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Hydrocort and Dexilant for Secondary Adrenal Insufficiency
Diabetes & Endocrine System | Last Active: Sep 2 9:43am | Replies (32)Comment receiving replies
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
Replies to "Hi Teresa @hopeful33250 I am on hydrocort (Cortef). 10 mg by 8 am and 5 mg..."
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@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.