Woke up at 7:30 feeling a little tired around the eyes, but definitely ready to get up. So here I am, 7:36, typing in my health log. Yesterday I decided I was ready to start reducing my intake of cortisol (in the form of prednisone). I'm currently taking 5 mg per day (along with 5 mg of pregnenolone and 15mg of DHEA, to make up for the lack of production by my adrenal glands). Yesterday I only took 4.5mg, and today I'm doing the same. So far, no bad effects - no depression, extreme tiredness, irritability, hypoglycemia. My endocrinologist says it is very important to come off this slowly, about 0.5 mg reduction per month. The important thing is to not confuse my hypothalamus or pituitary glands, which are responsible for regulating the cortisol levels in the blood. For example, normally when blood sugar drops, you start exercising, or something stressfull happens, the pituitary gland notices this and tells the hypothalamus to send out a messenger (ACTH). This messenger tells the adrenal glads to get busy creating cortisol. Cortisol is used all over the body. In any case, one of cortisol's functions is to help the cells increase blood sugar production. I've read that if you adjust adrenal levels drastically too many times through drugs, then your pituitary gland can lose some of it's ability to self-regulate. I'm oversimplifying a bit here, but you get the idea.
For a nice description on how the adrenal glands affect hypoglycemia, read http://www.adrenalfatigue.org/hypoglycemia.php.
I suppose I'd better make the standard disclaimer at this point: I'm not a doctor (well, not a medical doctor), so I don't intend anything on this page to replace the recommendations of a doctor and naturopath. (I've become a fan of naturopathy in the last few years since they treat the whole body/all symptoms rather than looking at a patient piecemeal... but don't get me wrong, we need western medicine too. Knowledge is power. More knowledge is more power).
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As far as I can tell, the pituitary still manages how much cortisol is in use at any given time. It detects deficits, and tells my adrenal glands to produce more when needed. Taking the prednisone is just like adding extra cortisol to my bloodstream. The pituitary sees that there is plenty around, so it tells the adrenals not to work as hard, at least until the dose I've taken has been used up. I'm taking about 1/4 the daily dose that is produced by adrenals on average, so my adrenals are still working most of the time - this just gives them a part-time break.
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