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Addison's Disease Message Board

Addison's Disease Board Index

[SIZE="1"]Hi, an intro on myself. I am a 23 yr old female who was diagnosed and recently reverted from Cushing's syndrome. I am now in what I hear called an addisonian state.

I had a unilateral adrenalectomy of my left adrenal for a 2.5cm tumor 4 wks ago. My right adrenal is atrophied. I was placed on the 5th day after my surgery on Cortef, 10mg @ 8am and 5mg @ 6pm (=15mg total). Doctor has informed on doubling up on dosage if I feel ill with nausea, fever or dizziness as serious signs. I have had the need of doubling up on one occassion for bouts of AI (Adrenal Insufficiency) symptoms. Right after surgery I was placed on high hydrocortisone replacement (8mg dexamethasone) for three days and tapered to 2mg until I was placed on my physiological dose of 15mg of Cortef. Since being on this physiological dose, I have still felt ill, most cases are very mild and usually subside on their own taking hours. However, I have had to increase to 20mg w/o consultation for about 1 wk for those, not serious but intolerable bouts and have slowly tried to taper back to my 15mg original dose by cutting back 2.5mg's at a time. After a 1wk increase to 20mgs, yesterday was my first day back on the 15mg's original.

I have a few questions for those familiar with secondary Addison's due to Cushing's, if anyone can kindly answer in this order.[/SIZE]

1) My doctor only specified "before breakfast, before dinner" for my dosing, but no specific hours. What is the best way to distribute dosing keeping as low as possible?

2) Why would Addisons cases experience too high cortisol on physiological hydro replacement if the whole point of this condition is too low cortisol? For example: I have really bad hair loss. My hair loss manifested with my Cushing's state, but was not as bad as it is now. In fact, my hair loss seemed to have subsided right before they removed the tumor before surgery. Suddenly after surgery it started back up with a vengeance. I have been informed that hydro is a steriod and it can cause hair loss. The high doses I recieved right after surgery could have caused this increase in hair shedding. But this high dosing was for only 3 days and I have been consistent with a physiological dose of 20 or 15mgs thereafter (except for that one day I had to double up to 30mgs). Shouldn't the hair loss decrease by now? First the problem was high cortisol and now it is low cortisol? This doesn't make any sense to me. My case is very specific and I am still due for more bloodwork, so my general question is: Can hydro cause hair loss even at a 20-15mg dose?

3) My whole recovery from secondary addison's now depends on that other adrenal. In cases of Cushing's, I have been told it is usual to have an atrophied adrenal. This is a response to the other adrenal removed hyperfunctioning. I am interested in getting more info on adrenals as it is my case, but I can't find any. Cushing's I understand is a rare condition and all I keep getting feedback from is cats/dogs in my search. If you can provide any info on atrophies of adrenals, it would be greatly appreciated.

Thank you.

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