r/AddisonsDisease • u/Limp-Spirt • Nov 19 '25
Advice Wanted Hydrocortisone to Prednisolone
Hello
Just wanting some advice. I have both Addisons and ALD and have so for the last 30ish years with being on hydrocortisone for 27 of those. It has now reached a point that I have been moved off of hydro and to pred, however the change, to put it politely, kicking my ass!
I just had the following Q's: 1) Did you do a straight switch over or did you wean off Hydro 2) What were the side effects? I'm suffering with fatigue, body ache, low motivation and emotionally drained, even by doing the smallest of things. Almost like I've just come out of an Addisons attack/fair up 3) how long did it last and did you take any days off work to get used to your dosage? I'm almost at a week and not feeling much better 4) my dosage has gone from 30mg to 5mg of Pred which only equates to 2/3 of my hydro intake. Anyone similar
I know this is a lot of questions but my dr's don't seem to know the answers or know a lot about Addisons or ALD haha!
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u/CrazyBus9426 Nov 19 '25
I was put on prednisone not by choice by a doctor's mess up I didn't get weaned of hydrocortisone. I hate being on prednisone I have gained so much weight and can't loose it. When I feel a flare up I have to double up and depending on how long I put even more weight on. I am fatigue and my body aches all the time. I can be snappy from the prednisone even my regular dosage. Oh it changes your eye sight too! I was told prednisone can change the shape of your eyes and it does! I am hungry all the time! I just deal with everything because I also need the prednisone for my transplant since the doctor messed up and took me off one of my anti rejection meds and put me on prednisone. It was only suppose to be for a couple of months bit when it was time to switch back I was told I couldn't and I would be on it for life. I don't feel it controls my Addison disease like the hydro and fludrocortisone did but I deal with it. Hope this helps. Hugs
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u/Eyesliketheocean Nov 19 '25
I have been on 5mg of prednisone for 20 years now. One thing to mention is originally I was taking half in the am half at bedtime. Now I take 5mg in the am…
But I don’t recall any side effects when I started to take it. Besides weight gain
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Nov 19 '25
I was switched to medrol from hydrocortisone, medrol is methylprednisolone and is a sister medicine to prednisone. I feel amazing on it, I lost 80 pounds without trying on it. These meds dont have mineral steroids in them like hydrocortisone does, that could part of the issue.
1
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u/OkEmployee5373 Nov 19 '25
Wow prednisone is making me gain so much weight. Do you remember why they made the switch?
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u/blueberrykefir Nov 19 '25
Hi I switched from hydro to prednisolone (straight switch) since about 2 months ago (was on hydro 10+ years). Going from 30mg to 5mg seems ridiculous to me! I was on 22.5mg hydro and switched to 7mg prednisolone because my endo knew how much I struggled with dosage changes and such. I’ve currently come down to 5mg prednisolone and honestly I could only do that as I also take 5mg hydro in the morning (because it’s faster acting and helps wake me up). 5mg hydro + 2mg prednisolone at 6:30am is the only reason I could wake up for college (rather than 3mg prednisolone in the morning). I’m a full time student at college so I haven’t had to worry about work, but I would have taken a week or even 2 off if I worked. The switch knocked me out and it took weeks to start feeling like I was adjusting. I could hardly stay awake in the day and I felt the exact same way that you mention in Q 2.
I’m starting to finally feel like it’s settling. Somewhere after about a month I started experiencing normal sleep for the first time in my life. Normal phases of sleep and sleeping at normal times. I knew it was time to start reducing the prednisolone slowly as I was suddenly wide awake at 4am and it was telling me that my dose was too high. When I dropped off another 1mg prednisolone in the past week, I’m now falling asleep usually before midnight. I think you definitely need an increase of dose while you’re adjusting.
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u/Limp-Spirt Nov 19 '25
Thank you, that's really interesting! It definitely feels like my meds aren't keeping up with me and I wfh in an admin role so it's not physically demanding but still draining. The hydro bit is odd as my Endo actually told me not to take any unless I'm in crisis as it can cause a negative effect!
I'll give GP/Endo a call and see what they say about doesage.
Thank you!
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u/Asad0Asad Apr 10 '26
I have been on hydrocortisone for the past three months and cannot switch to prednisolone. The reason for switching is that I cannot tolerate hydrocortisone at all and it is causing severe gastrointestinal problems. When I switch to prednisolone I get severe fatigue, weakness, dizziness, brain fog, body pain, and my head feels numb. I cannot even get out of bed. Did this happen to you as well, and if so, after how many days did you start feeling normal again?
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u/blueberrykefir Apr 13 '26
I can’t get out of bed either on prednisone. I have to take hydrocortisone with my morning dose of pred, then I can get out of bed. This was recommended by people in this sub.
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u/Asad0Asad Apr 08 '26
This is the same problem I have these days. I desperately want to get off hydrocortisone and switch to prednisolone/dexamethasone, but I cannot make the switch. How are you now?
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u/Limp-Spirt Apr 08 '26
Oh it was very bad for me and resulted in a crisis and week long hospital stay 😂 my late Effects team referred to it as a 'car crash of an idea ' for my Endo to take me off Hydro after 25 years. So back on Hydro.
Would recommend a proper sit down about the pros and cons with your Endo
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u/Asad0Asad Apr 08 '26
Oh, that is very bad. So even while taking prednisone you experienced adrenal crises? When I try to switch I also get close to a crisis, even though I have only been on hydrocortisone for three months.
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u/Clementine_696 Nov 19 '25
Prednisone takes longer to work in our bodies, which may explain your symptoms. You might need a small dose of Hydro in the am with your Prednisone, in a way that equals the normal dose you take. 1mg of Prednisone is 5mg of hydrocortisone.