Addison Disease Support Group

Ive been on 20mg per day of hydrocortisone for 4 years. i am wondering if my daily dose is not enough. Even though my labs come out normal....is it possible im still too low. My concern comes from the fact that i feel like im having trouble keeping weight on. I feel like a rat on a wheel, i am eating but not assimilating. Where it get confusing, is im not sure if its low cortisol, or the fact that i have a very physically demanding job. I run a dance studio, and teach more then 15 hours of dance per week. I read different stories about weight gain after starting steroids. i wish i could gain some weight. is it possible i need more cortisol, even thogh my labs are fine?? thx, ratty

Well IMO the first thing to be concerned about is whether you have any other AI symptoms. Normal blood tests are not indicative by themselves of good health. If your energy is "good" then you aren't far off of course. If you are fatigued all the time dosage is worth adjusting just based on that. ie tackle that first before you even consider adjustments for weight.

Weight gain from gluco-corticoid use is basically a trait of using too much. Replacement for AI is about getting the right amount, never "too much".

If you have good energy and are not hyper then it is probably just a energy in vs energy out thing. ie you need to eat more! Of course muscle bulk is something else entirely, maybe even loss of androgens (DHEA etc) is the cause of that. That loss certainly goes with both primary and secondary AI. I don't have your history/DX etc in front of me, so I can't even guess. Male/female? Do you have DHEA/testosterone/estrogen test numbers?

If you do elect to increase HC you'll get a water weight increase as well as a BG to starch/fat via insulin one. Your BP will also rise. It will probably all reach a homeostasis level at some point. I think it important not to just up the dose without some "why is it so" thinking first though.

If however you are hyperthyroid as a result of whatever drugs you take, that may account for you "fast burning" energy and staying low weight.

Yes it can get complex. It is in fact a balancing act between a few system, not just a single cause.

More data?

Bob

Thank you Bob for the input. I am a 43 year old female. I was diagnosed at age eleven with low thyroid. I have always been paper thin, weird with the hypothyroid. I have been an athelete my whole life. First intense training as a gymnist, then ballet training. I was diagnosed 7 years ago with Addisons. I take 20mg. of hydrocortisone, .1 fludro,and 100mcg of thyroid. I have been researching intensley for the last few days,i will see my doctor in June. But I think it is what you hit on, i have sooooo much output, that i cannot keep up with the replacement. For someone without Addisons it would be hard. With Addisons I do have to work that much more at staying balanced. My energy is pretty normal, but that muscle wasting is really noticable. What I have discovered, I have to eat more frequently to keep my blood sugar normal. I dont have any problems with my pancreas, but am very aware of the relation cortisol and blood sugar. I also read that too much cortisol can break down muscle. Oh well, I will continue to research, and learn more everyday, thx to sights like this one. Ratty

You may have some luck keeping your blood sugar a little more normal by reducing carbohydrate consumption - I find it helps a lot (although mine still stays at the low end of normal and I can get bad drops from a hard workout). I don't know the systems as in depth as some here, but have you tried the traditional things for increasing weight/muscle like increased protein consumption? Adding extra fat to your food may help some too. I can generally at least keep the weight on and not lose if I do high fat, high protein and the lower carbs to stop the blood sugar swings. I'm also generally able to get by with just three large meals/day instead of the constant eating that I used to have to do.

Thanks Mamame, I will take that into consideration. Its nice here people understand losing muscle and weight because of wacked out hormones is a real worry. Whereas most people think its a great thing to be skinny. For me its one of my biggest concerns, I need to have that extra weight, just in case i do get the flu. Without some reserve, I feel like I'm in danger. I usually do eat pretty high fat content, but obviously, Im not doing enough. I'm 5 '6 1/2, and weigh 107 today. My goal would be 117.It really bothers me that I sometimes look sickley, I run and own a dance studio, and dont want my clients to think i dont live a healthy lifestyle, because I do. Yes I have tryed it all, protein shakes, weight gain powder. I know I just have to be consistent and eat hearty whole food, often. Thx, Ratty

I know I mentioned it, but do actually you have any androgen test numbers?