I had pituitary surgery, on date____________ I had adrenal surgery, on
date_____________ Adrenal Insufficiency & Cortisol Withdrawal
After pituitary and adrenal surgery, adrenal insufficiency can occur as replacement steroid hormones are tapered and adrenal hormone production slowly improves toward normal. If hormone production does not return to normal then replacement hormones will be needed on a permanent basis.
If you have pituitary or adrenal surgery it is recommended that you wear an ID bracelet, or necklace that will identify you as being adrenal insufficient. There are many places to purchase medical ID’s. Your local jewelry store or pharmacy will probably have them. There’s also a vast supply of merchants that sell medical ID’s on the Internet.
With Cushing’s the body is producing too much cortisol. Over a period of time the body gets accustomed to the high levels of cortisol.
After surgery for Cushing’s ideally the cortisol level
will decline. As the decline in cortisol level continues it is common to
experience withdrawal. The pain from withdrawal can be horrible but it’s a
positive sign that you likely got a cure from the Cushing’s. It is
important that you follow your doctor’s advice as he will adjust your
replacement dosage accordingly.
It’s
important to KNOW the difference between what is considered to be common
cortisol withdrawal symptoms and Adrenal Insufficiency. Death can occur
from Adrenal Insufficiency due to overwhelming shock if early treatment is not
provided. Always follow your doctor’s advice and never adjust your replacement
medications on your own.
Adrenal Insufficiency: is an abrupt, life-threatening state caused by insufficient cortisol, a hormone produced and released by the adrenal gland.
Those who are at risk for Adrenal Insufficiency should be taught to recognize signs of potential stress that may precipitate an acute adrenal crisis. An Adrenal Crisis can occur suddenly and unexpectedly. Some people are taught to give themselves an emergency injection of hydrocortisone in times of stress. It is important for the individual to always carry a medical identification card that states the type of medication and the proper dose needed in case of an emergency. Never omit replacement medication. If unable to retain medication due to vomiting, notify the health care provider as you may need injectable replacement. Some of the initial symptoms of Adrenal Insufficiency may include but not limited to some of the following symptoms headache, weakness, fatigue, nausea and or vomiting, diarrhea, confusion, rapid heart rate, joint pain, chills, fever, low blood pressure etc. later symptoms as the Adrenal Insufficiency progresses may include but not limited to dehydration, darkening of the skin, weight loss, appetite loss, rash, coma.
Treatment:
Intravenous or intramuscular
injection of hydrocortisone ( injectable corticosteroid) must be given
immediately. Treatment of low blood pressure is usually necessary and may be
treated with intravenous fluids. Hospitalization is often required for adequate
treatment and monitoring.
It’s very important for someone who has the potential to have Adrenal Insufficiency to let their family members and friends know what the symptoms are and what actions should be taken in an emergency situation.
We have utilized a form to be printed, filled out and kept in the possession of those who are potential candidates to have an adrenal crisis. Hopefully, the information on the form can help your medical providers provide you with the best care possible. If you are a potential candidate to have an adrenal crisis we encourage you to keep a copy for yourself and you may want to provide a copy to a relative or friend.
I’m a potential candidate to have an adrenal crisis due to the following:
I had pituitary surgery, on date____________ I had adrenal surgery, on
date_____________
Other
reason ________________________________________________________
Name_____________________________________________________Phone____________________________
Address____________________________________________________________________________________
In case of an emergency please contact my family member or friend:
Name______________________________________________________________________________________
Home # _______________________Cell #______________________Work #____________________________
My Medical Doctor:__________________________________________Phone___________________________
Address____________________________________________________________________________________
My Endocrinologist:___________________________________________Phone__________________________
Address____________________________________________________________________________________
My current dose of daily steroid replacement is:
Name of drug_____________________________________Doseage_______________ Times per day_________
My current “stress” dose of steroid replacement is:
Name of drug_____________________________________Doseage_______________ Times per day_________
Other Rx or OTC med. herbs & vitamins in addition to the above:
Name of drug______________________________________Doseage_______________ Times per day________
Name of drug______________________________________Doseage_______________ Times per day________
Name of drug______________________________________Doseage_______________ Times per day________
Name of drug______________________________________Doseage_______________ Times per day________
Name of drug______________________________________Doseage_______________ Times per day________
Name of drug______________________________________Doseage_______________ Times per day________
Name of drug______________________________________Doseage_______________ Times per day________
(Attach an additional sheet of paper if
needed)
Circle all medical conditions that apply to you and list any
additional medical conditions
or information that your health care provider
should know.
Heart
Diabetes
Other________________________________
High Blood
Pressure
Sleep Apnea
Other________________________________
Asthma Arthritis Other________________________________
Emphysema Kidney Other________________________________
Blood Disorder Liver Other________________________________
Form provided by:
Cushing’s Understanding Support & Help
Org.
________________________________________________________________________________________________________________
Cushing’s Understanding Support & Help Org. We're a non-profit organization. We're not a medical authority, therefore we do not claim to have medical knowledge. Always consult your doctor or healthcare provider with any medical questions that you have concerning test, treatment, advice, etc. This information is provided as a service to Cushing’s patient's their family and friends and should never be considered as medical advice. It can be printed from this site for personal use only. The information is not to be edited. Using the information for any other reason than mentioned above requires prior written authorization from CUSH.
