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Suggest The Ideal Dosage For Cortisol Taken For Retinal Migrane
Question: Hello Doc,
I am panhypopituitary following a macroadenoma in the pituitary stalk and its removal.
i have been experiencing problems with glare and symptoms of retinal migraine and was told that my dose of 34mg of Cortisol was probably too high.
today I have been out for lunch and by the end I was feeling extra lousy and unsteady.
on arriving home I took my blood pressure after lying down for a minute or two
it was 129/80 76BPM
3 mins later 135/77 73
3 mins 132/76 74
3 mins 133/76 72 these were all lying down, I then stood up, walked 6 metres and stood resting on a stair hand rail and took my BP after 2 mins again, it was, 108/69 90 after 3 more mins it was,
127/82 88
from previous experience this means the Cortisol dose is not high enough.
Am I right??
Regards XXXX
I am panhypopituitary following a macroadenoma in the pituitary stalk and its removal.
i have been experiencing problems with glare and symptoms of retinal migraine and was told that my dose of 34mg of Cortisol was probably too high.
today I have been out for lunch and by the end I was feeling extra lousy and unsteady.
on arriving home I took my blood pressure after lying down for a minute or two
it was 129/80 76BPM
3 mins later 135/77 73
3 mins 132/76 74
3 mins 133/76 72 these were all lying down, I then stood up, walked 6 metres and stood resting on a stair hand rail and took my BP after 2 mins again, it was, 108/69 90 after 3 more mins it was,
127/82 88
from previous experience this means the Cortisol dose is not high enough.
Am I right??
Regards XXXX
Brief Answer:
Cortisol
Detailed Answer:
I see what you are saying here. Significant fall in blood pressure with upright position is 20 mm drop in the upper number and / or 10 or more drop in the lower reading. Moreover this is after 5 minutes of lying down resting followed by 2-5 minutes of standing and resting. So check it in this manner. If you meet these criteria then you can discuss the possibility of under-replacement of cortisol with your endocrinologist. However your dose is already well above average so under-dosing is unlikely
Cortisol
Detailed Answer:
I see what you are saying here. Significant fall in blood pressure with upright position is 20 mm drop in the upper number and / or 10 or more drop in the lower reading. Moreover this is after 5 minutes of lying down resting followed by 2-5 minutes of standing and resting. So check it in this manner. If you meet these criteria then you can discuss the possibility of under-replacement of cortisol with your endocrinologist. However your dose is already well above average so under-dosing is unlikely
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Shehzad,
I am sorry , I have misled you.
I failed to tell you that for the last week I have only been taking 20mg Hydrocortisol each day. We reduced the dose to see if the eye problems reduced, if they did it was only marginal.
I am a guy who is 6' 2" and weighs 220 lbs. I live in constant pain due to my complex condition.
As well as the BP problem I have noticed that I am sweating far more than usual when I am exhausted at the end of the day
Does this help.
Regards
XXXX
I am sorry , I have misled you.
I failed to tell you that for the last week I have only been taking 20mg Hydrocortisol each day. We reduced the dose to see if the eye problems reduced, if they did it was only marginal.
I am a guy who is 6' 2" and weighs 220 lbs. I live in constant pain due to my complex condition.
As well as the BP problem I have noticed that I am sweating far more than usual when I am exhausted at the end of the day
Does this help.
Regards
XXXX
Brief Answer:
Follow up
Detailed Answer:
It is important to ensure your other hormones are adequately replaced. The following tests wil help determine this.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC
Electrolytes
Calcium
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests
Kidney function tests
Total Testosterone
SHBG
Prolactin
Free T4
25 hydroxy Vitamin D
Follow up
Detailed Answer:
It is important to ensure your other hormones are adequately replaced. The following tests wil help determine this.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC
Electrolytes
Calcium
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests
Kidney function tests
Total Testosterone
SHBG
Prolactin
Free T4
25 hydroxy Vitamin D
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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