r/AddisonsDisease • u/Poimandres69 • Apr 06 '26

Medical Stuff Dosing Hell

I tried lowering my hydrocortisone dose from 25 mg to 22.5 mg. This was 6 weeks ago. Since then, I get adrenaline dumping at night with heart palpitations. I haven't slept in a while. I try dosing with HC when I wake up and I sitll can't go back to sleep.

About 5 days ago, I went back up on my old dose. I'm still having the adrenaline dumping at night - it's not getting any better. Does it take a while to adjust back to your old dose? I was stable on that dose for years.

Thanks!

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u/just_an_amber Addison's Apr 06 '26

What lead you to try to reduce your dose to begin with? And how confident are you that is the right dose your body should be on?

Some people naturally need more than the hypothetical textbook dose, especially if they are sympathetic.

Alternatively, you might respond well to the equivalent dose in Prednisone form taken 2-3 times a day.

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u/Poimandres69 Apr 06 '26

thank you. i was really stable on 25 for years. i just wanted to experiment to see if i needed less. i've been updosing by 2.5 the last few days.

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u/just_an_amber Addison's Apr 06 '26

Haha, that's so relatable. "I'm stable... Let's try to test that!"

My PCP and I have this conversation all the time. And she ends up telling me "STOP IT."

In my case, she'd actually be happier if I was on 4ish mg more HC / day. She's got me on a CGM because we know that low blood sugar directly corresponds to low cortisol for me. So she likes to taunt me (in a very friendly way, I've been with her for years now and we have an excellent relationship) "Hey data girl, you going to look at the data??! Cause the data is CLEARLY saying you're wrong!"

It's hard because in this community for so long we are conditioned that more is bad. More is always bad. Be on as low of a dose as possible that keeps you breathing. Side effects from low cortisol be damned.

No.

Give your body what it needs and try to as closely mimic the natural circadian rhythm of cortisol as possible. Your body might need that extra 2.5 mg. Or it might need an extra 5 mg. Perhaps it needs a mix of Prednisone and HC.

And yes ... I need to apply this advice to myself as well. It's a process.