any tapering tips to awaken adrenals?
Adrenal insuff due to long term steroids (crohn's). Am tapering off dex but can't get lower than 0.25 mg. Any tips?
Will require it fore: Will require it forever unless new agent discovered. ...Read more
Yes: Yes it will.Get a more detailed answer ›
No: An adrenal adenoma is a benign tumor of the adrenal gland. It typically causes no complications. Someimes these tumors become "active" or "functioning" producing hormones, often in excess of what the adrenal glands typically produce. This excess of hormones can cause primary aldosteronism, Cushing's syndrome and other medical conditions. They do not stop hormone production.once functional. ...Read moreSee 1 more doctor answer
Is adrenal insufficiency after pituitary tumor removal permanent? How long before most usually gain pituitary function for acth back?
Not exactly: Addison' s disease is a state of adrenal insufficiency but not vice versa as there are many other causes besides ad ( an autoimmune disease) that can lead to cortisol deficiency state such as tuberculosis of the adrenals, hemorrhage of the adrenals, certain genetic storage syndromes and hypopituitarism. ...Read moreSee 1 more doctor answer
What is considered a "physiologic dose" of hydrocortisone when supplementing for adrenal insufficiency?
Physiologic: This is a dosage which will provide serum and tissue levels sufficient to replace the normal cortisol concentrations without added supplements. It will vary with the degree of adrenal insufficiency and will be regulated by measuring cortisol levelsin the patient. ...Read moreSee 1 more doctor answer
Addisonian or acute adrenal crisis is a life-threatening condition that occurs when there is not enough cortisol, a hormone produced by the adrenal glands. It can manifest with fatigue, nausea, poor appetite, fever, joint pain, fatigue, coma, or seizure. Addison's disease is usually treated ...Read more
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