If you are diagnosed AI, you have low cortisol.
The issue is that replacements are not perfect in that they cannot react to the body's needs, so generally one must take a bit more daily than you need, and that adds up over time, giving us the oversight problem.
There is a time release low dose replacement in development. It is available in some countries but not the US.
If you have not seen your endo, you should as it sounds like your dose could be adjusted down as your symptoms are consistent with steroid induced Cushing's. That would lower your thyroid.
As for diet, you need more salt than most people. Depending on you past test results, you may need to avoid potassium rich foods when you are not feeling well. In general, with AI, you have to be consistent. Consistent with your meds, how and when you take them. Diet should be healthy but what is healthy for us is high sodium.
I generally do best on a low carb diet as sugar is an issue for me - but you have to figure out what is the best for you.
thanks for the reply rumpled so if i was initially diagnosed with AI but with taking the hydrocortisone for years is there a chance that i may be now high cortisol ?
Because i get confused my symptoms seem to be made worse by exercise. the less excercise i do the better i seem to look, sleep is also a big part if i get a good sleep i can look thinner the next day if it is cut short i look bloated and unwell.
I would never had thought salt as i generally hate the stuff and have always avoided it all my life that and vinegar.... and i was always one to believe the body will tell you what i wants and salt has never been a craving.
and also stayed clear of salt because of hearing about water retention ?
what about exercise, i feel like when i exercise that it does things to me hormonally, i find that depending on the exercise it can cause me to have erection problems not being able to get one at all never mind maintain onebut when i stop exercising for a few days they return to normal.
Jogging/cardio seems to the be the worst culprit, lifting wieghts is fine aslong as i don't over do it, and walking seems to be the best for not messing with my hormones at all but is useless for losing and keeping off fat for me.
So what i'm geting confused it if i have issues with low cortisol then surely exercise that increaes cortisol should be a good thing ? yet it makes me feel and look worse and makes me gain weight.
AI is a salt wasting disease.
If you have AI and you exercise, you are still abnormal and will not produce cortisol under stress - any stress - so that will simply bring you down, not increase your cortisol production. AI means you don't produce your own cortisol, and certainly when you don't need it.
Are you familiar with stress dosing, and with the symptoms of a crisis? Do you know what to do when you are sick, and how to deal with a crisis? How to avoid one?
Summer is the worst for me as sweating means a loss of sodium. I have low BP and it can drop me into a critical low.
What is your dose, and when do you take it? How do you divide it? How you dose is important and consistency is important. HC is great as you can mimic a normal body pretty closely. Normally one takes the bulk of their dose on waking 7-8am, then a small dose, say 5mg between 2-4pm. This would keep dosing consistent with a normal diurnal rhythm.
If you dose too late, you may not sleep well and the body may not recover bone, muscle etc. If you take too much overall you can have steroid induced Cushing's.
For those of us with AI, salt is necessary! I even take an additional medication to hold sodium.
Were you diagnosed AI with a stim test? Have you been monitored lately?
Many with AI are not very tolerant of exercise. I know I cannot.
God you are so helpful rumpled, damn lot more helpful than my docs!
I was initialy diagnosed with a prolactinoma with secondary hypo gonadism, cortisol insufficiency, low test, low thyroid.
i think basically that i was low in everything because of the tumor, and since then have been on 10 mg HC in the morn and 5 mg at lunch. and cabergoline twice a week.
The reason i'm so confused is because i show symptoms of high cortisol esp if i jog, i blow up in the face and abdomen and look like a balloon.
Exercise seems to make me worse than better i actually put weight on and sometimes i just collapse into a deep sleep for days, by that i mean all my energy suddenly disappears and i stay in bed for days sleeping then i have energy back all of a sudden then repeat but i'm sure that aint a good thing.
would you recommend a good diet, exercise plan and supplements for me ?