Another important aspect to consider is how your current medications might be affecting your adrenals in a negative way. It’s possible that adrenal insufficiency can develop when a person taking glucocorticoid hormones (like prednisone) for a long time, which act similarly to cortisol, suddenly stops taking those medications. If you’re on any prescriptions for treating inflammatory illnesses like rheumatoid arthritis, asthma or ulcerative colitis , talk to your doctor about how to adjust your dosage appropriately before changing them yourself since these can lower ACTH and cortisol.
During minor illness (., flu or fever >38° C [° F]) the hydrocortisone dose should be doubled for 2 or 3 days. The inability to ingest hydrocortisone tablets warrants parenteral administration. Most patients can be educated to self administer hydrocortisone, 100 mg IM, and reduce the risk of an emergency room visit. Hydrocortisone, 75 mg/day, provides adequate glucocorticoid coverage for outpatient surgery. Parenteral hydrocortisone, 150 to 200 mg/day (in three or four divided doses), is needed for major surgery, with a rapid taper to normal replacement during the recovery. Patients taking more than 100 mg hydrocortisone/day do not need any additional mineralocorticoid replacement. All patients should wear some form of identification indicating their adrenal insufficiency status.
The . Food and Drug Administration (the government agency that oversees most food and medical products) does not oversee nutritional supplements and vitamins. This means there is no guarantee that what's on the label of a supplement is really what's inside the bottle. In some cases, supplements have very few, if any, active ingredients. In other cases, the dose of a particular ingredient may be too high. This is true if you purchase supplements from your local drug store or a specialty pharmacy (sometimes called a compounding pharmacy) where supplements are made directly by the pharmacist.