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Dr. Andrew Rynne

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Could Adrenal Insufficiency Cause Problem In Handling Stress?

i am suffering from MCTS, overlap of scleroderma and SLE, i am on 6 mg steroid, some time i am having extreme fatigue, before that i had hyperpigmented areas all over my face and inside my ear is black also i am not able to tolerate stress..is it adrenal insufficiency, I am a doctor myself
Thu, 6 Nov 2014
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Endocrinologist,  's  Response
Hi,

Welcome to HCM. I had gone through your question and understand your concerns.

I would like to know a few more things - Which steroid you are on? Have you done any blood tests like serum electrolytes or cortisol?

Two causes of adrenal insufficiency can be there in MCTS
1. When you are on long term steroids your adrenal will stop producing steroids. So when you miss your regular dose of steroid you may feel problems with low steroids in blood -adrenal insufficiency

2. In MCTS there can be autoimmune destruction of your adrenals leading to adrenal insufficiency, in which you can have hyperpigmentation and tiredness.

If I were your treating physician I would have changed your steroid to hydrocortisone for a week then stop it for 24 hours to check your cortisol axis (cortisol and ACTH).

Since you are a doctor you can check these tests and let me know the results.

Hope I have answered your question. If you have any further questions I will be happy to help.


Regards
Dr Ajish TP
Consultant Endocrinologist
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Could Adrenal Insufficiency Cause Problem In Handling Stress?

Hi, Welcome to HCM. I had gone through your question and understand your concerns. I would like to know a few more things - Which steroid you are on? Have you done any blood tests like serum electrolytes or cortisol? Two causes of adrenal insufficiency can be there in MCTS 1. When you are on long term steroids your adrenal will stop producing steroids. So when you miss your regular dose of steroid you may feel problems with low steroids in blood -adrenal insufficiency 2. In MCTS there can be autoimmune destruction of your adrenals leading to adrenal insufficiency, in which you can have hyperpigmentation and tiredness. If I were your treating physician I would have changed your steroid to hydrocortisone for a week then stop it for 24 hours to check your cortisol axis (cortisol and ACTH). Since you are a doctor you can check these tests and let me know the results. Hope I have answered your question. If you have any further questions I will be happy to help. Regards Dr Ajish TP Consultant Endocrinologist