Suffering from Low Cortisol, please help

[ill13632]

I've been suffering from exhaustion, sleep apnea, fatigue, for months now.  I've had low cortisol with these labs:
2.4mg 1pm, 4.0mg AM level
I feel much better and can rest and breathe better on 25-50mg/day of Hydrocortisone and I've been trying pregnenelone at 100-150mg/day.  Should I only be taking 25mg HC/day?  thanks very much

[ill13632]

it is really horrible, I'm crippled from exhaustion and don't know what's wrong.  I guess it's the sleep apnea and 75% oxygen

[ill13632]

but now I'm on this ventilator and I'm just trying to get the settings to work and not have the hose disconnect or take the machine mask off

[ill13632]

I'm still so exhausted and on a ventilator and oxygen.  I take the HC suppositories for another disease.  When I started taking them I felt right after great, like I could finally relax and rest like my body was on some hyper drive before and also maybe breathe better.

[rumpled]

You have to ask the pul specifically what kind.
I don't know if you have either - but with one or two test/s at one time of day - you don't have a good view of cortisol. Cortisol normal varies - and it takes a lot of testing.

[ill13632]

yes the pulm said I had inflammation, but what kind?  by the way, I don't understand why do you think I have Cushings when my cortisol is so low?

[rumpled]

It is meant to treat an inflammatory disorder, not AI - hence why it is temporary.

I am surprised the doctor is not tapering off a 10mg dose.  Pred even comes in tapered dose pack for shorter periods. I took that one of the few times I took it. Please consult your doctor and or pharmacist.

[ill13632]

I mean the prednisone makes me feel better and I can breathe better I think but still no energy left

[ill13632]

no it's just 10mg for 30days, maybe I should taper the dose now?  there are these pill cutters you can buy

[rumpled]

The doctor is not giving you a tapered dose?

[ill13632]

usually I've taken 14 days in the past- it's terrible not being able to breathe and relax!!!
you can break the tablets in half and taper the dose...

[senjin]

Any dose over 20mg HC aka 5mg of predisone shuts down the adrenals and  shuts down the immune system . this is why you taper off so the the adrenals can star back up slowly

[ill13632]

thanks for the info!!!
I told the pulmonologist office and they told me 1month prednisone was ok after thyroid glandulars and symbicort/proventil- I'm thinking I should just take prednisone 10mg for a few more days and stop at 18-20 days since I've been on HC 50mg

[rumpled]

But you have been taking other supplements, been on other corticosteroids, you have been taxing your adrenals.
One month under normal circumstances is not bad provided you taper properly.
Some people though are more sensitive.

[ill13632]

but how can 1month on prednisone  cause adrenal damage?

[rumpled]

You need to ask a DOCTOR these questions.

[ill13632]

so is it ok for me to take prednisone for 1 month?  I feel better and can breathe better on it

[ill13632]

I went to the doctor and I've started 1 month of prednisone- starting to feel better- so I have some sort of asthma or inflammation?  I should ask for specific blood tests?

[ill13632]

thanks so much!
I've had no energy still on the HC, but in the beginning it was helping me breathe better- yesterday I was having shortness of breath, face itchiness and chest tightness after switching from suppositories to HC cream

[rumpled]

HC is well absorbed via the skin and tissues. The OTC cream does not have much in it to limit the damage but the suppositories have the following listed side effects:

"The information in this medication guide is specific to hydrocortisone rectal cream or suppository.

Use this medication exactly as it was prescribed for you. Do not use the medication in larger or smaller amounts, or use it for longer than recommended by your doctor.
Do not take hydrocortisone rectal by mouth. It is for use only in your rectum.

An overdose of hydrocortisone cream or suppositories is not expected to produce life-threatening symptoms. However, long-term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body . Call your doctor at once if you have any of these serious side effects:

    * feeling short of breath, even with mild exertion; CUSHINGS
    * swelling of your ankles or feet; CUSHINGS
    * muscle weakness; CUSHINGS
    * rapid weight gain, especially in your face and midsection; CUSHINGS
    * severe rectal pain or burning;
    * bleeding from your rectum;
    * severe stomach pain;
    *sudden and severe headache or pain behind your eyes; or CUSHINGS?
    * seizure (convulsions).

Less serious side effects may include:
* mild rectal pain or burning;
    * acne;CUSHINGS
    * changes in your menstrual periods; CUSHINGS
    * increased sweating; or CUSHINGS
    *increased facial or body hair growth". CUSHINGS

As you can see, you can get steroid-induced Cushing's from the suppositories....

[ill13632]

anyway the pharmacist told me the HC cream and suppositories I've been using has no risk of adrenal suppression since it's topical

[ill13632]

thanks very much for all the great info!  maybe I am taking too much HC, I've switched to 2 doses of HC 2.25% cream and today I feel a little feverish and tired and I still have the chest tightness

[senjin]

Locate a book Safe Uses of Cortisone by Dr William Jefferies ISBN-13: 9780398045319 This book will explain a lot to you regarding low dose therapy works
20mg of HC is = 5mg of predisone anything over 20mg will shut the adrenal down any will require step down
there are dose calculation programs on line just Google drug cals

[rumpled]

One test was invalid as it was not at a diagnostic time. Plus cortisol is supposed to lower in the afternoon (probably not that low but it is supposed to lower) You have not had a stim test. You are not diagnosed properly.

Yes, people are on corticosteroids long term for arthritis - and it generally gives them steroid induced Cushing's. Corticosteroids are a double-edged sword. If you need them, you need them, but they can also do a lot of damage. Read up on the side effects. Replacement doses are fine - but once you go beyond that... however the *replacement dose* amount is very much in dispute from doctor to doctor.

[ill13632]

don't people take steroids long term for arthritis?