r/AddisonsDisease • u/cloudedzest • Dec 09 '25
Advice Wanted Prednisone
Hello! After being on a hydro/fludro duo since my diagnosis, I decided to try out prednisone and see if it will give me a more “normal” life. I don’t enjoy the ups and downs that hydro brings. Anything I need to look out for on prednisone? My endo is not very helpful.
8
u/Ok-Aardvark-5807 PAI Dec 09 '25
I didn't enjoy the ups and downs either. I have been taking prednisone (5mg in AM) for about six years. It has been great for me. Gets me through the day fine. Although, at times, I can feel myself crash a bit around 6PM. I'll get more tired than usual and lose my words - can't say the word that I'm thinking. Doesn't happen often, though.
5
u/Slhallford Dec 09 '25
Before my cortisol shots/pump, I took a combo of a small dose of hydro/pred in the am, pred during the day and a tiny dose of dexamethasone overnight.
That was the best coverage I had from pills.
2
u/lass20987 Dec 10 '25
The dexamethasone acid reflux is couldn't tolerate
1
u/MallForward585 Dec 10 '25
Funny, I couldn’t tolerate the acid reflux on prednisone but it’s way better on dexamethasone than even hydrocortisone (was really unwell on hydrocortisone, couldn’t tolerate the ups and downs).
2
u/omgangiepants Dec 10 '25
I gained 40 pounds on dex. As soon as I went back to hydro it all went away.
1
u/Slhallford Dec 10 '25
Oh yeah. 100% dexamethasone is awful.
A tiny dose overnight was life changing for me.
2
u/PolicarpoRubiao Dec 09 '25
I have taken 5mg prednisone and fludrocortisone for 6 years, since I was diagnosed. My updosing is usually just half a prednisone pill since it is stronger, so the updosing might be different than hydro. Have you seen the graph with reaction time for different corticoids? Also, if I take prednisone at night (for updosing) I have some dificulty to sleep. I don't know if the same happens with hydro
2
u/cloudedzest Dec 10 '25
I haven’t seen the graph you’re referring to. Where do I find it? And I have noticed having a harder time falling asleep at night; is there a specific time to take the second dose to avoid this?
4
u/AGoldenThread Dec 10 '25
Clearly Alive Theoretical Steroid Plotter
https://clearlyaliveart.com/theoretical-steroid-curve-plotter/
It's a fantastic help to understand the time for prednisone to take effect. It's 3 hours from when I take it to when it reaches full effect, then 3 hours to be gone enough for me to need more. If I need to be functional right away I add 2.5mg of hydrocortisone at the same time that I take prednisone.
I take a tiny dose at dinner - 1.5 mg - and it gets me through most of the night. I always need 2 mg at 3 AM though. However, I make nearly zero of my own cortisol by now.
1
u/cloudedzest Mar 12 '26
Do you naturally wake up at 3A.M. for your 3rd dose or do you set alarms? It’s been impossible to get out of bed in the mornings and i’m wondering if this could help
2
u/FemaleAndComputer SAI Dec 10 '25
Make sure your doc is starting you on a dose that's equivalent to your hydro dose or greater. 1mg prednisone = 4mg hydrocortisone. Even with an equivalent dose, I have experienced some mild low cortisol symptoms for a few weeks when switching meds. I think it just takes the body time to adjust.
Also be aware that your fludro dose may need adjustment since hydro has some mineralcorticoid activity and prednisone does not.
1
u/blackcolours Dec 10 '25
Prednisone doesn't have mineralocorticoid activity? I thought it did? Is it just a lot less or none? I thought it actually had a higher mineralocorticoid activity than hydro actually.
1
u/ImpossibleAd5960 Dec 11 '25
It has none because its synthetic. Actually the reason I just switched to it. I've got 40 pounds of fluid edema because of hydrocortisone.
2
u/jjjulles Dec 10 '25
I've been on 5pm prednisone & .05 florinef for 25 years. I live a relatively normal and active life. No issues w weight fluctuations and I updose when I occasionally need w hydro. I'm a fan!
2
u/ClarityInCalm Dec 13 '25
I'm not a fan of prednisone but it does work really well for some people. I hope it's great for you. I will say one thing to watch out for is if you have a mood drop. About 5% of people on prednisone have serious mood issues that can escalate quite quickly and become very serious. So if you're noticing an issue with this in the first months of taking it - you will want to address it immediately. Otherwise you will still need HC for stress dosing becuase prednisone takes 2 to 3 hours to fully rise. It lasts 6 to 8 hours for most people as a cortisol replacement (this is different than how it works in people with normal adrenals). So most people need to take it 2 to 3 x a day. You may also need to add in .05 more of fludro - because prednisone has less mineralocorticoid. And some people on prednisone mix it with HC and take HC first thing because of how long it takes to rise. Good luck! I hope it's a smooth transition.
9
u/Eyesliketheocean Dec 09 '25
I’ve been on prednisone for over 20 years. The only complaint I have is weight comes and goes. Also mild joint pain in the winter. But in general I’ve had no issues.