DR. PAUL MARGULIES' GUIDELINES
REGARDING CORTISOL STRESS DOSING
FOR ADRENAL INSUFFICIENT PATIENTS
Extra 5 mg of hydrocortisone for mild stress, such as a mild cold without fever, a mild
injury, or emotional stress.
Extra 10 mg for infection with mild fever.
Double the usual dose for significant fever or any illness that includes vomiting,
diarrhea or dehydration.
All these doses should be continued until the stress has diminished. Then return to the
normal dose without a need to taper.
If vomiting or dehydration cannot be controlled, or there is a severe illness or injury, go
to the nearest medical facility for intravenous steroids and saline.
Distributed courtesy of: National Adrenal Diseases Foundation (NADF)
505 Northern Blvd., Suite 200
Great Neck, NY 11021
NADF does not engage in the practice of medicine. It is not a medical authority, nor does it claim
to have medical knowledge. In all cases, NADF recommends that you consult your own physician
regarding any course of treatment or medication. .