Dexamethasone replacement therapy

[syeren]

I was diagnosed with non classical congenital adrenal hyperplasia 7 months ago and since I've been taking Yaz birth control as my treatment method. It worked to reduce my DHEAs levels but not my hydroxy progesterone or testosterone. Or my symptoms.

He prescribed me with .25mg dexamethasone as replacement therapy. Anything I should be worried about?

[syeren]

Thank you for your prompt response. I can always rely on you to help me out! You're very knowledgeable.

My endocrinologist basically said to me, "You have nothing to worry about by way of any side effects. It's replacement therapy. You're not 'overdosing' on cortisol, which would cause the nasty side effects". But he didn't tell me I couldn't drink alcohol whilst taking this crazy drug!

I just took my first one. I'm keeping my fingers crossed it's smooth sailing from here. At very least it has not bothered my stomach and that was all I was REALLY worried about. The weight gain I can keep at bay with my gluten free diet and exercise.

My biggest concern is my immune system. It's already weak to begin with, so I'm going to stock up on the vitamins and supplements to help boost my immune system as much as humanly possible. For example, I went to the clinic yesterday for 5 minutes just to see him and now I'm sick with a cold!

Thanks again for your advice.

[rumpled]

It is replacement - but he is replacing you with a really powerful steroid so I hope he still watches for steroid side effects. Some people are just super sensitive!

It just says "Limit alcoholic beverages" but you can still have one or two - so I can still have my wine at Christmas! Dang but now I am taking about 6 other drugs that say no...

Yes, the immune system thing is the worst - but if you have CAH, likely your immune system is already impaired. I get super sick easily too - I got my first flu shot and got super sick from that. Don't get any live virus shots!

[syeren]

I've never had a flu shot or anything of the like so there is no need to worry about that! I don't believe in them :) I don't even take Advil for a headache! Or Pepto Bismol for a stomach ache. All natural with me.

I do get sick lots, but I only get colds. No super infections; though last October I was certain I had the Swine Flu. I recovered nicely, and have only had one cold since then. I take a lot of vitamins and supplements and I like to think they're doing me a service!

"Limit alcoholic beverages" sounds MUCH better than the "Zero alcoholic beverages" instruction I received from my pharmacist. I think you just made my day!

Today is day 2 and I actually feel improvement already! My blood pressure doesn't feel as low and my nausea is pretty well non-existent! A step in the right direction I'd say :)

[rumpled]

Are you a salt-wasting CAH or non-salt wasting?
Glad you are feeling better!
Re the nausea, I get a script for generic zofran and carry it around - it is needed often.

[syeren]

How do I know which I am? All I was given was, "You have non-classical congenital adrenal hyperplasia, and this is how I know that".

Definitely noticing an improvement already. I've had a sore stomach for the past 2 days but I'm also taking a boatload of vitamins now so I am associating my stomach discomfort with that.

Dexamethasone is actually used to treat nausea in cancer patients and people undergoing surgeries of the intestines. Would that be contributing to my lack of nausea at all?

[syeren]

I don't think I am considered "salt-wasting" given my form is non-classical.

How long do you think it should take for me to start noticing a significant difference? And what will that significant difference be?

[rumpled]

The lack of nausea is due to the fact that you have proper replacement steroids - and you need to realize that so you know when and how to stress dose. If you get sick to your stomach, you need to stress dose. If you get dehydrated via the runs, you need to stress dose. If you get a fever, you need to stress dose.

Do you have a medic alert bracelet, emergency kit etc? You need all that? My purse weighs a ton from my extra meds, shot, and all...

Dex is an anti-inflammatory, so in cancer patients etc., it is usually used to reduce inflammation after surgery.

You are noticing a difference now, right? Once your steroids are right, you should feel better.

[syeren]

Yes, I am noticing a difference now. But every morning I wake up with a wicked sore belly. It tends to go away without food but man does it ever hurt!

I don't have a medic alert bracelet. I also don't have an emergency kit. My endocrinologist did not make mention of ANY of these things. I'm starting to think he's a bit of a flake.

I'll have to really look into this stress dosing stuff, as that's just one more thing my doctor refrained form informing me of. My job is HIGHLY stressful... sometimes I work 16-18 hour days... so I guess that's a good example of when I am going to need to stress dose :)

[rumpled]

Usually one only stress doses with illness, surgery and the like - be careful with dosing at night (you will not sleep) or over doing - you have dex and it will last too long.  Not like a small boost of HC to get you over the hump.

[syeren]

Thanks for the information! I have a surgery that I've held off on scheduling for this very reason.

Also I ordered my medic alert bracelet tonight. It's a pretty one! I'd like to consider it "retail therapy" but I know deep down it's not.

Here's to hoping I feel better soon. Thanks again for your information. Looks like I've a lot of reading ahead of me!