Question: I have been on permanent replacement hydrocortisone for many years. Is there a need to increase or decrease my replacement dose as I age?

Answer: This is a very good question. There is no literature that I am aware of that has addressed this specifically. However, as we age, we are at higher risk of type 2 diabetes, hypertension, and osteoporosis, all of which may be worsened by excessive steroid replacement therapy. Therefore, in older individuals it is even more important to use the lowest dose of glucocorticoid replacement that still maintains good quality of life.

By Dr. Roberto Salvatori, John Hopkins Pituitary Clinic, Baltimore, MD, Spring, 2016