Understanding Addison's Disease/Crisis with Prednisone

If you are taking any type of long term corticosteroid use your doctor should have talked to you about a tapering process. You doctor should also explain why you have to taper off of the Prednisone instead of jumping off of it like you do a lot of other medications. Even though it can be tough, it is extremely important to follow the tapering regiment your doctor has planned for you. If you don't you could become seriously ill with something called Addison's Disease and Addison's Crisis.

In order to understand what Addison's disease/Crisis is or why it happens we first need to understand a bit about the physiology of our body and how it works with Prednisone. Your adrenal glands actually make a hormone very similar to Prednisone called Cortisol. Most of you probably know that when you are stressed your body produces more cortisol and so you end up gaining weight (sounds familiar lol) While too much Cortisol can cause problems, Cortisol is actually vital for life. Cortisol helps the body to carry out processes and helps keep the body in a state of homeostasis or, rather, in a state of balance - super important.

The body makes about 7.5 mg per day equating to about 7.5 mg of Prednisone.

When Prednisone is introduced in the body at larger doses then 7.5 mg and for a few weeks and beyond your body realizes that there is too much Cortisol and so the adrenal glands quit making it as a way to compensate. The problem happens when you suddenly come off of Prednisone before the body starts making it again and that is what Addison's Disease is. In order for your body to acclimate to producing Cortisol again, the body has to understand that it's not getting enough and therefore slowly starts to produce it. Unfortunately it does take some time for your body to get back that process which can make getting off of Prednisone slow.

So what happens if you jump off Prednisone before your body starts making Cortisol? The symptoms can range immensely, from aches (addison's disease) to the more serious Addison's Crisis which can cause comas and even death. While tapering off of Prednisone it's extremely important to understand Addison's symptoms so that you can tell your doctor if you are experience any of them. Everyone's body is different so the tapering process might be different from one person to the next. Your doctor will be able to help if you are having any of these symptoms;

• Muscle weakness and fatigue
• Weight loss and decreased appetite
• Darkening of your skin (hyperpigmentation)
• Low blood pressure, even fainting
• Salt craving
• Low blood sugar (hypoglycemia)
• Nausea, diarrhea or vomiting
• Muscle or joint pains
• Irritability
• Depression
• Body hair loss or sexual dysfunction in women

There are more serious symptoms that indicate Addison's Crisis. If you have these symptoms you need to talk to your doctor immediately. They include; 

• Pain in your lower back, abdomen or legs
• Severe vomiting and diarrhea, leading to dehydration
• Low blood pressure
• Loss of consciousness
• High potassium (hyperkalemia)

The more you understand about Prednsione and your body the better your treatment plan will be. It's so important to talk with your doctor often so that you both are comfortable with your tapering plan. With good communicate between you and your doctor you should be able to avoid most (if not all) of the symptoms of Addison's Disease and certainly all of the symptoms of Addison's Crisis:)