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I had pituitary surgery for Cushings, why do I have to take steroid (cortisol) replacement (hydrocortisone (Cortef), prednisone or dexamethasone)?

April 26, 2017Cortef cortisol cushing dexamethasone Hydrocortisone Pituitary prednisone replacement steroid surgery

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I had pituitary surgery for Cushings, why do I have to take steroid (cortisol) replacement (hydrocortisone (Cortef), prednisone or dexamethasone)?

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This is the best outcome after pituitary surgery. It means that the tumor has been removed successfully and that the remaining normal ACTH producing cells in the pituitary gland are still suppressed (relatively “asleep”). It may take several months for the normal ACTH producing cells to regain function to stimulate the adrenal glands to produce a normal amount of cortisol (hormone necessary for life). In the mean time, steroid replacement is necessary to protect against adrenal insufficiency. At a later date, the need for continued steroid replacement is determined by blood tests off of the steroid medication. If a person has to take steroid replacement (hydrocortisone, prednisone, dexamethasone) he/she should wear a Medic Alert bracelet or necklace, which identifies the need for steroid treatment.