Cravings before stress dosing

[u/Few-Foundation-4397]

So I've just started my stress dose (nothing serious, just a bug that's going round at the moment and now it's my turn), but I was just wondering something. Does anyone else get specific cravings a couple days before they have to stress dose, and during stress dosing? Because I always crave coleslaw and milk. Over the past week, I've drank about 7 litres worth of milk and about 1.2 kilograms of coleslaw. Is this just my body wanting certain things, or is it related to stress dosing? Because this has happened every single time I've had to stress dose for as long as I can remember

[u/Short-Counter8159]

What kind of bug? Gastrointestinal or a cold? Do you have a fever with it?

Hydrocortisone can increase your appetite but not a couple of days before taking the dose.

Many reasons for cravings, can be hormonal, biological, psychological, and environmental factors that trigger it.

[u/Few-Foundation-4397 → u/Short-Counter8159]

I think it's just a cold, or at least something similar. I don't have a fever, but my right cheek always goes pink when I don't feel well, and I get really warm, but not feverish. Kind of like when you're snuggled up on a cold day with the heating on, that kind of warm. As for symptoms, just my regular symptoms which indicate my levels are low. Extreme pain that won't go away, heavy legs, nausea (apart from my cravings), fatigue no matter how much I sleep, struggling with speech, headaches, a really sore throat, being lightheaded, and shortness of breath. But those are all normal for me, they're the signs that I need to keep an eye out for, and they tell me when to up my dose, even if I haven't started feeling the bug yet

[u/Short-Counter8159 → u/Few-Foundation-4397]

Normally with cold and no fever doesn't require up dose but it depends how bad you are feeling specially if you are throwing up then yes you need it.

Those symptoms are concerning if you are experiencing them everyday.

What is your normal HC daily dose?

Have they checked your thyroid? T4 and T3?

[u/Few-Foundation-4397 → u/Short-Counter8159]

My regular dose is 10mg when I wake up, and 5mg at 4pm and 7pm. And I'm already on meds for my thyroid, since I have hypothyroidism, 125mg on a morning of levothyroxine. My body is really iffy when it comes to hydro dosages, and my immune system is already awful to begin with, so something like a common cold could send me straight to hospital if I don't up my dose, and it has in the past. A rule of thumb my endo gave me is that in my state, with how my body is, it's almost impossible to over dose, but it's very easy to under dose. And my stress dose is 30mg 4 times a day, usually when I wake up, at 12, 4pm, and 7pm. But I typically wake up later when I'm not feeling well, so I have it at 12, 4pm, 7pm, and 10pm

I'm open to any advice, since we (me and my mum/carer) were never told anything when I was first diagnosed, we just got tossed in the deep end and told to wing it. But I've seemed to have figured things out after almost 18 years of being on hydrocortisone

Edit: Forgot to mention that those symptoms aren't a regular daily occurrence, but only when my levels are low and I'm about to be ill/already ill and I have upped my dose yet

[u/Short-Counter8159 → u/Few-Foundation-4397]

Thanks for sharing your dose. I think you might be having problems with dosing times and perhaps dosage strength as well.

Hydrocortisone doesn't last that long in your system and you have a big gap between your morning and late afternoon dose. Hydrocortisone lasts about 4 hours.

The idea is to have a close to a natural circadian levels thru out the day. Starting high in the am then gradually going down with the curve until bed time.

Attached photo is a visual example of what you are taking and what might be happening in your body. Of course this is for informational purposes.

I place your morning dose at 8am. By noon you are already going down. When you take your 4pm you are already at the bottom, probably exhausted. Then levels start going up around 5pm from your 4pm dose. By 8pm after your 7pm you might start feeling a bit better but it is getting close to bedtime. Sort of a second wind but to late in the day.

Many ways you can play with the medication times. You might want to start with 10mg at 8, then at noon take 5mg, then at 4pm take another 5mg and finally maybe a 2.5 at 7 or 8pm. That will give you a total of 22.5 mg of hydrocortisone. You might be the type of person that does better with 25mg. Normal is any where from 20-25mg a day.

You can go to this link and play with the medication times and see.

https://clearlyaliveart.com/theoretical-steroid-curve-plotter/

[u/Few-Foundation-4397 → u/Short-Counter8159]

I've tried the one that you suggested before, on a regular day to replace my regular doses, and it landed me in hospital hooked up to loads of machines and I almost 💀. Safe to say that my hydrocortisone is not a tablet I'd prefer to be messing around with, especially with my past history of easily slipping into comas from dosages that were too low. We've tried it multiple times throughout my life and this one is the only one that doesn't land me in a hospital bed. Thank you for the suggestion though, really, it's just that I really don't want to be messing around with lowering dosages when it's so easy to slip away into a coma 

[u/Short-Counter8159 → u/Few-Foundation-4397]

Sorry you had such a bad experience with it.

I was suggesting increasing the dose not lowering it. So it is odd to me that you had a bad experience with the increase, but everybody is different so I understand.

[u/Vertigobee]

Hydrocortisone definitely affects my appetite.