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Post by pincushion on Feb 20, 2009 20:29:26 GMT -5
Ok, so I went way over board with the cream , so went to doc scared. I think I scared him. Anyway, he gave me prednisone and I am taking 2.5 mg at 6am, 11am, and 4 pm-a total of 7.5-or around 30 mg HC I am assuming. I think it is too much. I am getting anxiety, panic, strong heart beat, flushing red face and an increasing blood pressure. I stopped salt because blood pressure was getting too high. So doc prescribed cortef 5 mg tabs, 4-6X aday. Question is, hoe do I do this? I have been on the prednisone for 2 days. I could start the HC Cortef tomorrow? Do I switch over slowly? I have also had almost no appetite. I usually love food! Please help if you can. Pin
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Post by Lethal Lee on Feb 22, 2009 7:12:17 GMT -5
Hi Pincushion,
Prednisone I am taking 2.5 mg at 6am, 11am, and 4 pm- a total of 7.5-or around 30 mg HC That doesnt sound like too much to me. However WHY are you taking it so close together?
When I was dosing Prednisolone 3 times a day I took it 2.5 mg am on waking 2.5 mg 8 hours later 2.5 mg 8 hours later (bedtime)
Salt & BP I am getting anxiety, panic, strong heart beat, flushing red face and an increasing blood pressure. I stopped salt because blood pressure was getting too high. Stopping Sea Salt could be a mistake. First it is needed for general Adrenal health. Second low Sodium can cause HIGH BP & HR as well as low BP. It also causes BP to drop from sitting to standing.
Have you tested Sodium, Potassium, Aldosterone & Renin? Can you give me the dates, results & ranges?
My BP was very high before Sodium supping (needed Florinef eventually), and Potassium supping. After optimising my BP & HR greatly reduced!!!!
What is your sitting & standing BP & HR?
Low Sodium can also cause shakes, fast BP, nausea , headaches, muscle cramps.
Potassium levels are important too as is the Sodium/Potassium balance. Shortness of breath is common when balance is out as well.
edit: I looked up your RTH posts found these July'08 Sodium 137 (135-145) Potassium 4.3 (3.5-5.0) ???08 Sodium 139 (135-145) Potassium 3.6 (3.5-5.0)
You also said that Aldo Renin was being tested but I cant find any results?
Both Sodiums are very low in range (optimal 144-146) & both Potassiums are suboptimal (optimal ~5). The last Potassium is just in range. Both should have been supplemented. If thses were done a while ago you should retest to see what they are now.
Cortef So doc prescribed cortef 5 mg tabs, 4-6X a day. I dont know what this means. Are you saying 5mg tabs taken 4-6 times a day? That means a dose of between 20-30mg per day in total?
Or do you mean take 4 x 5mg tabs 6 times a day? I hope the former?
Question is, how do I do this? I have been on the Prednisone for 2 days. I could start the HC Cortef tomorrow? Do I switch over slowly? Being on Prednisone for only 2 days I doubt you would have really reached good Cortisol levels. It takes a week or so to really kick in. However I do think the way you were taking it would have left you too low later in the day & in the night. This would contribute to you feeling lousy.
I would just start on 30mg HC spread out throughout the day. For example
4 dose schedule 30mg Total 6am 10mg HC 11am 7.5mg 4pm 7.5mg bedtime 5 mg
5 dose schedule 30mg Total 6am 10mg HC 10am 7.5mg 3pm 7.5mg 7pm 2.5 mg bedtime 2.5mg
You will just need to experiment with the timing & dosages to find what suits you. Be prepared to do small stress doses 2.5mg-5mg if you find that you are having low Cortisol type symptoms. You may need to do this if in fact you were on a higher dose with the HC cream.
Then once you find that you have found a schedule for the 30mg HC that suits & you are dont need any stress doses in addition then you can consider weaning down a bit if you feel its too much. I would wean only 2.5 mg at a time a couple of weeks apart & dont go lower than 25mg HC in total. Thats the minimum we see is adequate for Adrenal support.
If you are intending to completely wean in order to do ADrenal testing then just continue to do ~fortnightly 2.5mg decrements as tolerated.
edit: I found these results July'08 9am Cortisol-9.7 (6-24) Date? Cortisol 8.7 (6-24) Date?Cortisol 8.1 (6-24)
Aug’08 ACTH Stim Cortisol Baseline 10.4 Cortisol 30mins 28.7 Cortisol 60mins 33.0
All above suggest Hypopit with Secondary AI. Stim tripled from low base. All Cortisols if done early am off meds are very low.
Why do you need to wean off for more testing? You've had everything except Serum ACTH with another am Cortisol. I dont think with the results already have is worth the pain of weaning. Why not just wean to 25-30mg HC & stay there?
I have also had almost no appetite. I usually love food! Little/no appetite is a sign of LOW Cortisol and/or Hypothyroid. Ravenous appetite is usually high Cortisol and/or Hyperthyroid. Alternatively the later can be sign of blood sugar imbalances...low blood sugar makes you crave carbs/sugar to bring levels backup.
The fact appetite is low is likely you are NOT on too much Adrenal meds, at least not yet!!!
Thyroid edit: found these.. July’08 before meds TSH--------0.5070 Free T4-------1.01 ~ (0.8-1.8) Free T3-------2.62 ~ (230-420) Anti-TG Ab.....<20 Anti-TPO Ab.....47 TBG 20.50
These appear to be only labs posted. I know you tried up to 45mg Armour then swapped to 25mcg Synthroid in Oct'08. Now on 50mcg.
Very low TSH with low Frees & Hashis Abs confirms Hypopit with Secondary Hypothyroid/Hashis combo. Obviously you also have Hashis & assuming 'normal' lab ranges both FT3 & FT4 were too low in range confirming Hypothyroid. These Labs are really old now do you intend to get some more soon?
Depending on your current FT3 levels you may get some dumping. That may cause temporary Hyper like symptoms. It usually doesnt last long. If distressing stop Thyroid meds for a day or two..usually no longer than that is needed. In fact some of the symptoms you describe may be dumping happening.
Sex Hormones The Labs you posted for Sex Hormones also seem to show Hypopit with Secondary Hypogonadism. I see no eveidence of PCOS or Menopause in the results below.
July'08 Sex Hormones Estradiol (E2) 27 Progesterone 0.22 Testosterone <20.0 DHEA 61 FSH 4.0
You dont have ranges but they all look low/deficient. Testosterone is below Lab test detectability. Are you still cycling?Despite this FSH is very low confirming Secondary Hypogonadism. Back in middle of last year you were Rxed Pregnenolone 50 mg, , 7Keto DHEA 25mg, Testosterone cream, Progestrone cream, Biest 50% E3, 50%E2 (a mixture). Did you start any of them or not? Whether you are on HRT for them or not you should really do a new set of Sex Hormone tests including...
Testosterone Total & Free DHEAS SHBG FSH LH Estradiol Progesterone
Other Results You also said Iron was super low on supp's for that, B12 was low at 607 & were to start supps for that too. Are you still supping these? Have you tested Ferritin to see if that is optimised? What about Vit D & RBC Folate ever tested?
Symptoms In your various RTH posts you mention these symptoms....
resting pulse is above 90, heart pounds into the 110-115. chronic dry eye dizzy just walking Short of breath and then afterward extremely exhausted, Frequent urination dry mouth, light sensitive, crave sweet and salty things like crazy, brain fog, can't sleep for feeling severe anxiety, weak legs, burning feet, numbness and tingling that I am having on my face, arms, legs, and bottom of feet
Are you still having some or all these symptoms? They are a mix of low Aldo (Sodium/Potassium levels), low Cortisol & Hypothyroid symptoms.
Did you ever try the Melatonin rxed for sleep issues? You were rxed Ativan for anxiety. Did you go on that or not?
Final Comments You really seem to have had your diagnosis back in July/August last year being Hypopit for Adrenals, Thyroid & Sex Hormones. Likely GH is low as well with the IGF levels you posted.
I know you didnt have Serum ACTH done but plenty of evidence to confirm just the same. I know you have had problems getting a Doc to recognise & RX for the low Cortisol. But they have basically wasted the last 7 months for you??? Why delay treating even more by AGAIN weaning for yet MORE testing?
If you stayed on HC you could sort out low Aldo issues, start DHEA/Testosterone support, and finally get onto Armour and start getting UNHYPO!!!
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