
Suggest Treatment For Low Cortisol Levels

Question: Hi, I have low cortisol but normal ACTH. My endocrine specialist seems bit unsure of how to HANDLE ABNORMAL PRESENTATION LIKE THIS. I have been given no medication or information but have a prescription for Cortisone Tablets.I think this is a potentially fatal condition as I can go into crises: but how will I know when that is?
I want only One consultation as I am on a disability pension and cannot sign up for a regular Q@A session Thank you, XXXXXXX
I was a psychologist for 28years and a PhD candidate, and am very pragmatic. Hence I want to know what I am facing: hold nothing back please.
I want only One consultation as I am on a disability pension and cannot sign up for a regular Q@A session Thank you, XXXXXXX
I was a psychologist for 28years and a PhD candidate, and am very pragmatic. Hence I want to know what I am facing: hold nothing back please.
Brief Answer:
About adrenal insufficiency treatment.
Detailed Answer:
Hello,
I can understand your concern.
If cortisol level has resulted low and you have signs or symptoms of adrenal insufficiency , than the diagnosis is confirmed.
The dose of hydrocortisone depends on the clinical symptoms, glucose level and electrolyte level.
In case of illnesses you should be instructed very carefully how to raise the dose.
Usually you will need twice the normal dose.
In severe illnesses you should take injections of hydrocortisone.
Wish you good health.
Kind regards,
Dr.Mirjeta
About adrenal insufficiency treatment.
Detailed Answer:
Hello,
I can understand your concern.
If cortisol level has resulted low and you have signs or symptoms of adrenal insufficiency , than the diagnosis is confirmed.
The dose of hydrocortisone depends on the clinical symptoms, glucose level and electrolyte level.
In case of illnesses you should be instructed very carefully how to raise the dose.
Usually you will need twice the normal dose.
In severe illnesses you should take injections of hydrocortisone.
Wish you good health.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Vaishalee Punj


Thank you. You said I have adrenal Insufficiency syndrome which I believe to be true but my endocrinologist says that it is due to my pituitary tumour (partially empty sella) and not my adrenals. I have ALL the symptoms of Addison's disease including the discolouration except for discolouration in the skin folds. Is adrenal insufficiency the same as Addison's disease?
XXXX
Good morning, my other question is: Is this a terminal condition?
XXXX
Good morning, my other question is: Is this a terminal condition?
Brief Answer:
It is a chronic disease, not a terminal one.
Detailed Answer:
Nice to hear back from you!
It is called adrenal insufficiency, rather it is primary ( due to adrenal causes) or secondary ( due to pituitary causes), would help synacten stimulation test and radiologic imaging.
Anyway, the treatment is the same (corticosteroids). In primary adrenal insufficiency ( XXXXXXX disease), mineralocorticosteroids are often needed ( except of corticosteroids).
In XXXXXXX disease often is seen darkness of the skin( due to high ACTH level), while in secondary adrenal insufficiency pale skin is characteristic.
If empty sella is the cause, the pathology is chronic and the treatment is longlife.
All you need is to take appropriate doses of corticosteroids and to avoid over or underdosages.
Fortunately, in our days most of the hormones that our body produces are easily substituted. So you do not have why to think of terminal illnesses.
Will be a pleasure to help you further.
Kind regards,
Dr.Mirjeta
It is a chronic disease, not a terminal one.
Detailed Answer:
Nice to hear back from you!
It is called adrenal insufficiency, rather it is primary ( due to adrenal causes) or secondary ( due to pituitary causes), would help synacten stimulation test and radiologic imaging.
Anyway, the treatment is the same (corticosteroids). In primary adrenal insufficiency ( XXXXXXX disease), mineralocorticosteroids are often needed ( except of corticosteroids).
In XXXXXXX disease often is seen darkness of the skin( due to high ACTH level), while in secondary adrenal insufficiency pale skin is characteristic.
If empty sella is the cause, the pathology is chronic and the treatment is longlife.
All you need is to take appropriate doses of corticosteroids and to avoid over or underdosages.
Fortunately, in our days most of the hormones that our body produces are easily substituted. So you do not have why to think of terminal illnesses.
Will be a pleasure to help you further.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Raju A.T


Hello Dr Mirjeta,
Thank you so much for your prompt reply.
I have had a 3 hour synacthen test and it showed low levels of cortisol throughout but normal levels of ACTH.
I thank you so very much for all your help. You have eased my mind considerably.
Many Blessings,
XXXX
Thank you so much for your prompt reply.
I have had a 3 hour synacthen test and it showed low levels of cortisol throughout but normal levels of ACTH.
I thank you so very much for all your help. You have eased my mind considerably.
Many Blessings,
XXXX
Brief Answer:
About adrenal insufficiency.
Detailed Answer:
Hello XXXXXXX
From your report seems that there is no diagnosis that you do not have!
I think that after starting corticosteroids many symptoms are improved. In most of the cases adrenal insufficiency is diagnosed late.
Your treating endocrinologist should have jumped into a conclusion after all the lab. and radiological exams.
if empty sella is the final diagnosis or cause of low cortisol level corticosteroid replacement therapy is the only medication suggested.
I really wish that all your problems are finished and will be a pleasure to ask further questions at any time.
Regards,
Dr.Mirjeta
About adrenal insufficiency.
Detailed Answer:
Hello XXXXXXX
From your report seems that there is no diagnosis that you do not have!
I think that after starting corticosteroids many symptoms are improved. In most of the cases adrenal insufficiency is diagnosed late.
Your treating endocrinologist should have jumped into a conclusion after all the lab. and radiological exams.
if empty sella is the final diagnosis or cause of low cortisol level corticosteroid replacement therapy is the only medication suggested.
I really wish that all your problems are finished and will be a pleasure to ask further questions at any time.
Regards,
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. Raju A.T

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