New to board

[Deo]

Hi all, I am 49, male and from the Caribbean. I was diagnosed with addisons in 2005. It was caused adrenomyeloneuropathy (amn). The diagnosis and treatment came over 15 years after the disease onsetted so you could imagine what life was back then. I was put on hydrocortisone then and life sort of resumed. Last year my source of hydrocortisone dried up and I was forced to switch to prednisolone. Anyway I have not been feeling good for months now. My bloodwork done a month ago revealed that I have hypothyroidism-the antibodies are very high-so I have been prescribed half tablet of euthyrox. Last week I developed an abscess on my finger and a really bad cough-went to the doctor and found out I have diabetes-with blood sugar over 200. It seem it was induced by the prednisolone-I tried to reduce the dosage but felt really sick. I am on metformin two tablets twice daily but my blood sugar still averages 166.
I would be grateful to those of you who are kind enough to read this post and share similar history to indicate what strategies you have adoped to manage this condition.
Deo

[gkardel]

Deo,

Sorry for delay in approving your post but welcome to the forum.

How was the adrenomyeloneuropathy diagnosis arrived at?

What dose of prednisolone are you on and what time do you take it? Prednisolone has a higher glucocorticoid component compared to hydrocortisone and thus causes increased release of glucose from the liver. Did you have a c-peptide test to evaluate your insulin production?

-Glenn

[Deo]

Hi Glenn,
The amn diagnosis only came about when my seven year old nephew was diagnosed with the childhood form of the disease-adrenoleukodystrophy. He died in 2007, one year after the disease onsetted. It is a genetic disease affecting males and is casued by a mutation of one of the genes on the x chromosone. It has caused addisions disease among other things with me.
I redid the bloodwork and saw my endocrinologist on Friday last. My TSH readings and cholesterol readings are back to normal-with crestor and euthyrox. I have given up on flour and try to eat only complex carbohydrates which seem to be working to send my blood sugar levels to close to normal-but with metformin and glibenclamide. My doc wants me to see if I could gradually reduce the prednisolone to 5g in the morning and 2.5g in the evening. Once I keep life stress free maybe I can do this.
I have not done a Cpeptide test but would discuss with doc next visit in 3 months. Thanks for your response.
Deo

[gkardel]

Do you take fludrocortisone?

Even 7.5 mg pred per day is on the the high side for cortisol replacement in adrenal insufficiency. 5 mg pred per day is more in line with recommended dose and would help with the type II diabetes. Some doctors argue that taking pred once a day at bedtime would do a better job getting closer to the normal cortisol production cycle. Pred has higher risk for side effects than hydrocortisone - important to minimize the dose.

An option for you to get HC may be through Canadian pharmacy online/mail order.

-Glenn