Why do some people with adrenal insufficiency have weight problems when they are treated with cortisone, while others seem not to have the same difficulty?
The cortisone replacement is designed to return your hormone levels to normal. It is very important that the amount of cortisone replacement is not excessive or it can lead to some weight difficulties. In the past, we have tended to use cortisone or prednisone doses which may be a little more than are actually needed. In general, patients can get along with either 25 or 37.5 mgs, of cortisone daily or 5 or 7.5 mgs. of prednisone. Its important to balance this with fludrocortisone. We tend to look at ACTH levels and renin levels as a guide to the dose of each of these medications. Once the cortisone and florinef replacement has been appropriately balanced, then activities as well as food intake are both important in maintaining appropriate weight. Question regarding weight problems, and raises the question as to whether or not the thyroid is important in this area. This questioner also asks about the role of DDAVP.
The cortisone replacement is designed to return your hormone levels to normal. It is very important that the amount of cortisone replacement is not excessive or it can lead to some weight difficulties. In the past, we have tended to use cortisone or prednisone doses which may be a little more than are actually needed. In general, patients can get along with either 25 or 37.5 mgs, of cortisone daily or 5 or 7.5 mgs. of prednisone. Its important to balance this with fludrocortisone. We tend to look at ACTH levels and renin levels as a guide to the dose of each of these medications. Once the cortisone and florinef replacement has been appropriately balanced, then activities as well as food intake are both important in maintaining appropriate weight. Question arose regarding weight problems, and raised the question as to whether or not the thyroid is important in this area. This questioner also asks about the role of DDAVP. Since the primary cause of adrenal insufficiency is autoimmune and
