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Doctor insights on: Glucocorticoid Taper For Adrenal Insufficiency

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Which is the better steroid replacement, prednidone or cortef (hydrocortisone)? For secondary 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 more

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Dr. David Geffner
261 doctors shared insights

Addison's Disease (Definition)

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


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Hypoadrenalism, hypocortisolism and adrenal insufficiency.. Is it the same?

Hypoadrenalism, hypocortisolism and adrenal insufficiency.. Is it the same?

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

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Will T3 (liothyronine) cure adrenal insufficiency?

Will T3 (liothyronine) cure adrenal insufficiency?

No: Adrenal insufficiency is the result of the failure of the adrenal glands to make cortisol. T3 (liothyronine) will not treat adrenal insufficiency because it is a thyroid hormone. ...Read more

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Why thyrotropin used cautiously in adrenocortical insufficiency?

Why thyrotropin used cautiously in adrenocortical insufficiency?

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

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Is primary adrenal insufficiency the same as addison's disease?

Often, yes: Addison's disease is an autoimmune disease which harms the cortex of the adrenal glands. However, anything that damages the adrenal cortex can also cause primary adrenal insufficiency. ...Read more

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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?

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 more

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How is adrenal insufficiency treated?

HRT: Hormone replacement: Hydrocortisone (some use Prednisone or dexamethasone) possibly Fludrocortisone in addition. These are given orally to replace the cortisol and aldosterone no longer made in sufficient amounts. ...Read more

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What is primary adrenal insufficiency (addisons disease)?

What is primary adrenal insufficiency (addisons disease)?

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

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How is adrenal insufficiency diagnosed?

How is adrenal insufficiency diagnosed?

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 more

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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?

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?

Slowly: An endocrinologist can assist you with this, but tapering off of long term steroids in the setting of adrenal insufficiency may take several months. Hopefully there will be fewer patients exposed to long term steroids in the future. ...Read more

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How do multiple steroid shots effect cortisol level and adrenal functioning?

How do multiple steroid shots effect cortisol level and adrenal functioning?

Cortisol shots: Cortisol shots will increase your blood cortisol level and look after your adrenal glands. Please go online and look for "cortisol shots" - you will learn a lot. Take your time reading the several articles. ...Read more

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Can a adrenal adenoma stop functioning?

Can a adrenal adenoma stop functioning?

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 more

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Is adrenal insufficiency after pituitary tumor removal permanent? How long before most usually gain pituitary function for acth back?

Sometimes: It is really quite variable when the pituitary function restarts after the operation. It often depends on how much was removed. Unfortunately, sometimes it is permanent. Check with your neurosurgeon for more details. ...Read more

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Is adrenal insufficiency the same as addison's disease?

Is adrenal insufficiency the same as addison's disease?

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 more

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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 more

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Dr. Chad Levitt
131 doctors shared insights

Addisonian Crisis (Definition)

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


Dr. Cayce Jehaimi
381 doctors shared insights

Adrenal Insufficiency (Definition)

Adrenal insufficiency is either an absent or abnormally low production and/or secretion of hormones produced by the adrenal gland. Hormones produced by the adrenal glands include those involved with salt regulation, sugar metabolism, and sex hormones ...Read more