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Does Intake Of Hydrocortisone Help In Treating Secondary Adrenal Deficiency?

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Posted on Sat, 1 Oct 2016
Question: I was diagnosed with Secondary Adrinal dificiancy aprx. 10 years ago; however, in the last 1.5 years I became increasingly ill and bed ridden and my endocrinologist that I was seeing was no longer available to me. I went to a new Endo and she did several other test and stated I had Primary Adrinal Difficianciy related to my Putuatary gland not functioning. I am incrieasingly getting sicker and I have looked on the National Adrienal Foundation web site and they suggest a test called 21-Hydroxylase-Autoantibodies. I have already been diagnosed with several other autoimmune diseases listed in the pamplet that I printed off regarding the test. Currently I am seeing an immunoligist who statest that I have Mucoutaneous Candidiasis (severe in my mouth), but that he will not jepordize my health to treat this condition. Should I try to get the 21-hydroxylase Autoantibodies test done. Or, is there a specialist within the Endocronology department that I should seek out? My health is depleating day by day and, as I am only 40, I fear I my die from thes complications and the doctors in my area that do not care. I certainly do not want a life lived out in my bed...which is what I have been doing over the past year and a half and the doctors just tell me to learn how to deal with it!
doctor
Answered by Dr. Mirjeta Guni (30 minutes later)
Brief Answer:
Adjust the dose of hydrocortisone.

Detailed Answer:
Hello,
Sorry to learn about your bothersome symptoms.
Regarding to your concern i am trying to give you some more information.
If you are diagnosed with secondary adrenal deficiency than there is no need to check 21-hydroxilase antibodies. They are responsible for primary adrenal insufficiency.
It is not easy dealing with adrenal insufficiency but it is very important to monitor the symptoms and adjust the dose of hydrocortisone regarding to them.
The blood pressure and electrolyte level are the main indicators of the hydrocortisone dose.
If your blood pressure is low with the actual dose, than it may be the cause of your actual situation.
The lack of thyroid hormones may be abother cause of fatigue, depression ect.
Hope the information will help.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Mirjeta Guni (3 hours later)
Thank you for answering my question. I would have like more information on Primary adrenal insufficiency, as that is what I am diagnosed with.
doctor
Answered by Dr. Mirjeta Guni (2 hours later)
Brief Answer:
Info regarding to primary adrenal insufficiency.

Detailed Answer:
Welcome back,
So you mean that the first diagnoses hasn't been correct?
If you want to have more information regarding to primary adrenal insufficiency, the most probable cause ( in 80% of cases) is autoimmune disease that is confirmed by checking 21 hydroxilase antibodies.
They are very sensitive in making the diagnosis, but in later phases of the disease they may result negative.
In most of the cases is associated with other autoimmune diseases ( poliendocrine autoimmune syndrome).
When a primary adrenal insufficiency is diagnosed, thyroid hormones, glycemia, Estrogen level and full blood count are checked.
The difference in treatment of primary with secondary adrenal insufficiency is the need for florinef in primary adrenal insufficiency ( not in all cases).
If antibodies result negative than a ct scan of the adrenal glands is performed to try to find other causes.
Hope the information will help.
Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Mirjeta Guni (13 hours later)
They have not scanned my adrenal glands, but did an extensive MRI and looked very closely at my Pituitary glad. Essentially, they said that my pituitary gland is "dead" and that I know have Primary adrenal insufficiency, but they are still treating me as if I still have secondary adrenal deficiency. However, as the months passed by my whole body began to shake uncontrollable and I could not walk on my own, I began passing out when I got out of bed just to walk to the bathroom; I do have epilepsy and I began to have more and more seizures. My husband took me to see my Endo after looking up Adrenal Crisis, but she just looked at me like there was nothing wrong and told us to go home. Several hours later when I was unconscious my husband took me to the emergency room and the Dr. there did not know what to do for me, so he just gave me pain medication and several sailin bags. We looked up on the National Adrenal Diseases Foundation site and found out about the 21 hydroxylase Autoantibodies test. After reading it we realized that I had already been diagnosed with several of the autoimmune syndromes that it listed, and that is why I want to be tested. I have been diagnosed with Mucocutaneous Candidiasis, Pernicious Anemis, Hypoparathyroidism, Alopecia, Autoneropothy, Raynoids and that is just a few of the ones I have.
doctor
Answered by Dr. Mirjeta Guni (9 hours later)
Brief Answer:
Hydrocortisone dose and other hormones need to be checked.

Detailed Answer:
Sorry to learn about your situation.
When the adrenal glands remain unstimulated for years, due to the lack of pituitary hormone, than the atrophy happens leading in primary insuficiency too.
Regarding to your symptoms, you need an endocrinologist detailed examination and some biochemical and hormonal exams.
You should know that in case of illnesses the dose of hydrocortisone should be doubled, the lack of thyroid hormones can cause many symptoms too.
So the evaluation of the hydrocortisone dose and a check up of other hormones to see if there is other hormonal problem too, is needed.
Kind regard,
Dr.Mirjeta
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. Nagamani Ng
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2413 Questions

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Does Intake Of Hydrocortisone Help In Treating Secondary Adrenal Deficiency?

Brief Answer: Adjust the dose of hydrocortisone. Detailed Answer: Hello, Sorry to learn about your bothersome symptoms. Regarding to your concern i am trying to give you some more information. If you are diagnosed with secondary adrenal deficiency than there is no need to check 21-hydroxilase antibodies. They are responsible for primary adrenal insufficiency. It is not easy dealing with adrenal insufficiency but it is very important to monitor the symptoms and adjust the dose of hydrocortisone regarding to them. The blood pressure and electrolyte level are the main indicators of the hydrocortisone dose. If your blood pressure is low with the actual dose, than it may be the cause of your actual situation. The lack of thyroid hormones may be abother cause of fatigue, depression ect. Hope the information will help. Kind regards, Dr.Mirjeta