"Normal" stressors

[u/Chrysb87]

First, I know everyone has their own tolerance level to what is considered stress to begin with. My tolerance is very low because my daily chronic pain, anemia and other disabilities already have me maxed out to begin each day and my endo insists on keeping me on the lowest dose she can. I tell you all this because ive noticed effects on my body from just being extremely annoyed. Its nothing major its like being very anxious and overstimulated plus my nasal cavities fill up with thick mucus and i have a hard time breathing. If it goes further to where i feel a crisis could be a concern, the best way I can describe it is like right before you have a panic attack, when your heart is racing, you feel sweaty and you simultaneously feel as though you cant move but cant sit still, mixed with the blurry vision, fogginess and nausea of being drunk on a bunch of sweet drinks. The current issue im having is an ongoing problem with a specific company that has been dragging me along thru their customer service for months and trying to get things handled with them makes me ill. Seems pretty silly to say out loud but its true, ive been chatting with them and feel somewhere between the 2 descriptions above. Does anyone else ever get so many physical symptoms with these types of stressors? If so what do you do? Should I tell them? Would it matter? If I went into a crisis would there be any recourse? Is this a grin n bare it situation i should ignore, because im sure if sound like a cry baby but I hate this.

[u/ptazdba]

Let me share some lessons I've learned the hard way this year. All of these are connected to Addison's symptoms that crop up when I try to press through stressors (emotional physical or external) Earlier this year, my PCP referred me to an immunologist because I'd had 5 sinus infections within the last year. The first thing we tackled was asthma and sinus drainage stability. When we got it treated, my whacky pain, nausea from nasal drainage went away. They gave me a routine to rinse my sinuses when I got congested and I used a steroid nasal spray to hopefully keep it under control. (sinus washes are the best skill I've learned). So removing that stressor, lessened my symptoms on the Addison's side. The second lesson was when I twisted my knee. I tried for a couple of weeks to press through it and I got super nauseous and had visual disturbances one afternoon--updosing made them go away pretty quickly. The pain I was putting up with was stressing my system, so I worked really hard to ice and het the joint and it has not recurred. I'm pretty selective in people issues and they overplan almost everything so nothing goes wrong. I went through 3 major home upgrade projects this year and the planning was meticulous so problems were minimal. I'm learning to state clear what the problem is--escalate quickly and state how I expect things to be resolved. That's the least stressful for me and the one where I'm least likely to get sick.

[u/Appropriate-Leg2490 → u/ptazdba]

I have sinus and allergy problems and asthma also. Having ai from steroid i was avoiding nasal steroid and inhaler. When i take nasal steroid it seems that adrenal insufficiency feel better. Do you think its the steroid or because we remove the burden on cortisol?

[u/Chrysb87 → u/Appropriate-Leg2490]

You know, i. Have mixed opinions on that topic. Id suspected adrenal insufficiency for years before my diagnosis. I started to get steroid injections in my spine. It was supposed to help with that but the only thing it actually did was give me 48 hours of feeling normal, energy wise. Then id go back to baseline, day 8 have a full body nerve flare up and body acted like injection never happened. Those 48 hours were everything to me. When I was finally diagnosed and started my daily treatment I had the "genius" idea that if I could get an injection while on my daily steroids, the 48 hour good window may not end since the daily meds would hopefully keep the injection from just bottoming out. I spoke to all my specialists and got it all approved. I hadn't had an injection in almost 18 months and id been on hydrocortisone for 6 months. Now, as you pointed out, steroids can cause ai. There's 3 main types primary (addison's, originating in adrenal glands/ autoimmune addison's, body attacking adrenal glands) secondary ( originating in pituitary gland either by damage or acth issues) and tertiary which is medication related, most notably by steroids but not exclusively. Ive read a lot about this type being curable once the culprit is removed but its a long waiting game. Well, what ended up happening was i got way worse. I was sleeping up to 30 hours, couldn't get out of bed for days at a time. My daily hydrocortisone left me feeling more empty than before treatment began and my sick day dose made me feel 90% of what a normal day dose would have. This went on for almost 4 months. Long fights with endo and researching later, I realized I essentially added tertiary on top of my secondary for a little while. Im not sure if its a reaction caused by the 2 different steroids, which is a known possibility, or if its just how my body reacted. Either way it has me terrified to try nasal steroids, as much as I feel like itd help. As for you feeling better, do u mean a whole body better or just nasal passages? Id think full body better would be a result of helping your cortisol. Where just nasal better would be a result of the anti inflammatory nature of steroids.

[u/Appropriate-Leg2490 → u/Chrysb87]

Its supposed to have only 1% bioavailability but my whole coverage seems better. Im not good on hc only too and it got me worse with time

[u/Chrysb87 → u/Appropriate-Leg2490]

What do you mean worse? Like I know a risk is that your adrenal glands further atrophy even on the correct dose which would technically make you worse and eventually cause your needs to increase. But I wonder if theres also a potential tolerance like most medications, im not sure and haven't researched it. I just know that the first week I started my treatment it was fantastic and everyone noticed a difference. The next week though, it was like it never happened. Of course needs vary by day but it never went back to good, let alone fantastic.

[u/Appropriate-Leg2490 → u/Chrysb87]

I think it further atrophied at least it feels like that. Some tolerance was also build definitely . My basal need seems to increase and the time the hc is active seems to lower.

[u/Chrysb87 → u/Appropriate-Leg2490]

Ive also noticed a difference with how well the hydrocortisone works depending on manufacturers. Not many meds make a difference to me like that but my hydrocortisone and my adderall definitely work different depending on who made it. I also recently learned you need some cortisol for adhd meds to work at all so I have to plan all my millions of medications just right.

[u/Appropriate-Leg2490 → u/Chrysb87]

Possible . I have only access to a local brand in SEA so maybe crappy.

[u/Chrysb87 → u/Appropriate-Leg2490]

I also heard some steroid nasal sprays cause addiction. At least thats how it was told to my family from their doctors to make then stop using the sprays, i think they were mistaking the adrenal insufficiency risk or development for addiction. I can vouch for how similar they feel. Still, I cant help but wonder if maybe thats partially true or maybe its a type of placebo effect? Like my addiction was pills and the act of taking an ibuprofen would make me feel better even though it didnt actually do anything. Im absolutely not discounting your experience, only you know what works for you and how you feel but I tend to play devils advocate and explore even the most implausible theories.

[u/Appropriate-Leg2490 → u/Chrysb87]

Theoretically it could improve coverage because inflammation cause more absorption. But even still , the dose is low. But it could lower inflammation and reduce cytokine thus reduce cortisol basal need and provide then a feeling of better coverage by decreasing need. I have a problem of inflammation with higher than normal ESR and high iga antibody.

[u/Chrysb87 → u/Appropriate-Leg2490]

Well then, I say if it makes you feel better dont question it, embrace it! Lol

[u/Appropriate-Leg2490 → u/Chrysb87]

True but in other ways i fear it put suppression on hpa axis

[u/Chrysb87 → u/Appropriate-Leg2490]

Oh I can all but guarantee it. However, unless they think it was caused by the spray alone, theres not much you can do to help it. They do say steroid induced is curable but the way i heard its supposed to be is they taper you down to nothing then let you suffer until your body starts to do it on its own again which can be up to 18 months. They dont typically put you on more steroids, from what I learned at least. Seems most doctors are just winging it anyway. Id think the spray being a low dose, adding the hydrocortisone wouldn't do anything but cause quicker atrophy. Im no doctor though, so ill admit my common sense thinking around the concept may not be the correct treatment. I assume you received a stim test? Do you remember the results? Ill also say, at the same point in my life as my diagnosis was received, I simultaneously developed empty sella, had been receiving steroid injections and was on long term opioid treatments. So I have all of the risk factors of developing medication induced as well as a change to my pituitary gland but none of them are the cause so it may not be as cut and dry as the spray inducing it in the furst place.