20mg will completely replace the function of the adrenal glands so that they are suppressed. So if you are going to reduce or go off that dose, you have to wean or taper off carefully so that adrenals wake up.
Usually people are diagnosed by a doctor and are on the medication for a reason - either short term for an illness to take advantage of the anti-inflammatory properties of the corticosteroids, or long term in which case you just keep taking them and the adrenals atrophy. The *need* is determined by the illness treated. Adrenals do not fatigue - replacing them only causes them to atrophy. They are built to last a lifetime just like the rest of your body and the only issue arises if they are diseased - just like the rest of your body. In that case you take the med to replace the function.
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