Endocrinologists are specialists in hormonal diseases, including adrenal and pituitary conditions that cause secondary adrenal insufficiency. An endocrinologist will have more training and experience in properly diagnosing and treating secondary adrenal insufficiency than most physicians. Most cases of permanent secondary adrenal insufficiency should be managed by an endocrinologist. In cases of steroid withdrawal for the treatment of medical conditions, endocrinologists often work with the primary physician or specialist in that disease to assess the recovery of pituitary-adrenal reserve and provide guidance about whether long term glucocorticoid therapy is needed.
It is often frustratingly hard to find and maintain an effective course of treatment. This area demands new solutions. One of the primary concerns for someone with AI is a sudden or severe drop in their level of cortisol. The body produces cortisol to respond to stress. Cortisol is also important in maintaining blood pressure and cardiovascular function, slowing the immune system’s inflammatory response, balancing the effects of insulin in breaking down sugar for energy and regulating the metabolism of proteins, carbohydrates and fats. Because of this, a significant drop in cortisol can have serious and life-threatening effects on the body. This drop is referred to as an adrenal crisis and a person with AI must keep a close watch on their body and its functioning at all times in order to prevent this type of medical emergency.
Prednisone is a drug that belongs to the corticosteroid drug class, and is an
anti-inflammatory and immune system suppressant. It's used to treat a variety of diseases and conditions, for example: inflammatory bowel disease (Crohn's
disease and ulcerative colitis), lupus, asthma, cancers, and several types of
Common side effects are weight gain, headache, fluid retention, and muscle weakness. Other effects and adverse events include glaucoma, cataracts, obesity, facial hair growth, moon face, and growth retardation in children. This medicine also causes psychiatric problems, for example: depression, insomnia, mood swings, personality changes, and psychotic behavior. Serious side effects include reactions to diabetes drugs, infections, and necrosis of the hips and joints.
Corticosteroids like prednisone, have many drug interactions; examples include: estrogens, phenytoin (Dilantin), diuretics, warfarin (Coumadin, Jantoven), and diabetes drugs. Prednisone is available as tablets of 1, , 10, 20, and 50 mg; extended release tablets of 1, 2, and 5mg; and oral solution of 5mg/5ml. It's use during the first trimester of pregnancy may cause cleft palate. This medicine is secreted in breast milk and can cause side effects in infants who are nursing. You should not stop taking prednisone abruptly because it can cause withdrawal symptoms and adrenal failure. Talk with your doctor, pharmacist, or other medical professional if you have questions about beta-blockers. Talk with your doctor, pharmacist, or other medical professional if you have questions about prednisone.
If you notice other effects not listed above, contact your doctor or pharmacist. In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.