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
Category Archives: Doctor’s Answers
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
Illness and Dose Increases
Question: What changes should be made to replacement medications during illness? Answer: For minor febrile illnesses, like the flu or other viral illness, use the “three for three” rule. This can be done without notifying your endocrinologist. Increase your dosage to three times the maintenance dosage for three days, while doing all the other things… Continue Reading
Steroid Replacement and a 24hr Urinary Cortisol Test
Question: Does a 24-hour urinary cortisol measurement give any information on whether a patient without any adrenal glands is taking the correct amount of replacement hydrocortisone? Are there other tests that can be used to determine the correct replacement dose? Answer: For the most part, adequacy of the hydrocortisone (glucocorticoid) dose is judged by clinical… Continue Reading
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