George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science , International Society for Clinical Densitometry , Southern Society for Clinical Investigation , American College of Medical Practice Executives , American Association for Physician Leadership , American College of Physicians , American Diabetes Association , American Federation for Medical Research , American Heart Association , Central Society for Clinical and Translational Research , Endocrine Society
Disclosure: Nothing to disclose.
The adrenal glands don’t really get ‘tired’ in the way that you might expect. What happens is that, after a period of chronic stress, your body starts to run out of the hormone precursor material that it uses to make certain hormones. As this continues, it becomes more and more difficult for your body to produce the required levels of stress hormones, sex hormones, and other hormones and neurotransmitters. That’s when the ‘fatigue’ starts to kick in, and that’s when you need to offer your body some extra support.
Stopping corticosteroid therapy
In autoimmune disease, clear end-points should be set before starting therapy. Corticosteroids may improve mood and give patients a feeling of general well-being unrelated to the effect on the disease being treated. Subjective assessments can therefore be misleading. Objective clinical parameters should be used to monitor the need for continuing or restarting therapy . proteinuria in nephritis, spirometry in asthma and creatinine kinase in myositis. Therapy should be tapered off. For example, with prednis(ol)one, the dose is reduced in steps of -5 mg every 3-7 days down to 15 mg/day. At that point, switch to alternate day therapy and reduce in mg steps over 2-3 weeks. This minimises the impact on mood and lessens the drop in general well-being.