1. < Diabetes & Endocrine System

Hydrocort and Dexilant for Secondary Adrenal Insufficiency

Posted by pagray24 @pagray24, Sep 19, 2017

I hope this topic will get some chatter.
I currently take hydrocort (Cortef) and Dexilant. Does anyone else take that combo? If so, what time of day do you take each?

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kellyp67 | @kellyp67 | May 13 11:19am
In reply to @johnbishop "Hello Patricia (@pagray24), I have no medical training or background but I did a little searching..." + (show)
@johnbishop

Hello Patricia (@pagray24), I have no medical training or background but I did a little searching and found references discussing adrenal insufficiency (Addison's Disease) that point out that is caused by an autoimmune disease. Here is a list of a few sites that I found with the information:

National Institute of Healh site:
https://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease
National Adrenal Diseases Foundation:
http://www.nadf.us/adrenal-diseases/addisons-disease/
Pituitary Network Association:
https://pituitary.org/knowledge-base/disorders/adrenal-insuffieciency-addison-s-disease.
Autoimmune health related problems can be difficult to pin down. I like that you are being your own advocate and searching for answers. I like to use Google Scholar (https://scholar.google.com/) when doing research mainly because it finds articles and research information/studies and allows you to show the most current links for information by selecting the year at the left side of the links shown.

I don't have the answer for your question on when to take hydrocort (Cortef) and Dexilant but I'm wondering if just a simple call to your local pharmacist may be able to help to see if they have a recommendation.

Hoping you find an answer soon.

John

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Recently I have been diagnosed with adrenal insufficiency. As of yet I been told it was primary and secondary. I believe it’s secondary
As my pituitary gland is almost nonexistent.
I’m on steroids, which from day one was and continues to hard on my heart and kidneys.
I get about 2-3 hours a day and then I’m completely exhausted.
They continue to run tests but I am seriously considering going to Mayo Clinic.
As I have chronically anemic, low red blood cells for almost 3 years. Chronic kidney problems and now adrenal insufficiency

REPLY
ladyaceintx1 | @ladyaceintx1 | Sep 2 9:43am
In reply to @pagray24 "Hi Teresa @hopeful33250 I am on hydrocort (Cortef). 10 mg by 8 am and 5 mg..." + (show)
@pagray24

Hi Teresa @hopeful33250
I am on hydrocort (Cortef). 10 mg by 8 am and 5 mg before 5 pm.
The medication is definitely helping. I started on it just 1 year ago. I do not like the weight gain side effect but truly believe it has kept me alive, as my doctor suggested. Prior to the med I was dizzy, experiencing falls, exhausted, confused, and upon raising quite often I would nearly collapse.
You mention and provided a link to auto immune diseases. Is adrenal insufficiency an autoimmune disease?
Patricia

Jump to this post

@pagray24
@teresa
Hello,
In the autoimmune context, there are 2 types of Primary or Addison's disease and one type is considered to be an autoimmune condition. Secondary adrenal insufficiency is not an autoimmune condition. Your post said you have Secondary Adrenal Insufficiency/SAI which is the type I have as well, and that means our pituitary gland does not secrete enough of the hormone called ACTH to our adrenal glands to secrete cortisol which is one of two necessary hormones for our survival. The other hormone is from the thyroid. That is why we must take a cortisol supplement. Some people with SAI are able to go through a weaning trial and eventually are able to reduce or eliminate the need for a steroid replacement altogether. Others, like myself because of how long my pituitary was suppressed will never be able to stop steroids and will be on them for life.
Most patients with SAI have tried a variety of the steroids to find the one that works best in their system. Hydrocortisone is the closest biochemically, to the body's own cortisol production, so most people start with this medication. It works best if you divide your dose up in 3-4 doses in a 24 hour period because each dose only stays in your system between 4-6 hours depending on your metabolism. So, in order to prevent symptoms of low cortisol, you need to make sure you are dosing correctly. I started on HC and tried it x 6 months but continued to have tremors, nausea and severe bloating because HC has a higher mineralcorticoid effect which contributes to bloating. Recently, I discussed my symptoms with my Endo and he agreed to let me trial Dexamethasone 0.25mg once a day in the morning. It's been great so far. No more morning nausea, tremors and reduced bloating plus only one dose per day.
As far as what caused your pituitary to fail...there are multiple causes which I cannot guess because I don't have enough medical history from you based on your post. The most common cause for SAI is being placed on steroids for a medical reason, like asthma, or COVID. Some people have a pituitary tumor, others had a bad car accident with head trauma. Only further testing or playing detective into your medical history can support the reason. Let me know if I can help further. Sending you a big hug today.

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