Question: I recently had an episode of adrenal insufficiency and it is now suggested that I carry an emergency syringe. When exactly should I use the syringe? Answer: In a patient who has adrenal insufficiency, and normally takes steroid replacement, the replacement dose should be increased in the setting of stress (such as fever or… Continue Reading
Author Archives: kkc
Twice versus Three Times Daily Hydrocortisone
Question: I am on permanent cortisone and florinef replacement. I have heard that some people take their cortisone 3 times per day rather than twice. Is this beneficial and how would I divide my current dose of 25 mg into three doses? Answer: Patients with primary adrenal insufficiency (disease of the adrenals themselves rather than… Continue Reading
Tapering Steroid Replacement
Question: I have been trying to taper my replacement dose of Cortisone following adrenal surgery, and have ended up in the Emergency Room several times due to adrenal insufficiency. I have been told that for my adrenal gland to start working again, I need to be this low. Is that true? What tapering protocol would… Continue Reading
Stress, Replacement Steroids and Recurrence
Question: Does stress make it more difficult to discontinue replacement medication and does stress increase the likelihood of pituitary recurrences? Answer: While it is my clinical impression that patients with Cushing’s syndrome do not report more stress in their lives than patients with other medical disorders, to my knowledge, there are no data in the… Continue Reading
Steroid Replacement for Surgery
Question: I take replacement hydrocortisone and recently had surgery. I know that increased doses are required during and after surgery, but they gave me 100mg every 6 hours, which I know was way too much. How much cortisone does one really need during and after surgery? Answer: Usually the dose of additional hydrocortisone required for… Continue Reading
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