It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....

Addison's Disease Message Board

Addison's Disease Board Index

I am having such a difficult time with figuring out dosing of Hydrocortisone. I seem to burn through Hydrocortisone so quickly and this is especially causing problems with sleep. I NEVER sleep through the night, and I always wake up feeling very ill, in steroid withdrawal around 4-5a.m. Then I take 2.5 mg cortisone & go back to sleep. When I try to wake up around 9 or 10 I feel absolutely runover.. usually can't get up until 10-11. Then I'm exhausted all day .. so need more cortisone. It has gotten so bad that I have been to the ER twice in the past month in adrenal crisis & dehydrated.. I've lost significant weight (only weigh 87 lbs).have very little appetite, and have grown very depressed.

I'm wondering if anyone has ever switched to Prednisone for its' longer-acting effects? I've been trying to avoid Prednisone as I believe it's a more aggressive form of steroid replacement, and thus the long term side effects will be more serious. However, at this point my quality of life has deteriorated so significantly, I'd like to feel somewhat "ok" while I'm still alive.

Thanks very much for anything any of you can share...

Hi, Mollie,

My 22 year old son was diagnosed May, 2011 and left the hospital on hydrocortisone and fludrocortisone. His endocrinologist switched him to 5 mg of prednisone with breakfast. The switch improved my son's quality of life significantly and he's now working again. You should be discussing your symptoms and treatment options with an endocrinologist. I did have concerns about prednisone, but the Endo does not. We are still new to this and are also looking for alternatives. I hope that someone else on the forum responds to you. Also, throughout this forum there are several discussions regarding "Hydrocortisone vs. Prednisone" -- reading those discussions may help you.
actually vice versa. pred to hydro. pred kept my stomach messed up and took alot longer too get in my system. i would look into supplements if hydro alone isn't cutting it. never right but melatonin helps. i have actually became nocturnal. it has helped alot. your body actually uses less cortisone at night. i feel great at night. plus waking up feeling terrible is improved sleeping during the day. sounds crazy but true.
My son, who is currently on Prednisone and Fludrocortisone is also "nocturnal" often and very tired and sleepy during the afternoon, especially since he returned to work. He takes his meds around 6:00 a.m. Often he wakes up at night or has trouble getting to sleep. Similar to Luvthesun, his appetite has changed considerably -- he hasn't really lost any weight, but he only wants junk food -- especially pizza. He used to love salads and fruits, but he can't stand to eat anything cold. His endocrinologist checked his thyroid function, which turned out to be normal. Again, in answer to Luvthesun: if you have been in crisis twice, something is wrong with your dosage of hydro. My son found it very difficult remembering to take meds several times per day and he really was not feeling well. He was still experiencing mild orthostatic hypotention (dizziness when standing up due to blood pressure and heart rate changes). That is why his endocrinologist changed him to Prednisone.
Also, I noticed that luvthesun said:

"I believe it's a more aggressive form of steroid replacement, and thus the long term side effects will be more serious."

I wish that I could get a definitive answer about that. I, too, have gotten the same "impression" as Luvthesun reading things on the internet. BUT, the doctors keep saying that Pred and Hydro are the same except that Pred lasts longer and the patient does not have to take several doses daily. Also, the doctors have told my son that taking "cortisone-steroids" (either hydro or pred) in adrenal insufficiency or Addisons is a REPLACEMENT dose, so there are not side-effects. When people take these types of medications for other medical conditions, there ARE side effects because their dose is NOT a REPLACEMENT dose.

Again, I wish I could get a more definitive and correct answer about the long term safety of taking Prednisone vs. Hydrocortisone.
i base this entirely on 11 years of taking corticosteroids. prednisone is a more concentrated time released form of the drug. harder for your body too digest. worse on your stomach and liver. i did not really see any longer lasting affects. my liver function drastically went south. i lost weight which i shouldn't considering it is still a steroid. i took prednisone for 2 1/2 years. i came right back too hydrocortisone. miraculously i ate better, less stomach issues, 6 mnths later liver function improved.

as for the fact that it is longer lasting. i say hogwash. i take my hydro 2 times a day. i took pred 2 times a day. actually better affects on hydro. i understand we want it too last longer so we don't have too take pills all day. but hydro simply is a better product with less side affects. the body breaks it down easier because it is a naturally occuring hormone and puts it to use quicker. that is how my new endo explained it. as for my old endo who prescribed prednisone and really didn't care that i would need a liver transplant 10 to 15 years down the road can you say

there is name brand hydro and yes it is better. just like anything dealing with this stuff. always go with name brand. my new endo writes on every script brand necessary.
Perhaps the steroids effect different bodies in different ways. I agree that prednisone is more difficult to digest and is more difficult on your liver, but I have felt the difference in terms of longer-acting affects. Over the past few days I have switched out my evening dose of hydrocortisone (10mg) for 2 mg of prednisone, and for the first time in a looooong time, I've been sleeping through the night - not waking up at the usual 4:30am in need of steroid.

For me, it has nothing to do with just not wanting to take more doses of hydrocortisone - that's not a big deal, but I can't stand all of the symptoms I get everyday around the time I need the cortisone.. fatigue, lightheaded, depressed, etc. For me, it's a constant reminder of this illness. Other Addisonians lead very normal, high-functioning lives, but it has been a different journey for me thus far. My sleep has been greatly affected, so my energy & mood are greatly affected.. i lost my marriage due to my husband's inability to accept me with my limitations (creap) and the list goes on. Anyway, I am learning to trust in the natural unfolding of my life.. it all happens as it's supposed to. Getting back to the topic of this post... for me, sleep is CRUCIAL for my wellbeing as I have gone many nights (years) with very poor sleep & the days following are miserable and sometimes I barely function so I'm starting to believe that if I need to take a little prednisone to get me through the night, then that's what i need to do. Of course, I do not want to put my liver and gut health in jeopardy so I will monitor these and make necessary adjustments.

I have a question for the person who previously posted... when you say that prednisone is hard on your stomach.. what do you mean by this?

Thanks so much for all of your responses.. incredibly helpful to know that I'm not alone with learning how to manage this condition.. haven't found an Endo yet who truly understands the complexity of hormone health.

you know your right different meds for different folks. i simply meant that in my case weighing the side affects and effectiveness hydro is for me. what i meant by stomach issues is nausea and after about 2 years of taking pred i developed bleeding stomach ulcers. healed and hasn't come back on hydro. if i had my choice which i do hydro. i understand your sleep issues. most people with addisons have sleep issues. ever think the reason you are sleeping better is because the pred really isn't working good. i found it takes alot longer for pred to work too. during stressful situations you need help asap. something as insignificant as a broke toe could lead too an adrenalin crisis. i don't carry the injectables around so taking hydro is the quickest option. 11 years no adrenalin crisis. cross my fingers. i wouldn't wish a crisis on my worst enemy. good luck too you and always remember it really isn't what form of steroid you are taking as much as IF you are taking it. that one guys story of not affording meds almost brought me to tears, because i've been there.
Thank you for sharing your experiences with Prednisone. My son is young (22) to be dealing with this. He was very unhappy having to accept that he had Addisons and absolutely hated taking meds. I think his Endo switched him to Pred basically because he was not good about sticking to a schedule and making sure he took his meds at regular times. Also, it was summer and he was hiking and experiencing orthostatic hypotention (dizziness and fluctuations in BP and heart rate). He is doing better on Pred, but I have concerns. Right now, he does not want to think about "side effects." He just wants to feel better. I can't blame him. He was probably in adrenal crisis for quite some time, until he almost died and it landed him in the hospital for several days, and they diagnosed him.

Anything that gets processed through the liver is of concern. The liver is responsible for thousands of essential body functions. Most people know that the liver processes alcohol and can be damaged by excessive drinking, but many are unaware that the liver is also responsible for aiding other important functions such as digestion, the processing of medications and toxins, general metabolism and a healthy immune system. The liver is involved in detoxifying just about everything that enters the body, including chemicals and cleaning products that we breath.

So, because my son is currently taking Prednisone, I have encouraged him to stay away from alcohol, tylenol, avoid chemicals and pollutants, etc, eat healthy (fruits and vegetables, limit fats) and take supplements that are good for the liver -- vitamin C and occasionally milk thistle.

I liked that CHRISWVA shared his concerns and personal experience on prednisone. Also, I did not realize that hydrocortisone works faster than prednisone and that under stressful conditions taking hydro is an option for avoiding a "crisis." Thanks for sharing that.

All times are GMT -7. The time now is 08:25 PM.

© 2022 MH Sub I, LLC dba Internet Brands. All rights reserved.
Do not copy or redistribute in any form!