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Secondary adrenal insuffiancy
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Secondary adrenal insuffiancy

Hello
I have a low ACTH level therefore a low cortisol level and secondary adrenal insuffiancy. I had gotten down to 3mg of prednisone every other day and was doing ok when my endocrinologist changed me to HC and I had a crisis two weeks ago. Back on pred now but had to increase my dose due to poison ivy outbreak. I was wanting to know how quickly I can cut my dose. I am currently at 10mg daily and had to leave work early because of my low blood pressure. I went from 20mg to 10mg just wondering if maybe that was too big of a cut at once in my case?
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I am only a patient - but that is a hefty, fast cut. Weaning is best done in increments.

If you are having issues with low blood pressure, has the doctor tested your sodium, potassium, renin and aldosterone? Perhaps you need florinef aka fludrocortisone? That will help keep out of trouble without high doses of steroids. My doctor also suggests adding salt to my diet and I take salt tablets to keep my BP up. You may need to see a cardiologist as well.

The florinef can help you stay out of crisis as you will retain sodium.

You can wean - but make sure you increase your sodium and I would not make large cuts fast. Even though pred is long acting, you may be using it.

A normal replacement dose of pred is 5mg - why are you shooting for 3mg? Do you have steroid induced Cushing's?
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