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hyrodocortisone replacement
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hyrodocortisone replacement

I'm sorry to ask this question again, because I'm sure it's been asked and answered before, but I did a search and really couldn't find what I was looking for.

I'm going to have surgery to remove an adrenal tumor, and the endo prescribed replacement hydrocortisone following the surgery. I understand I will have to take steroid replacement as the other adrenal gland is likely non-functioning, and hydrocortisone appears to be the best choice for replacement.

My questions are this:

The amount of hydrocortisone the endo prescribed appears to be 10mg tablets, with instruction to take 2 tabs in morning and 2tabs in afternoon. That is 40mg/day.

I thought the usual Rx replacement was 20mg/day.

Is the larger amount she prescribed because I will be having the surgery?  If the larger amount is due to the stress of surgery, how long should I expect to take this higher amount? I'm sure I will get guidance from her, but after reading so many posts here about doctors who don't know their stuff, I'd like to get as much information as I can from people who "live" it.  

In your opinion(s), how soon could I reasonably start to taper to try to "wake-up" the other adrenal gland?

And lastly, I know it's based on how I feel, but rumpled, you have suggested in another post, that a good way to taper is to go down and then back up, and then back down, every couple of days.

I can't find that post, so if you'd direct me to it, I would appreciate it, or if you would repeat your recommendation, that would be terrific.

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She could be giving you extra for stress dosing - in other words, padding the script. As you always need some extra for stress dosing. I hope that the script is padded for stress and for weaning... otherwise that is a lot. You may need a tad extra for healing but if you take that much for too long, you won't recover... you will get Cushing's.

Somewhere around 20mg is a normal dose for most. As for tapering after surgery - that can depend on the doctor. After all, I had my adrenals out and I left the hospital in 4 days on 25mg. But I had a hysterectomy and the doc dosed me on 100mg every 8 hours for days and after a while, man, I was crawling the walls. They then dropped it to 50mg and then I had to taper it down when I left the hospital. So you have to know how the doc is going to treat you in the hospital and then decide how to taper from there. Since you are recovering AND trying to wake and adrenal, you need to take it easy IMHO...

There are two methods to taper - to taper slowly directly and the other way is if you have problems, to bounce a bit and go up and down a bit to go down. Just take your time and get a pill cutter to slice and dice.

Recover fully from the surgery before you taper below 20mg.
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