Hello... Due to a recent move I have just begun treatment for my Addison's Disease under a different Endocrinologist. He seems very knowledgeable. However, he replaced me two med treatment of Addison's (Cortison Acetate and Florinef) with only one med instead (Hydrocortisone). I have had Addison's since I was 18 (I am 40 now) and have taken the same dosage of meds since then. 25mg am and 12.5mg pm of Cortisone Acetate and 0.1mg of florinef (also known as Fludrocortisone). Now this Endo has me on 20mg am and 10mg bedtime of Hydrocortisone alone. No more Florinef. He said the Hydrocortisone will do the work of both.

My main question is... Is there really a difference between Cortisone Acetate and Hydrocortisone? Also, don't I still need the Florinef. I always thought it was important.

Thanks in advance for any input.

Woodrunner

Your endo is an idiot! If you have Addisons then you need both. Hydrocortisone won't do it.

I am a recent Addisons patient, I would love to hear how your life has gone.

By the way, the standard dose of hydrocortisone is 10/5/5mg/day morning, noon and night. 20/10mg/day is now considered too much and risks osteoporosis, which you should have yourself checked for. I believe the acetate dose you describe is equivalent to 20/10.

[This message has been edited by orion (edited 09-11-2001).]

[This message has been edited by moderator3 (edited 03-24-2002).]

How 'bout more info... Again, what's the difference between Cortisone Acetate and Hydrocortisone? What's the role of Florinef?

It might be important to point out that I also have Hypothyroidism and Diabetes Type 1. All actually caused by Schmidt's Syndrome (Autoimmune Polyendricone Syndrome Type II)

In Addison's Disease the entire adrenal cortex is destroyed so the body can't produce cortisol and aldosterone.

Fludrocortisone is a synthetic minerocorticoid which acts similar to aldosterone.
Hydrocortisone and cortisone acetate both act similar to cortisol.

So I would think u need to replace both. Tell us what ur endocrinologist says.

oops..and just to answer the question Florinef aka fludrocortisone helps body retain salt and water and excrete potassium and acid.

I just did some research and found out that cortisone and hydrocortisone are pretty much the same thing. They actually have some mineralocorticoid action too so not everyone needs to have fludrocortisone added to their treatment.

And I guess since the doses of the two drugs are different; perhaps u r just taking a small dose of a potent drug or a larger dose of a less potent drug.

However... I have taken the Florinef(Fludrocortisone) for 22 years. Now since he switched me from Cortisone Acetate to Hydrocortisone I have been off the Florinef. (per his orders) It's been two weeks now. It just seems strange. I plan to ask him (my new doc), and confirm this new change, but he's a busy Chief of Endrocrinology. I am trusting his change. Thanks for your input.

I only take hydrocortisone. My endo says that Florinef is salt, so all you need to do is eat salt on your food.

I am concerned that they would take you off of the florinef. I have been on both of the same regimes you have. The straight hydrocortisone and florinef work wonders for me. If I dont take the florinef I suffer from my blood pressure falling rapidly when I stand up. I know that florinef is salt, but as we all know with Addison's we cant seem to keep that salt in balance, and that is why we become orthostatic. The doctor who put me on this saved me from those pesky fainting spells and most of my acute onsets of Addison's Crisis. Up to that point I was in the ICU several times a yr. This doctors is with Stanford and his name is Crapo. I hope this has been helpful. Are you suffering any symptoms that you didnt have before they took you off the florinef?