Pred reduction but adrenal insufficiency!!

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Hi guys,

My daughter (4yrs old) has been on maintenance pred for 2yrs for her Brittle Asthma.

Shortly after going onto the maintenance pred, she was diagnosed with Adrenal Insufficiency. Her natural cortisol levels were zero and her adrenal glands had shrunk so small they were not visible on the scan!!

We are now trying to reduce the pred again as the weather has been good and she has been relatively stable for a while (apart from a small blip a couple of wks ago).

Anyway my worry is, by reducing the pred, her adrenal glands won't be supported so what happens with regards to the Adrenal Insufficiency?? Will she not then be at risk of going into crisis?? They didn't even mention giving her hydrocortisone instead, they merely are taking away the pred and saying that her adrenals will kick in slowly. But it's not as if they were still producing cortisol!! It was zero!!

Anyone out there with AI and experience of this??

Due to her still being so young, she still finds it hard to tell me what's wrong and never ever moans. It's merely a guessing game for us

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Hi Emily ,

I have secondary AI.

Does your daughter have a separate Endicrinologist? If so perhaps you could contact them for advice?

I take hydro cortisone 3,times a day. Tha hard and fast rule from the Endo Consultant for me is, take the HC as it is a replacement. Prednisolone from respiratory team s used on top to control the asthma, not the AI.

Wondered if you had come across this site, it is quite helpful. addisons.org.uk/ gives good clear advice on symptoms and management.

If things are uncleared, or you are unhappy with the proposed care plan ask to speak to the prescribing Dr and discuss you concerns. You aren't making a fuss or bothering anyone, this is a partnership to get the best outcome for your child and keep her as well as possible.

Good luck,

Sarah x