Corticosteroid Replacement Basics – Quick Guide for Patients

If your body can’t make enough natural steroids, doctors will give you a replacement. This is called corticosteroid replacement therapy. It’s common for people with Addison's disease, congenital adrenal hyperplasia, or after long‑term steroid use.

When is corticosteroid replacement necessary?

The adrenal glands produce cortisol and sometimes aldosterone. When they fail, you can feel tired, dizzy, low blood pressure, or get a sudden crisis with vomiting and confusion. A simple blood test shows low cortisol levels, and the doctor will start you on a replacement.

Typical reasons include:

• Addison’s disease (primary adrenal insufficiency)
• Secondary adrenal insufficiency after stopping high‑dose steroids
• Congenital adrenal hyperplasia in children
• Some cancers that affect the pituitary or adrenal glands

Practical tips for safe steroid therapy

The most common replacement drugs are hydrocortisone, prednisone, and sometimes dexamethasone. Hydrocortisone mimics natural cortisol best, so many doctors start with it in the morning and a smaller dose at noon.

Key dosing ideas:

• Take the biggest dose early in the day to match your body’s rhythm.
• If you feel extra tired or stressed, you may need a short “stress dose” – an extra tablet on sick days.
• Never skip doses. Missing a pill can trigger an adrenal crisis that needs emergency care.

Watch for side effects like weight gain, mood swings, high blood sugar, or easy bruising. If any of these show up, talk to your doctor about adjusting the dose.

Regular check‑ups are a must. Your doctor will test blood sodium, potassium, and glucose levels every few months to make sure the replacement is balanced.

Keep a medical alert bracelet or card that says you’re on corticosteroid replacement. In an emergency, first responders need to know you may require a rapid steroid injection.

Finally, don’t change your medication on your own. Even over‑the‑counter supplements can interact with steroids and affect hormone balance.

By understanding why you need the therapy, what drug you’re on, and how to handle everyday situations, you can stay safe and feel better while living with corticosteroid replacement.