cortisone dosing during the day

[teo1958]

i take hydrocortisone for about 20 years after a tumoor surgery in germany in my brain which harmed  my hypothalamus
order center,   i reached the 97 kilos weight , after diet and exercise daily i was  86 kilos , but i took all the weight i lost in six monts on 2009 , till now  neither i nor the doctors can explain what happende  and help me , but lately observing myself , i see that one year before 2009 and for about one year i took cortisone not very regularly ,i mean not every morning in the six for example as i always did and for 2 days i take 10 mg on six in the morning , 5 mg on the 9 5 mg on the 11 5 mg on  the two midday and maybe 5 mg on the 4 ,Is it possible that i gained weight because of the irregular taking of the hydrocortisone and that now i will go better ?
                                                        Yours teo

[teo1958]

thanks for repling

[rumpled]

Potassium and sodium are electrolytes. They need to be in normal ranges so the heart functions normally. The kidneys and the adrenals regulate the amount as dictated by the pituitary and the hypothalamus - using cortisol and aldosterone.
If you have ever had a crisis (low cortisol) is is caused by either a spike in potassium and drop in sodium (typical) or in some, a drop in both potassium and sodium. They work in tandem. If you crave salt, it usually means you need it. As your issue is in the hypothalamus, I am not as familiar with your issues. I have pituitary and adrenal issues.

[teo1958]

hello, i take testosterone every three weeks and T4 220 mg per day , i do not see problems with my skin and nobody spoke to me about potassium and soda , what exactly are they

[rumpled]

So you are hypopit or panhyopituitary.
The skin darkening would show if you have elevated ACTH and if the replacement may (or may not) be too low.
Are you taking any replacement androgen - testosterone?

How often are you tested? Is your pituitary intact? It seems like you are on a lot of thyroid etc. Have you spoken to your doc about the weight? Do you have any issues with potassium or sodium?

[teo1958]

hello, i did not have any skin problems after  the surgery , but i forgot to say that i take thyrormone T4 220 mg. every day , and my body does not produce the growth hormone , also  i take 20 to 25 mg cortisone every day, my diet is very low fat , also i exercise every day (jogging )
                          

[rumpled]

Replacement of hormones is a funny thing - it is part art, part science.

I actually have quite a few questions for you. Is your skin tan and did you develop a lot of dark spots after the surgery? Did you gain all the weight after the surgery with the hydrocortisone? Did they try any other corticosteroids? Have they tested you for any other hormones that you may be missing like thyroid, growth hormone, androgens etc and do you replace any other hormones? Do you get regular testing?

HC replacement is one of those things - you can live a bit without it, but if you got sick, you would be at risk, From what I can tell - you take a total of 40mg? That is or can be roughly twice the dose of what most people I know are taking. That can lead to the weight gain as you may have steroid-induced Cushing's.

If you read up on what other people take - and it can vary widely depending on activity, other diseases, the doctor, etc. it can be from 10mg to 40mg so you are on the high end. Most people are around 20mg that I know. Most people take the bulk in the morning - aka 15mg to mimic the diurnal rhythm and then 5mg early afternoon and nothing later on. That is consistent with a normal body who has nothing later on in the day and how a body sleeps, recovers bone etc.

It is possible to change how you dose and the amount - talking to your doctor - and feel better! HC is very necessary for your life and you need to be careful about dosing. I don't have adrenals and I know the struggle. There are also meds available or coming available in Europe that are hydrocortisone meds that imitate the diurnal rhythm with just one pill. I would look into those. Those should help you feel so much better.