COVID-19 :New UK steroid guidance issued Advice for patients who take replacement steroids

[COwithAMN]

COVID-19 : New UK steroid guidance issued

Advice for patients who take replacement steroids (hydrocortisone, prednisolone, dexamethasone or plenadren) for pituitary/adrenal insufficiency.

alextlc.org/covid-19-new-uk...

[SongStream]

Thanks Chris! Ever since my diagnosis of Addison's 31 years ago, I was advised 3x3, whereby, I triple my dose for 3 days. Is double the medication standard fare?

[COwithAMN Administrator AMN EASIER Volunteer in reply to SongStream]

I don't know I'm afraid. Don't take it. Maybe someone else knows?

[StevenSims in reply to SongStream]

When I was first diagnosed 2002 I was told to double but I've learned that it's not enough and I take x3 or x4 sometimes!

All the best

Steven

[csak in reply to SongStream]

Hi, I don‘t know if it helps (if I even understood the question right), but in this article, Site 18/24, „Crisis Management“, they write about to double if ... triple if ... (it‘s in the blue box on the lower right corner): bartsendocrinology.co.uk/re...

On Site 20/24 they write about the dosages for certain surgeries.

There are also some interesting information about dosing corticosteroids:

cahisus.co.uk/pdf/HYDROCORT...

More information from this google search of cahisus.co.uk, when we should double dosage:

google.at/search?client=saf...

And in general looking for more information:

google.at/search?client=saf...

From here on, I digress:

Ok, this article (cahisus) is probably not really answering the question you asked, and is more adressing (pre-)adolescents and their families, but I thought, it is interesting as well as the following one:

addisonssupport.blogspot.co...

I have this last two links from this site:

clearlyaliveart.com/theoret...

Could be interesting medications: Plenadren (I didn‘t heard so much good about this tough) and Chronocort (the last med is probably not approved for Addison‘s at present) — I think, Chronocort could give us more of a cortisol curve like a healthy person would have; Cortisol rises in the early morning hours when we sleep, with Chronocort one takes something like an extended releasing Hydrocortisone preparation before sleeping, as I understand it, that imitates this rising and peaks when we wake up and then declines during the day (ignoring the slight „peaks“ after meals, I think), another different Chronocort pill would imitate these daytime curve — falling gradually, I think.

More information about Chronocort:

ncbi.nlm.nih.gov/pmc/articl...

The link explains it way better than I could and it is always possible that I didn’t understand it right!

The dosage, I think, mainly depends on our metabolism/ metabolic rate, height, weight.

Sorry, for always editing my posts, I make mistakes every time.

[julie_]

Thanks, Chris. My brother is steroid dependent. He also increases his dosage when he needs it.

[bluejadedwho]

This is partially incorrect. It says in Adrenal sufficiency it recommended to get vaccines. This is counter indicated.

[COwithAMN Administrator AMN EASIER Volunteer in reply to bluejadedwho]

I don't understand exactly what you are saying. Is it about the recommendation to get a flu vaccination? What is the counter-indication?

[SongStream in reply to bluejadedwho]

Every year, I am advised to get the flu vaccine. We are at high risk and of having an Addisonian crisis as a result.

[COwithAMN Administrator AMN EASIER Volunteer in reply to SongStream]

If I understand you correctly, you are saying that flu vaccine is dangerous to those with adrenal insufficiency? That's something I hadn't heard. If that's what you are saying, have you checked with your AMN metabolic consultant? I can check with mine.

[SongStream in reply to COwithAMN]

Oh, no Chris. Not at all. Just the opposite. It's imperative that we do get the flu vaccine. Thanks for the clarification.

[COwithAMN Administrator AMN EASIER Volunteer in reply to SongStream]

Thanks for making that absolutely clear!