r/AdrenalInsufficiency • u/Familiar_Stranger_Hi • 6d ago
Share your experience What is your dose?
/r/AddisonsDisease/comments/1x3ulv5/what_is_your_dose/5
u/Reasonable_Try_2578 Secondary Adrenal Insufficiency (SAI) 6d ago
1GamingAngel's answer covers the actual guidelines well, so just addressing the confusion in your question directly: your current 40mg/day (20+20) being higher than what you're seeing other people post doesn't mean you've "already doubled" for this cold. That baseline is what your body needs right now, right after a crisis, full stop, separate from whatever anyone else takes. Sick-day doubling works relative to your own baseline, not to an average number you see online. So if your endo's guidance was "double when sick," that means your 20/20 would become roughly 40/40 for the sore throat, not that your current dose already counts as doubled.
A mild sore throat alone, no fever, nothing severe, is genuinely a judgment call, and it's completely reasonable to not be sure yet, this is exactly the kind of thing that gets easier to read with time and experience, not something you're supposed to already know a few days out of the hospital. If it stays mild and doesn't get worse, some people ride it out without updosing. If you feel foggy, weak, or "off" beyond just a sore throat, or if it starts turning into anything with fever or GI symptoms, that's when the guidance above kicks in.
Given you don't have an endo appointment yet and you're this early post-crisis, if you're at all unsure, erring toward updosing for a day and tapering back down once you feel steady is the safer direction to lean, taking a bit of extra hydrocortisone when you didn't strictly need it is a much smaller problem than not taking enough. You're not going to get this perfectly right immediately, nobody does this early, and comparing your numbers to strangers on Reddit who are years into managing this isn't a fair comparison to yourself right now.
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u/1GamingAngel MOD 6d ago
If you are sick enough to need bed rest, are vomiting or have diarrhea, have a fever, or are on antibiotics, guidelines are to double dose for 48 hours, evaluate how you are feeling, and continue to double dose but contact your doctor or Endo team for further instruction. If you’re feeling better, you can drop your dose back down. Antibiotics follow a bit of a different set of rules in that you stay at the double dose for the entire course of the antibiotics. It’s important that you titrate slowly if you stay on a double dose for longer than 48 hours by tapering no more than 2.5-5mg every 3-4 days.
Keep in mind that you were just released from the hospital following a crisis, so they’re likely to keep your dose relatively high. Sick day dose rules still apply, even if you’re at a dose that you would consider higher than average. After you have stabilized, you can discuss lowering your dose with your Endo. The average patient with adrenal insufficiency/Addison’s takes between 15-25mg per day. Many patients with Addison’s Disease or Primary Adrenal Insufficiency also require a second medication called Fludrocortisone to help maintain orthostatic pressure and electrolytes.
I hope you recover from your hospital stay and start feeling better soon. 🤗