I recently had a shirt synatchen test and it came back with very low cortisone levels the doctor rang to tell me to change from 2mg of pred to 10mg in the morning and 2.5 mg in the afternoon Of hydrocortisone, I'm concerned as he was talking about what to do if I was sick or couldn't keep the tablets down, he said he had written to me, but I haven't received the letter, I'm also worried about weight loss and was having tests for this, but he told me to cancel the the appointment which was the next day to have an endoscopy with ultrasound
I did post this yesterday but I don't think I posted in the right place, I was diagnosed with PMR in 2013
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kate1978
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I imagine that they are now assuming that the weight loss is due to your non-existent adrenal function. It is a typical symptom.
I explained the difference between the use of HC and pred for adrenal insufficiency in the other reply - it is horses for courses.
Hydrocortisone (HC) is the usual management for adrenal insufficiency as HC has the same structure as cortisol and has a shorter halflife in the body so that it can be used in a way that mimics natural cortisol production. Normally you have a larger amount produced in the early morning to prepare you for the day and another boost in the afternoon.
Using HC as 2 doses replicates that. It is also a corticosteroid and theoretically should be OK for your PMR as long as the dose is enough (in terms of numbers, the total HC dose should be 4x the pred).
It isn't that HC or pred is better - it is what it is being used for. With HC it is possible that your adrenal function may return in time, it may even on pred but would probably take longer. What neither I nor anyone else can say is whether the HC will be adequate for managing the PMR or whether you will get on well with HC. Some people do, some people don't. That is a suck it and see question.
I have now received the letter from the consultant and it says my pre synatchen test was low at 120 and after the the the cortisol the level was 180 which he said was very low, would be interested to know what good levels are?
I am to start the hydrocortisone 10 mg in the morning and 5 mg in the afternoon
The endoscopy and ultrasound test which had to be cancelled for now was to see why I have lost so much weight
Both me and Dadcue, who both experienced sudden rapid weight loss, turned out to have adrenal problems so you might as well investigate that route before exploring other gastro reasons for weight loss I think. Other symptoms of adrenal problems can include vomiting and diarrhea.
I started yesterday, 10mg in the morning and 5mg at 4pm I'm a bit nervous as the consultant said if I get a cold I must double up and if I get sickness and can't keep the tablets down I must ring 999
Worry about it when it happens, not before - but be proactive and sensible and do make sure your family knows too and put a note on the fridge in case you are ill so a paramedic could see it and know.
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Hydrocortisone instead of pred 
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Prednisone to Hydrocortisone 
