Saturday, December 18, 2010

Prednisone Hydrocortisone Flip Flop Flim Flam

The endo called and is perplexed that the HC is causing problems.

All I can say is I had one AI patient warn me that HC threw them into a crisis and landed them in the hospital.

They take prednisone now.

Adrenal stuff is the weird shiznit.

Or maybe it was just the BP meds. Maybe my high blood pressure has just gone back to normal. Which is also weirdness of the yo-yo variety.

Regardless of the weirdness, we agreed for the weekend I'm doing prednisone and then I'll go back to Hydrocortisone on Monday. If it doesn't go well, I call back.

Just so we don't have to worry about me totally crashing over the weekend.

Which is a blessing as I am volunteering at the preschool's allegedly 'free' breakfast with Santa Claus (since when did free mean I have to provide $20 worth of food?) and going directly out-of-town for the extended family Christmas/ Grandpa's 80th birthday party on Saturday. It is a go go go day.

Not a good time to be struggling and not the kind of thing I can survive without some steroid support.


  1. Sounds like you gotta good doc this time. Hope the weekend goes/went well.

  2. As I know it, the theory was that hydrocortisone suppressed the adrenal axis less than prednisone.

    So, the hydrocortisone was initially supplemented to whatever was actually needed. Cortisol is usually highest in the a.m., then drops off. So 3/4 of the hydrocortisone was given in the morning, then 1/4 around 2-3 in the afternoon.

    Is the afternoon when you are crashing?

    In my husband's case, after being on the hydrocortisone for a while (months) his adrenals were awake enough to attempt a taper (he went 2 days with no steroids, did a a.m. cortisol). He didn't feel well, but didn't fall over, and got an 9, so they decided to go ahead and try a taper. Then, the afternoon dose was the first dropped.

    It sounds to me like you are nowhere near being able to taper. I'd suspect the prednisone has your adrenals good and suppressed, and they may need some time on hydrocortisone to (hopefully) wake up. Sounds to me like you need twice a day dosing for a while too - since it seems that the hydrocortisone works, for the first half of the day. Personally, I'd prefer 2x dosing of hydrocortisone, rather than going back to pred (although I understand the weekend thingy).

    I'm no endo, but have seen how a really top endo does it, so that's what I'm going on.

    Hopefully, they figure out something that works for you soon.


  3. we're all different ..and each day is different. i've been on hydrocortosone and gone into crisis, had it only help and not cause problems,and yet another time that it did diddly squat (neither good nor bad) .
    I have 2 autoimmune diseases (and many many other issues)I have myasthenia gravis and lupus.
    I take prednisone (80 mg per day) and will likely never be on any lower than 5 mg for the rest of my life.

    we all have to do what we've got to do ...

    I just found your blog, looks like we have some things in common (#'s 1,3,7,9,11 and nodule w/enlarged thyroid dx, and PCOS... my moles have been mostly either fine, pre cancerous .. 2 melanoma and 1 non melanoma cancerous ...14 total removed add migrains, MG, SLE ... and a bit more)


Thanks for your comment. I read all comments and do my best to respond to questions, usually in a new post.

If you have adrenal issues and want to connect with other patients the following message boards are wonderful resources: