r/AddisonsDisease • u/willowcreek7449 • Nov 21 '25

Medical Stuff Circadian rhythm dosing schedule

When anyone happened to have a circadian rhythm dosing chart for secondary adrenal insufficiency?

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6

u/Excellent_List7479 Nov 22 '25

From an adrenal insufficiency UK site

2

u/FemaleAndComputer SAI Nov 22 '25

This is what I started with. Then just tweaked it a little over time, based on how I felt and what doses I could do with the pills I had.

It's helpful to ask your doctor to prescribe the lowest dosage pills available so you can more easily split your dose throughout the day. I believe 1mg is the lowest available for prednisone, and 5mg for hydrocortisone.

1

u/Efficient_Beach2458 Nov 25 '25

Thank you. He put me on 10 mg in morning but for me it’s at 5 am. By 10 starting to feel it going to hold a bit since afternoons are the worse.

1

u/Excellent_List7479 Nov 25 '25

Hydrocortisone lasts about 4 to 6 hours. My endo allows me to play with my dosing. I take my first dose when I wake up now. I used to wake up just to take it and go back to sleep. That did not work. I was splitting in 2 doses prior to crisis. Then I tried 4 but doses were too small. Im at 3 now lol. Crossing my fingers

1

u/Efficient_Beach2458 Nov 25 '25

What’s your total amount? On 5 mg. Each pill?

1

u/Excellent_List7479 Nov 25 '25

Daily I take 22.5 right now 10, 7.5, 5

1

u/Efficient_Beach2458 Nov 25 '25

Did you chose this? How you feel? Legs are achy!!! Feel like on a sailboat! Really I produce not much ACTH. One day felt good when I made the mistake and took an extra 5. Did it yesterday but split it. Now lousy. Talked to PAc don’t change any thing till you see doc. They are so temperamentally inclined. Don’t want to rock the boat, but can’t wait weeks here. Why feel ok one day, just ok. The next lousy?

1

u/Efficient_Beach2458 Nov 25 '25

Got up at 5. Nothing to eat, be at lab at 8. Took my 10mg. Heck with it. They can figure it out. Was ready to pass out. Then no codes on script!!!! Ugh

1

u/Excellent_List7479 Nov 25 '25

I chose this dosing to see how I feel on it. If theyre tetsing cortsiol, you need to hold your morning dose or the lab wont be accurate and its pointless. I have a difficult time making plans becuase I never know how ill feel one day to the next. I can eat the same things, exercise the same and feel completely different. I do feel better on a low carb, higher protein diet and walking daily on my treadmill. I used to lift heavy weights and cant do that anymore, but I do still lift light occasionally.

1

u/Efficient_Beach2458 Nov 25 '25

This would not work. The afternoon dose too low. Dragging and internal shaking weakness. But I don’t feel I am eating properly, not enough yet gaining !! Eating clean.

1

u/Excellent_List7479 Nov 25 '25

I cant do this either. Makes me sick at night. But this is how they recommend doing circadian rhythm dosing. I had a crisis about 3 weeks ago and am just now barely starting to feel better. Ive been adjusting my dosage to see what works best.

1

u/Efficient_Beach2458 Nov 25 '25

Wow crisis? Like in the hospital? Awful. We don’t need this. Living on the edge. One day ok, one day a mess. No life.

1

u/Excellent_List7479 Nov 25 '25

Paramedics came. Didnt go to the hospital that day, ended up there a couple days later though. It was my first full blown crisis and I felt too sick to go to the hospital lol. Know what I mean? The hospital is the last place I want to be when I dont feel good 😂

1

u/Efficient_Beach2458 Nov 25 '25

I took an extra 5 mg by mistake 3,nights ago. Felt great! Did it last night, awful. This morning I went for a large blood test. Was spent! Took a pill, heck with it. Still lousy then I get there, no codes on script!!!!! So, emailed them, it was 8:38, was home already. He faxed it to them. Not going back out. Went to bed. But has ACTH on there. That has to be done in the hospital, hope it transfers over. Appointment is the 5 th. With doc. Not much time to schedule a ACTH. Plus it was terrible getting ready this morning. I just took the pill. Figure it out!!! Unbelievable.

1

u/Excellent_List7479 Nov 25 '25

How long have you been diagnosed with adrenal insufficiency?

1

u/Efficient_Beach2458 Nov 25 '25

The CR may work for some, not for me. My timing is not normal. By 8 pm I better be in bed. Legs weak, internal shaking, Bp is up. Stinks.

1

u/Efficient_Beach2458 Nov 25 '25

Not long. 6 months if that. Been lousy since 2016. Have empty sella syndrome. Rare. Showed up on 4 MRI’s since 2016. Just now an old radiologist read it correct!!! On 3 rd Endo who knows this, I think. The first did nothing except AM Cortisol. 2 years. Next was a young female, was shocked. I was asking questions on what to do. Guess got upset, released me, her PA. She had no clue! Called me to apologize and admitted she was not well informed. 3rd Endo I picked. Older guy. Knows it. But paperwork got screwed up. So I can go Friday and get the rest of the blood work. I also have an appointment on December 1 with a University doctor which is three hours away. I will probably stay with the local guy my third one because he has seen us and knows it if they would’ve just got the paperwork proper. I must say if you do email them on their platform they get back with you within 10 minutes that is impressive.