Wednesday, February 8, 2017

Medication and Stresses

A woman asked me about adjusting her adrenal medication.

The thing to remember is you are trying to get your cortisone level to be at a point where you can function fairly well. You need to keep your blood sugar, respiration, blood pressure and other things at a good level. Your body does this automatically if it is working well. If it is not working well, then you have to supply the necessary cortisone in a pill (or even a shot).

Stresses compound. If you have stress of dental work, then you will need a certain amount of cortisone to handle it. If you also have an infection, you need a certain amount of cortisone. This will be more cortisone. Taking a small increase in your cortisone medication does not enable you to handle any amount of stress. You can only handle the amount of stress you have medication to cover. If you have more stress, you need to increase your cortisone medication.

Since you want to keep your cortisone medication as low as possible, it is best not to do schedule several things at the same time. If you get an infection, then wait for the dental work.

If you are in an accident or some other major stress, then you may need to take larger doses of cortisone for a short time, usually in shot form. This should only be done under your doctor's supervision.


  1. Cheryl, I have primary addisons for many years. My renin levels have been very high, but my blood pressure is not. I'm craving salt. Should I be taking more flofineff? I currently take 0.5 MGs five days a week. thank you

  2. I looked up renin levels. It said:
    Renin. Renin activity is elevated in primary adrenal insufficiency because a lack of aldosterone causes increased renal sodium losses. This lowers blood sodium levels and decreases the amount of fluid in the blood (which lowers blood volume and pressure), which in turn stimulates renin production by the kidney.Aug 16, 2013
    Addison Disease - Lab Tests Online

    It looks like high renin levels results sodium loss which causes you to crave salt. It looks like the lower salt level results in low blood pressure.

    My Addison's was not Primary, but Secondary caused by excessive physical and mental stress. Taking the .5mg dose of Fludrocorisone (Flofineff) daily which is recommended for Addison's disease helped me feel better. I have never heard of anyone who could only take it 5 days a week.
    Usually, people with Addison's are advised to more more salt in their diet than regular people do, have more salt when they crave it which often happens in hot weather and when under excessive stress.

    Some people need more Fludrocortione (perhaps 7 days a week which is normal for Addison's disease), or more salt in their diet to feel well. You might want to ask your doctor about it to find what would be best for you.