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Treatment for Hypoadrenalism - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2009
Answered : 594 Questions
User :   i have proplem with my cortisol hormone.its 0,04-0, taking hydrocortisone(30mg daily) for 4 months and nothing.all the other hormones are ok.what can i do?
Doctor :   hi
User :   hi doctor
Doctor :   May I know your age and gender?
User :   im 27 male
User :   from cyprus
Doctor :   Are you symptom improved with hydrocortisone supplements?
Doctor :   *Have you symptoms improved?
User :   i dont think so
User :   4 months
User :   and nothing
User :   the proplem came before a year when i got dexamethasone and injection for allergies
Doctor :   Ok
Doctor :   The values that you have mentioned, you have not mentioned the units in it?
Doctor :   Do you mean the values were 0.04 - 0.26 mg/dl?
User :   i think yes
Doctor :   Are these serum cortisol values?
Doctor :   And were they done on the early morning samples?
User :   the standar is 5-26 if i remember well
User :   yes i do my exam in morning and at 12.00 usually
Doctor :   Ok
Doctor :   Let me explain to you.
Doctor :   Hypoadrenalism characterized by reduced cortisol levels is of 2 varieties
Doctor :   Primary hypoadrenalism and secondary adrenalism.
Doctor :   Primary variety is diagnosed where there is an adrenal gland dysfunction, in which adrenal hormone supplements cause rise in the serum cortisol levels.
Doctor :   Secondary hypoadrenalism can occur due to suppression of hypopituitary - adrenal axis.
Doctor :   In this variety, cortisol supplementation has very little effects on the serum cortisol levels.
User :   ok dr
User :   but now what i do?
User :   becuase this hydrocortisone has side effects..
Doctor :   Most patients (primary hypoadrenalism patients) have a normal serum cortisol levels at 20 mg per day dosage and very rarely higher levels of 50 mg are needed.
Doctor :   Having said this any dosage between 20 to 100 mg are given in primary hypoadrenalism.
Doctor :   As a general physician, my knowledge is restricted in the evaluation of hypoadrenalism.
Doctor :   You may have to discuss this issue with an expert endocrinologist who will be able give you much clearer information on the treatment protocols.
Doctor :   We do have on such expert in the form of Dr Shehzad topiwala.
User :   is this dr online now?
Doctor :   He will be able to shed more light on this condition than me.
Doctor :   He is available for second opinion.
User :   thnk u dr
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