One hour after HC administration, significantly increased plasma cortisol levels were noted in patients taking high-dose HC compared with those taking low-dose HC (median 741 nmol/L; interquartile range [IQR]: 669-870 vs median 499 nmol/L; IQR: 363-605; P <.001). Similar differences were noted 5 hours after the morning HC dose (median: 235 nmol/L; IQR: 170-314 and median: 112 nmol/L; IQR: 75-199; for higher and lower doses, respectively; P <.001). However, no z-score differences were recorded in any somatosensory functioning measures, and rates of sensory abnormality did not differ between patients taking lower or higher doses of HC (27%; 95% CI, 14%-40% vs 29%; 95% CI, 16%-24%, respectively).
Adrenal crisis is awful. It's terrifying. And what makes me want to cry as I write this (who am I kidding, I am crying) is that I couldn't have cared less if I lived or died. I was not in my right mind, I felt so horrid. All the surgeries combined, today was the worst day I've ever had. And it was a huge wake-up call. I need to have a better medic-alert bracelet because they had no idea what "Stress dose steroids" were. I need to have a list of what to do in crisis on my fridge, in my purse and with every family member. Same with the letter from my endo on how to treat me. Because when I'm in crisis, I don't know any better. I need to have things that speak for me. Thank God for family that knows, and for good doctors.
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.