Question: I am 51 years old and have Cushing’s Disease due to a pituitary tumor that was removed 5 weeks ago. I presently take 30 mg of hydrocortisone a day. Last week I had an ITT test and coincidentally later that day got a virus and had to go to the hospital. I was given iv cortisol. For 3 days I took 90mg hydrocortisone, 3 days 60mg and then back to the daily prescribed dosage of 30mg. The Doctor said I should get a flu shot this year. I’ve never gotten a flu shot before. Do you agree that this is a good idea? Will I get sick from it and have to increase my hydrocortisone again?

Answer: Generally, patients that are on replacement hydrocortisone should get a flu shot. If one is on replacement and does get the flu, hydrocortisone doses need to be increased quickly. Getting a flu shot can prevent catching the flu, thus the need to increase replacement doses. Also, in general those on replacement hydrocortisone should have the regular flu shot which is a dead form of the virus rather than the live form that is offered in nasal sprays. The only caveats are warnings about allergic reactions and a history of Guillen Barre. These questions are in the form patients are asked to complete before getting the shot. Without a history of these reactions, the shot is safe, you should not get sick from the flu shot and should not need to increase your replacement dose.

By Dr. David Schteingart MD (Winter, 2009)