Secondary adrenal insufficiency

Posted by jentucker @jentucker, Feb 28, 2018

I have been terribly sick for a little over a month. I have RA, fibro, and CAD. I am completely exhausted, badly nauseous, shaky, kind of keep a headache all day everyday, and have abdominal pain. My doctor has been checking my cortisol levels for a month since I had a Kenalog shot about a month ago. My cortisol levels and ACTH levels have been extremely low. I've had one stim test and it was abnormal. She wants to do another 30 days out from the kenalog. She started me on hydrocort and it has helped some. However I am draggy and my body feels heavy. The weirdness of all of it besides the obvious is I haven't lost weight. I haven't been eating very much, and usually don't feel like eating anything until about noon, but my weight has stayed stable. I have so many questions and there is so little information and it all seems so complicated and overwhelming. Has anyone else been diagnosed with SAI that didn't lose weight? I can't figure out what causes my hands to shake, but they shake so badly it makes my job as a nuclear medicine technologist a little difficult.

By the way this all started when I got on an elliptical for 10 minutes. My heart rate shot up and my entire chest cavity exploded with pain. That chest pain lasted for nearly two weeks and was not heart disease related. I had that checked out because of my history. I still have pains in my chest, rapid heart rate, and just an over all feeling of unwellness.

I would love to hear from anyone who has experienced similar symptoms.

Thanks for any help or advice.
Jennifer

Interested in more discussions like this? Go to the Diabetes & Endocrine System Support Group.

This site is wonderful for medical advice and genuine help. There is another site on Facebook called Secondary Adrenal Insufficiency, it’s wonderful to message others just like you.

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Profile picture for jentucker @jentucker

My heart rate went up, of course, because I was exercising. I felt slightly light headed but that tends to happen when I exercise and my heart was pounding really hard. The most unusual thing was the pain throughout my chest cavity and back. Basically it’s all been down hill since then. I have such a complicated medical history with auto immune disease and CAD that sometimes it is very hard to tell where my pain comes from. But I don’t remember anything more about getting on the elliptical. I just haven’t really recovered since then. Thank you so much for the contacts.
Jennifer

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I was dx with SAI about one year ago, but they (Dr’s) have been warning me for years to expect this, as it will get here. It did! It is very hard to get any info because most just don’t know. I received the best info on the National S A I. I found this on Facebook of all places. Go to Facebook / Secondary Adrenal Insufficiency request being a member, you will answer simple questions. And you will be notified. They are strict rules you will have to follow, but they are simple to follow. Just common sense.
Sincerely, Cecilia Schermaul

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I was also told not to do any vigorous exercise, just stretching.

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Profile picture for rckj @rckj

@lisalucier Hi to everyone. I wrote to you. Lisa, because I didn't know how to address a general "to all" post. I have secondary adrenal insufficiency and was seen at Mayo in Rochester in the fall of 2017 after 10 years of illness without much good treatment. I live in a major east coast city so you think it would be better but it wasn't until I had a Mayo action plan. I'm doing better now but it is a long road back to a more everyday life. I'm trying to learn to live with this illness. I easily go into adrenal and septic shock with infection, usually pneumonia. I often land in the ICU, in critical condition with multiple symptoms, including delirium. It is often life-threatening and I get really scared. I have a good support system and a wonderful husband. The closest hospital has learned how to treat these crises aggressively and I am grateful to them for my life and improving health. I am concerned about the repeated pneumonias which then cause adrenal shock. I have had low IGG and IGG1 levels but the medical debate goes on whether this needs treatment with IVIG. I'm not sure if I should ask Mayo endocrinology about this. They have been tremendously helpful with the action plan and coordinating with my local treaters but I'm not sure whose area of medicine this issue falls into for a plan. It's always hard to write when I often feel so weak and I have always had a hard time asking for help. Does anyone have similar problems or advice for a solution? Thank you so much for listening. Rhoda

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Do you have nutritional deficiencies?

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Profile picture for spice @spice

Hi Jen you are starting to feel the beginnings of addisons I have been on prednisone for four years at 8 times the required amount I cant taper to the appropriate levels. When you are low on cortisol it is the top of the pyramid it controls your acth which regulates potassium it also regulates adrenaline which could be part of your shaking, when doing things for long periods of time your muscle groups become stressed and you have no stamina to maintain the activity you simply just have to sit and wait to recover most employers don't appreciate that unfortunately. I have now been through four docs and none have done some of the things you have had done. What I can say is the longer you stay on a steroid the less likely your body will return to producing the proper amounts of cortisol on its own. I wish I had better answers for you to find a solution but from all my experiences and research the adrenal system is complex and hard to diagnose. Most of the time the treatments seem to be very set and it ends up trying to fit a square peg to round hole. Learn to pace yourself some how, continuing to exercise somehow helps greatly the cordisone is probably preventing any weight loss.

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@spice Hi no it’s not addisons because she has low acth and low cortisol. Addisons and Cushing have one of those low and one that is high

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Profile picture for annbonari @annbonari

@spice Hi no it’s not addisons because she has low acth and low cortisol. Addisons and Cushing have one of those low and one that is high

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@annbonari I have secondary too

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Hi, I’m am new to this diagnosis of secondary adrenal insufficiency. I see an Endrochronogist on the 17th. My primary consulted with the endocrinologist and they started me on 5mg of prednisone for a month till my primary spoke with the endocrinologist…5 days now on tapering to 4mg. I feel awful increased pain fatigue nauseated all day light headed weak and mental fog.. anyone else experience this while tapering? Thank you!

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Profile picture for cecilias @cecilias

This site is wonderful for medical advice and genuine help. There is another site on Facebook called Secondary Adrenal Insufficiency, it’s wonderful to message others just like you.

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@cecilias oh great I’ll look for that. I’m new to the diagnosis and haven’t seen the Endrochronogist till the 17th

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Hello Jennifer 🙏 I have had all test & been ill over a year now, Literally 2 or more . My body is not working at all. I passed out for hours & ER had to staple my head . I am not producing Cortisol or ACTH . All test are showing my adrenaline glands are working. Something is blocking them to work . My Endo is sending me to a team in KY. A University. It's a 9 hr. Drive for one appt. I am not wealthy nor able to make such appointments constantly. My question is ? Do you ? Or ? Can you sleep 22 hrs a day ? For days ? In the beginning I did NOT . But as time goes on . I'm now doing this. Even with 200 mlg x 2 a day of Modafinial? Had sleep test was fine. I honestly feel I have No help . I hate to think that way . It's not me !! Always active . Have you found Any help at all ? I'm praying for you 🙏❤️🙏

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Hello all... I see that this conversation ended 6 years ago. I am hoping that it will start up again here in 2026. I would like to know how individuals with central adrenal insufficiency adjust their action plans to accommodate frequent long term infections, and prevent over- replacement of the cortisol? And are there any "objective" parameters to indicate that the cortisol is taking a dive.... beyond fatigue, nausea, etc???

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