Aa
Replacement Steroid
I would like to know how it is possible to know when is a good time to begin to taper from replacement steroids? (following an adrenalectomy and trying to stimulate the other adrenal gland to begin functioning again).
Is it a matter of time? That seems arbitrary.
Is it a matter of some test for cortisol level? Not sure if there are any tests that would be accurate while on a steroid replacement.
Also, in addition to the replacement steroid, currently Rx'd at 40 mg per day (20mg AM and 20mg early PM) should I ask for an emergency/stress steroid? Or is 40mg considered to be a stress level/amount because of the stress of surgery?
Is it a matter of time? That seems arbitrary.
Is it a matter of some test for cortisol level? Not sure if there are any tests that would be accurate while on a steroid replacement.
Also, in addition to the replacement steroid, currently Rx'd at 40 mg per day (20mg AM and 20mg early PM) should I ask for an emergency/stress steroid? Or is 40mg considered to be a stress level/amount because of the stress of surgery?
Yikes, I don't know what happened, but this afternoon I feel like ***t.
Is there a rebound effect from the stim test?
I'd swear I was having a hot flash, but I also had a bit of dizziness and felt a little queasy. So I took 5mg of HC, I feel a little bit better but not much. I'm wiped out, the same way I would feel after a really bad, long panic attack. ughhh.
Is there a rebound effect from the stim test?
I'd swear I was having a hot flash, but I also had a bit of dizziness and felt a little queasy. So I took 5mg of HC, I feel a little bit better but not much. I'm wiped out, the same way I would feel after a really bad, long panic attack. ughhh.
Well, I just finished the stim test this morning, therefore I should know the results in a couple of days.
By the way, I took 5mg of HC on Sunday, 0mg on Monday, took the test Tuesday morning, so any cortisol present should definitely be ALL me.
If there were a problem or deficiency, I think I'd have more symptoms without HC. So by not taking it, and feeling fairly good, I think that means my right adrenal is functioning again.
The results will tell the true story of course.
By the way, I took 5mg of HC on Sunday, 0mg on Monday, took the test Tuesday morning, so any cortisol present should definitely be ALL me.
If there were a problem or deficiency, I think I'd have more symptoms without HC. So by not taking it, and feeling fairly good, I think that means my right adrenal is functioning again.
The results will tell the true story of course.
Yeah for the stim test you are supposed to fast and I think my doc said (it may have been another stim test) not to do a lot of physical activity the day before.
If you have not been nauseous or anything - that is great. The low BP is cruddy - but do make sure you have enough water. Water itself can help raise BP...
You can't do just an 8am test as cortisol can vary and a point in time test can miss. The stim puts the adrenals under stress so will tell the doc if you can be off meds for sure. The test is not the most pleasant - make sure someone takes you there and home but most are ok, some can get sick just from the stress agents (after all, they are stressing the body). They differ in agents now - some use glucagon, some use other agents.
If you have not been nauseous or anything - that is great. The low BP is cruddy - but do make sure you have enough water. Water itself can help raise BP...
You can't do just an 8am test as cortisol can vary and a point in time test can miss. The stim puts the adrenals under stress so will tell the doc if you can be off meds for sure. The test is not the most pleasant - make sure someone takes you there and home but most are ok, some can get sick just from the stress agents (after all, they are stressing the body). They differ in agents now - some use glucagon, some use other agents.
This thought just came to me, wouldn't it be sufficient to have just an 8am serum cortisol test to determine if my right adrenal was functioning?
If I didn't have any HC since the morning before at 6am, and then just a small dose at that (5mg), wouldn't the serum test 26 hours later be all internally produced cortisol? And wouldn't that be sufficient to show function.
I was just curious as to whether I really needed the stim test. If I really don't have to take it, I'd probably prefer not to, aren't there side-effects?
If I didn't have any HC since the morning before at 6am, and then just a small dose at that (5mg), wouldn't the serum test 26 hours later be all internally produced cortisol? And wouldn't that be sufficient to show function.
I was just curious as to whether I really needed the stim test. If I really don't have to take it, I'd probably prefer not to, aren't there side-effects?
Just a quick update. No results back yet from the path report on tumor secreting status. Maybe I will have that information on Monday, but it won't matter one way or the other. I'm going to do a stim test monday morning.
The endo doesn't think I'm in any danger of adrenal crisis and agrees that I can continue to taper. I'm not sure why she is so positive, but I have to trust that I would have far more symptoms if my body was struggling with this.
So today I took 10mg this morning and skipped the afternoon. I'll try the same Saturday and maybe drop to 7.5mg on Sunday morning just to make sure I'm not going to crash on Sunday.
I'm feeling pretty good so far, but I have forced myself not to do anything taxing. And I'm watching for ANY change. I've got my fingers crossed for Monday.
But gee-whiz, you really have to watch these doctors. I asked if I should fast for the test and she said no it didn't matter either way. But later on I checked. The test says you should fast. Go figure.
The endo doesn't think I'm in any danger of adrenal crisis and agrees that I can continue to taper. I'm not sure why she is so positive, but I have to trust that I would have far more symptoms if my body was struggling with this.
So today I took 10mg this morning and skipped the afternoon. I'll try the same Saturday and maybe drop to 7.5mg on Sunday morning just to make sure I'm not going to crash on Sunday.
I'm feeling pretty good so far, but I have forced myself not to do anything taxing. And I'm watching for ANY change. I've got my fingers crossed for Monday.
But gee-whiz, you really have to watch these doctors. I asked if I should fast for the test and she said no it didn't matter either way. But later on I checked. The test says you should fast. Go figure.
I have swollen ankles, they look nad feel like tree trunks, my neck and face seem puffy, like a cushy face, my middle is definitely bigger!
I have been eating a ton of salt, because of the low blood pressure. But I have been drinking more water. Maybe with all the salt I still need more water. It could be the salt making me retain water. I'll keep monitoring my BP and maybe cut back on the salty stuff.
I did ok on 15mg Thursday. I'm going to try the same today.
I see the endo today, and I should know if the pathology report confirms whether the tumor was secreting extra cortisol. If it was not (ughh), then my right adrenal would have been working all along and would have only been suppressed while I was on 50, 40, 30mg HC. If my right adrenal returned to functioning when I got below 20mg, then it's probably the HC I'm taking now that is making me feel like a bowling ball.
Or, it might be PMS to top it all off, but its the WORST swelling and tenderness there that I have ever felt my entire life. ahhhhhhhh
I have been eating a ton of salt, because of the low blood pressure. But I have been drinking more water. Maybe with all the salt I still need more water. It could be the salt making me retain water. I'll keep monitoring my BP and maybe cut back on the salty stuff.
I did ok on 15mg Thursday. I'm going to try the same today.
I see the endo today, and I should know if the pathology report confirms whether the tumor was secreting extra cortisol. If it was not (ughh), then my right adrenal would have been working all along and would have only been suppressed while I was on 50, 40, 30mg HC. If my right adrenal returned to functioning when I got below 20mg, then it's probably the HC I'm taking now that is making me feel like a bowling ball.
Or, it might be PMS to top it all off, but its the WORST swelling and tenderness there that I have ever felt my entire life. ahhhhhhhh
Have an Answer?
You are reading content posted in the Adrenal Insufficiency Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Even though HC has a short half life - your body is, or rather a normal body, is used to and wants some down time from steroids. That is when the body repairs itself - makes bone, repairs muscle etc. That is why HC is healthier then say, pred which lasts all day and all night - and causes more side effects.
A normal body has the greatest amount in the morning and really tapers down during the day and has little in the evening so you can sleep.
I take all my dose at once in the morning. Keep an eye on the salt though things may change now.
Congrats on the benign!!! Yippee!!! Are they going to confirm if it is hormone secreting or not?