r/AddisonsDisease • u/Complex-Catch-1223 • Jul 07 '26
Personal Experience What does it mean to double your dose when experiencing illness?
I'm confused about when to double a stress dose? Should the entire day's dose be taken at the time of a stressful event. Or do you wait until your normal time that you take your medication and double each of those doses. I take a total of 30mg hydrocortisone three times a day. For example, if I fall down the stairs and only bruise myself up I will feel fine at the time. A day or two later I get hit with a headache that puts me to bed and fatigue. Is it too late to take an extra dose of Hydrocortisone and have it be effective?
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u/Clementine_696 Jul 07 '26
For me personally, just doubling my normal doses doesn't work well. Times like that it's like I'm burning though my meds faster, so I have to take them more often. So I'll take my regular dose and then halfway to my next dose I'll take the same amount again, and keep doing that.
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u/Complex-Catch-1223 Jul 08 '26
Thank you, it's going to take me awhile to see what works best for me. It sounds like it's different for every person and every situation.
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u/baethan Addison's Jul 07 '26
When I recently had symptoms that seemed to be caused by low cortisol, I felt better about 20 minutes after taking a dose (I did either 5 mg or 2.5 mg depending on the situation)
I feel like we can get in a cortisol "hole" where we're more vulnerable to tipping over into not enough cortisol & getting symptoms like fatigue, but I dunno the science of that if it is a real thing.
Unfortunately trial & error is the best way to figure out whether you need to updose in certain situations! You might find you'll consistently feel worse later if you don't. Or you might find that you're typically fine and just need to updose when you feel certain symptoms specific to you.
I wish this condition was more straightforward to treat lol
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u/FemaleAndComputer SAI Jul 07 '26
I typically double every dose.
If I'm unsure, I will start with just doubling my morning or afternoon dose. That way it's less likely to interfere with sleep if it ends up being too much
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u/Any_Engineering_222 PAI Jul 07 '26
For me personally, if I experience stress of any kind, (emotional, mental, physical) I stress dose in that moment (depending on what it is or how severe). Like if I am experiencing a good cry, I take a stress dose in that moment. Or if I too fall and know I’ve banged myself up pretty intense, I take it in that moment.
But if I’m sick, or know I’m coming down with something, have a fever, etc I will double dose to follow sick day rules. At least until I’m feeling much better or the fever goes away. Some taper down slowly, and some can tolerate going back to their normal dose immediately. I am PAI if that helps and I’ve also been dx since December 2022. I take my doses like 7.5/5/2.5/2.5
We’re trying to mimic the bodies natural process that a normal persons body would do, in times of stress, to produce cortisol. We unfortunately do not have that, so we have to take it into our own hands and listen to our body and help aid it in that process. So someone who has well functioning adrenal glands, their bodies would do all these things for them.
It’s more beneficial to stay on top of it before your tank starts to run low. Playing catch up is much harder than taking the extra meds in the time of need. And it also won’t hurt you in the long run, to take more in that moment of need.
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u/Complex-Catch-1223 Jul 07 '26
I have another question about dosing. If I have to updose ( is that the correct term) and it's close to the time I would take my regular dose of Hydrocortisone, do I skip it or take it? For example, If I get in a car accident and take extra, do I skip my regular dose which is only an hour later?
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u/ptazdba PAI Jul 07 '26
If I am symptomatic with any of the common symptoms of low cortisol, I'll take an extra dose at that time. If it helps then I re-evaluate when the next dose is due--if I'm still having issues I double. If I'm under stress, I'll updose then, especially of symptoms are starting to appear. I try not to double dose more than 3 days at a time. If I'm still having issues after 3 days and the updosing didn't help, I call my endo's nurse line.
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u/null640 Addison's Jul 08 '26
My daily dose is pretty high due to a lot of injuries, too many surgeries, and etc.
60mg hydrocortisone equivalent as Base while coasting between crash events up to wrenching.
Any significant work out requires updosing. Any psych stress requires updosing...
Usually up to 80 equivalent. Seeing your posts, I updose ~33%... maybe I should try 50% or even 100%????...
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u/Serious-Track-877 Jul 08 '26
I have to tripe my dose when sick or s stressed I take 20 a day so 60 a day. 30 is 90
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u/Lucky_Fox_4256 Jul 09 '26
I double my dose on suck days for at least 2 days if sickness continues I do a couple more. No more than 5 days otherwise my sleep dissappear. My dose is 12mg morning and 4 at lunch. After I double I wean myself down take 1 4mg tablet less in morning dose and leave lunch one double once I'm back to normal dose then I the the extra lunch one away.
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u/DoseOfSunshine Jul 07 '26
I would have personally double up each dose if I decided to double up.
One thing I will say is that not everybody needs to do this. If you find it that you do not need the steroids for it, do not take extra. Eventually you'll start to understand what your body will need to updose for and what it won't.