On 5mg Cortef 4x daily, help with med scheduling please.

[mkgbrook]

Hey you all. I am one of the newest hypoadrenalism sufferers to officially join you all. So now in addition to the Hashimoto's, secondary hypothyroidism, and possible hashimoto's encephalopathy; I get to add Add.. hypoadrenalism. My Cortisol was below range and my ACTH was high as well. My IM didn't say Addison's.. but preferred to call me a adrenal insufficient/hypoadrenalism. Gotta love the MD speak. But given my autoimmune happy body.. I am betting it is.

So my MD told me I need to start Cortisol support by taking 5 mg hydrocortisone 4xdaily. I was also told it will take some tweeking on my part would be required to figure out when and how often to take my pills. The one issue I am worried about is sleep interference. I have sleep apnea and insomnia.. so I would prefer to not add to the insomnia. My sleep is precious and needed, what little I get.

So I am calling all experts out there. How do you time out and schedule your med dosages? I have to balance Gerd, allergy, and thyroid meds with this as well. So this is what I plan on doing.. tell me if it sounds good. Or if I am asking for trouble.

Synthroid at 6:30 am
hydrocortisol 7:30 am
hydrocortisol 11 am
hydrocortisol 3 pm
hydrocortisol 7 pm
vitamin and supplement slurry at 8 pm
antihistamine, decongestant, reflux meds at 10 pm.

It is sad, but I have had to set alarms to remind me to take my meds. Ugh! Who knew having to take supplements to replace your failed endocrine system could get so complex. I am glad I am a bit obsesive about schedules and such. Also do you all take additional supplements to aide in improving your function? If so what kind and scheduling works best for you.

My sincerest thanks in advance to everyone reading and sharing advice.
MG

[kmatthew]

Finally I can give you some advice. You are always there for me.
The last cortef needs to be taken before five or you will be awake into the wee hours of the night. Been there and done that. I am on 30mg of cortef

Ask your doctor if you can take two of them on one of your doses. Either that or start your synthroid dose earlier.
I take my synthroid and cytomel at 5
Cortef and florinef at 6
Aldoctone at 10:45
Cortef again with cytomel at 12:30
Cortef again at 4:45
Then you do several hours of homework with the kids, cook dinner, go to the gym and you are really tired.............
Trust me you will not have to set the timer long. I am dizzy if I forget Who needs watches

I hope your doctor's appts went well.
KM

[gettin' better]

You should take your largest dose of Cortef first thing in the morning. So, I would say, take 10 mg. first thing, 5 at noonish, and 5 at 4 or 5 p.m. I'm surprised your doctor didn't recommend this.

[kmatthew]

I am surprised that doctors do some of the things that they do too.
I tired to go off of one of my cortef dosings, and they told me to just delete the last dose at 5 (10 millagrams!!!!!!!!!!!!!!!!!) I think it may have been you that told me that you only taper 2.5 mg at a time. Boy did I learn the hard way!!!!!!!!!! I was really really sick from that.
Turns out I need the 30 but it was only after I told her about the tapering, and she is supposed to be one of the best there is in the field. That has been my only really bad experience. I get the feeling that thyroid is more of her expertise, but I really need her for that and she has really come through for me.

[rumpled]

30mg is a pretty high dose, IMHO. I have no adrenals and I take only 22.5 total. With taking of steroids, it is truly a balancing act and you want to take the minimum possible as too much will damage your muscles, bones, eyes - well, your body.
I take 15mg in the morning, 5mg at 1pm and 2.5 at 4pm. HC has a half life of roughly 6-8 hours. I agree that taking it late will keep you up. A normal body will produce it highest amount and peak at roughly 8am, fall to roughly half that at late afternoon, and fall to near zero at midnight - which is why people time their doses to correspond to that. A lot of my friends take 15mg at 8am and then 5mg at 3 or 4pm. I take a wee bit more as my ACTH is high and I am trying to suppress it.
I has my adrenals removed due to Cushing's and it destroyed my body - so please be careful with steroids. The damage is insidious.