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The Importance of Cortisol When Weaning Off Prednisone

Posted Oct 05 2010 12:00am

Hi Everyone.

As I’m sure many of you are aware…I have Churg Strauss.

I also just happen to take Prednisone.

I have done a few posts about tapering off of prednisone, but I wanted to take a closer look at the importance of Cortisol when the body is trying to get off of the dreaded pred!

For those of you who may be new to this blog, let me just explain what Prednisone is…

Prednisone is a corticosteroid hormone (glucocorticoid). It decreases your immune system’s response to various diseases to reduce symptoms such as swelling and allergic-type reactions. It is used to treat conditions such as arthritis , blood disorders , breathing problems , certain cancers, eye problems, immune system diseases, and skin diseases.

It is also used by people like myself who suffer from a vascular condition such as Churg Strauss.

And now a brief word from….

Cortisol, also known as hydrocortisone, is a steroid hormone or glucocorticoid produced by the adrenal gland . [1] It is released in response to stress , and to a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis, suppress the immune system, and aid in fat, protein, and carbohydrate metabolism. [2] It also decreases bone formation. Various synthetic forms of cortisol are used to treat a variety of different illnesses.

Okay, so that is cortisol…so now comes the explanation of just how these two effect one another….

Okay, so when someone such as myself is put on the medication Prednisone it is for the express purpose of suppressing one’s immune system, and prednisone is what is called a ” Synthetic Corticosteroid “.

Cortisol is produced by the zona fasciculata and zone reticularis of the adrenal cortex , which is one of two parts of the adrenal gland . [1]

It is released in response to stress , or to a low level of blood glucocorticoids, and this release is controlled by the hypothalamus , a part of the brain.The secretion of corticotropin-releasing hormone (CRH) by the hypothalamus triggers pituitary secretion of adrenal corticotrophic hormone ( ACTH ); ACTH is carried by the blood to the adrenal cortex where it triggers glucocorticoid secretion.

Okay, so this is where I am going to use myself in reference to the rest of this article…okay typically when I get to the point of being at the dosage of 20 mgs of prednisone, this is where my body is supposed to begin the process of producing it’s own cortisol…now please notice the term I have used here…” supposed ” because we assume that this is actually happening without a test on my behalf to see if this is actually in fact the case.

And this is also the point where it always seems to get harder to wean off of this sinister medication, as the weaning process seems to just come to a crawl as far as progress is concerned because we are waiting for our cortisol levels to elevate, and apparently this process is also slow at best because the ( and I forget just where I read this but…. ) adrenal glands tend to be a bit lazy when they have not actually had to produce their own cortisol for extended lengths of time, so sometimes it can take at least a year or more before they actually do start the production of cortisol…which just may explain why the weaning process to get off of prednisone can sometimes be so painstakingly slow.

So, there you have it…without there being proper levels of cortisol being produced by your body, the process of weaning off of prednisone can and usually is slow and painful as the body tries to adjust to the process of your using less of the synthetic steroid prednisone while waiting for your body to naturally start the process of making it’s own cortisol…it’s actually the worst ” Catch 22 ” I’ve ever heard of…don’t you think?

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