How to taper medication for secondary adrenal insufficiency?

Question

Hi doctor,

I recently had surgery which led to a four-day hospitalization and a diagnosis of secondary adrenal insufficiency. Oddly, I cannot get in to see an endocrinologist at the same hospital. I was put on Hydrocortisone (Cortef 20 mg) in the morning and 10 mg in the night. How do I taper this? I have already had 21 days of 20 mg and 10 mg, and it is affecting me to the point I have been attempting to self-taper. Kindly give your opinion.

Answer 1

Hello,

Welcome to icliniq.com.

Let me explain a few things. You got diagnosed with secondary adrenal insufficiency. That means your adrenal gland is not able to produce cortisol, the hormone which the adrenal gland is producing naturally. Now, as you got insufficiency, it means that perhaps this balance will get restored once you started treatment with Hydrocortisone. In such cases, we ask for repeating hormonal tests, then can start changes in current therapy. It is not necessary to get checked by the same doctor. If you have the medical records from the hospital and doctors who put on Hydrocortisone, you can choose any endocrinologist for further follow-ups. I do not recommend starting self-tapering or self-changing therapy.

I hope this was helpful.