why prednisone and not hydrocortisone?
by jdrtwin1, Apr 12, 2009
I was just wondering why my doc has me on prednisone for my adrenal insufficiancy and not hydrocortisone?  
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Member Comments (22)
by stella5349Blank, Apr 15, 2009
Well it does have most of the same components for adrenal repair as HC does - but the side effects of Pred are icky as far as I am concerned.

by jdrtwin1, Apr 15, 2009
they are icky...i've gained 20lbs in 5 months, grown facial hair and haven't had a good night's sleep in months which has led to depression and anxiety issues.
by rumpledBlank, Apr 17, 2009
Pred is a medium acting, long term steroid. It has a long half life. It can last longer than a day. So the body never rests - hence more side effects.

HC is a short term, fast acting steroid. It has a short half life. It allows the body to more closely mimic the natural diurnal rhythm if taken correctly (I will say, it is inconvenient) and is more like what the body makes itself.

They have finally developed a long acting HC, duocort, that will be available sometime soon and it will mimic the diurnal rhythm without the side effects of pred - so once a day dosing.

Look for a steroid calculator and you can see what I mean about half lives and all.
by boochay, Apr 25, 2009
I am on 20 mg prednisone for a year and hate it . my blood work still comes up low cortisol .
any idea if that is normal if you are on prednisone? does this mean I need more steroid?

can you detox off prednisone with hydr cortisone or corteff?
by jabele, Jun 08, 2009
yaeh, that seems excessive. You don't want to be on that much steroids if you don't ABSOLUTELY need to be because steroids are an immunosuppressant. I've having trouble w/ that taking 20mg a day of hydrocortisone which is less potent than pred.
by rumpledBlank, Jun 14, 2009
20mg of HC = 5mg of pred so your doc has you on 4 times the normal dose that a body needs. 20mgs is around what a normal person takes. Unless you have other health problems that require you to need more pred, you are eating your bones, muscle, eyes etc. It may not happen today - but it will happen in the future.

Why your blood work comes up low could be timing (pred takes a few hours to kick in, hence why it is not used in an emergency but with the half life, you stack dosing, another reason it is not great), lab error, or it can depend on what tests you are doing.
by quizshow904, Dec 04, 2009
I have adrenal insufficiency(as of 3 months ago) and just went from 25mg / day of hydrocortisone to 5 mg of prednisone. This is long term, at least 6 months, till we run tests again. My Endo feels that I was miss diagnosed as having Addison's. We'll see.
by inwardgranny, Jun 28, 2010
i'm taking both 40mg of predisone in the morning and 20mg of hydrocortisone at night. is there a reason why you can't take them both. i also have meniere ear which the predisone helps and my seg rate is high so i might have some other autoimmune disease. but i know this is working for me. i'm not swelling anymore taking them both.
by rumpledBlank, Jun 28, 2010
Well, you can take them both but it is very very hard on the body. Your 40mg is pretty high - as said before, 5mg is enough to shut down and replace adrenal function. Pred lasts 24-36 hours, so I am not sure why your doc is making you take HC at night unless he really really does not want you to sleep? A person who takes HC to live, like me, avoids taking HC anywhere in the afternoon so that they can sleep - the body needs to have a period of time off steroids to repair muscle, bones, etc. I would get a dexa scan and monitor your bones.

Usually pred is prescribed in the case of diseases like arthritis, ms, asthma, etc. where you need anti-inflammatory action to last. As you do not appear to be developing Cushing's symptoms, you must be *using* the steroid but many of the effects may be hidden in your eyes, bones and muscles.