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Cortisol deficiency, but with weight gain
Autoimmune Diseases | Last Active: Sep 15 2:34pm | Replies (50)Comment receiving replies
Hello, Thank you very much for your kind message. I have Secondary adrenal insufficiency. I take Hydrocortisone 5mg am & 10mg pm. My abdominal bloating began about 8 years ago. Not massive but very obvious . The real battle of the bulge began about this time last year. I agree, I must protect my liver first, I don't have a Hepatologist. Is this something I should share with my Endocrinologist or have my family Dr. refer me to a Hepatologist? Thank you Very much for your help. You said it perfectly, "It's hard to be a former shadow of the person you used to be." Good luck with your journey. Thank you.
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@tom1970
Does your insurance require a referral to see a specialist? If so, either your PCP or Endo could refer you. Your dose of 15mg total for Secondary adrenal insufficiency is very low and most Endocrinologists recommend taking your largest dose first in the morning because doing so mimics your body's natural circadian rhythm and gives you a cortisol boost to start your day. Also, as Secondary AI , we learn to space out our Hydrocortisone so that a small amount is always in our system. Most Endocrinologists understand this approach and allow their patients to experiment with both the frequency and the dose to fit your needs. I recommend discussing this approach with your Endo on your next visit. There are different types of liver disease, so my initial comment was meant "generally" not knowing what type you may have. I'm going to include a little bit more information but you need more diagnostic testing which is why a Hepatologist is needed.
Fatty liver disease, also known as hepatic steatosis, is a condition characterized by the accumulation of excess fat in liver cells. It can be broadly classified into two categories: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). The latter is more common and is often associated with obesity, type 2 diabetes, and metabolic syndrome.
### Types of Fatty Liver Disease
1. **Alcoholic Fatty Liver Disease (AFLD)**: Caused by excessive alcohol consumption.
2. **Non-Alcoholic Fatty Liver Disease (NAFLD)**: Not related to alcohol consumption. It can progress to non-alcoholic steatohepatitis (NASH), which is more severe and can lead to liver fibrosis, cirrhosis, or liver cancer.
### Diagnostic Tests
Several tests can be used to diagnose fatty liver disease:
1. **Blood Tests**:
- Liver function tests (LFTs) to measure levels of liver enzymes (ALT, AST) and assess liver function.
- Tests for viral hepatitis, iron levels, and other metabolic disorders.
2. **Imaging Tests**:
- **Ultrasound**: Most common initial imaging test used to detect fat in the liver.
- **CT Scan or MRI**: Can provide more detailed images of the liver.
- **Elastography**: Measures liver stiffness, which can indicate fibrosis.
3. **Liver Biopsy**: A definitive method to assess the extent of liver damage and inflammation. It is usually performed if there is uncertainty about the diagnosis or if NASH is suspected.
Early detection is key and now that you have a partial diagnosis, it's extremely important that more tests be ordered to determine the extent of your liver disease and then to formulate a treatment plan. Another thought, is to investigate seeing a team of specialists at a Mayo Clinic. They are the best qualified to put all the puzzle pieces together and give you the answers you seek. Each clinic offers their own clinical specialties, so the closest one to where you live may not specialize in the medical conditions you have. You can look this up online or on this site. I'm looking into this myself and there are no Mayo Clinics in Texas so I would have to travel to either Arizona, Florida or Minnesota. Try to keep your spirits up and remember that we can only do our best. (with plenty of rest, lol)