Question: I am trying to taper my replacement dose of hydrocortisone, but I am having difficulty tapering due to a rapid heartbeat which happens when standing and during stress. My AM cortisol is 9nmol/L. Is this normal during tapering? Should I increase my dose? Answer: Your very low cortisol levels indicate that your hypothalamic-pituitary-adrenal (HPA)… Continue Reading
Author Archives: kkc
Permanent Steroid Replacement and Nelson’s
Question: I had unsuccessful pituitary surgery and then had a bilateral adrenalectomy. I am feeling better, but have not been able to lose any weight. My maintenance dose is 37.5 mg per day of Cortef, which I understand is on the high end of replacement doses. My endocrinologist doesn’t think it is wise to decrease… Continue Reading
Osteoporosis and long term steroid replacement
Question: I have been on replacement cortisone following surgery for over 20 years. Are there health problems related to long term replacement that my doctor and I should watch for? Answer: Patients who have been on long term glucocorticoid (cortisone) replacement may be at risk for development of osteoporosis. Over-replacement with cortisone is quite common… Continue Reading
Low Blood Sugar and Steroid Replacement
Question: I am on permanent steroid replacement following a bilateral adrenalectomy and was recently changed from Hydrocortisone 10 mg two per day to Prednisone 5 mg at bedtime because of a low morning blood sugar and elevated ACTH. I am now having trouble sleeping. Is this a common problem? Answer: The suggestion here is that… Continue Reading
Increasing Steroid Replacement During Illness
Question: I have heard that Cortisol suppresses the immune system. Why is it that I need to increase my Cortisol when I am sick? This seems like the time that one would not want to suppress the immune system. Answer: This is a good question. Cortisol in high doses and chronically, and the key here… Continue Reading
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