Just diagnosed with empty sella, pit. atrophy and adrenal insufficiency. I gained 20lbs rapidly and am full of fluid. Blurred vision and headaches. I was given prednisone 2.5mgs. 2x daily. When I take only one pill [2.5] I have episodes of hot/sweating, dizzy spells,frequent urination, chest pains, worsening rapid heart rate with fluttering, stomach cramps, over acid stomach/reflux and distention,feelings of fear etc...My doc has told me hydrocortisone is for bad adrenals and mine is pituitary and it binds salt, so I need pred. I have low sodium and low bp and temps which are now all over the place too. A fever, then 5 min later, low. Also, Hashimoto's and low thyroid and on Armour. Please, advise. What can I do?
HC is the preferred replacement - it is chemically most like what the body makes - and since the half-life is short, it can be manipulated to mimic a normal diurnal rhythm.
Pred and dex have longer half lives and doses can *stack* where you actually still have some in the body when you take the next dose. I have not personally heard of taking pred in the afternoon for replacement purposes (as it can last up to 36 hours). You can eat with it to help avoid stomach upset.
If you have low sodium, then the normal course of action is to add fludrocortisone - florinef - a minercorticoid - so the body holds on to the sodium (I take salt tablets as well) to avoid having a crisis. After all, a crisis is low sodium.
Any corticosteroid can cause the adrenals to suppress - and the longer acting ones tend to be more of a problem.
It can cause AI (temporary or permanent) or even Cushing's (steroid induced - and in those that have tumors unknown, kick off everything).
I am not a fan of steroids either.
Steroids are a necessary evil in the treatment of SAI. What else am I supposed to take? Yes, they will suppress my adrenals, but what does it matter! My pituitary doesn't tell them to work anyway. They will/have atrophied over time with no signal. You say " cause adrenal fatigue" that is nothing compared to insufficiency. I wish I only had fatigue!
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