Hi there, appreciate the help of this community. I'm a 39 year old man and I've recently been diagnosed with adrenal insufficiency after a massive 2cm pituitary tumor macroadenoma that hemorrhaged and required emergency neurosurgery last year. The recover has been horrific. I was bedridden for months and had an inexperienced endocrinologist completely miss the symptoms of AI for many months after that. I started seeing my new endocrinologist in late February this year and he diagnosed me through an insulin tolerance test with secondary adrenal insufficiency and hypopituitarism.
My pituitary gland is basically non functioning -- I'm also on testosterone for low testosterone, on cabergoline for high prolactin (which has almost normalized) and I was also found to have low growth hormone (I was prescribed Omnitrope but had a bad reaction and had to take a week off of work to recover from severe facial pain and swelling and exhaustion and I have been taken off that for now to be revisited in the months ahead).
My question is around side effects related to hydrocortisone and AI. I am on 20mg of hydrocortisone a day. My doctor prescribed 10mg at 730am and 10mg at about 3pm but that dosing schedule didn't work for me. I now split my dose up in multiple doses throughout the day (10mg in morning, 5mg at noon and 2.5mg in late afternoon and early evening) and have been adjusting better with more energy and ability to cope with stress and take care of my young toddler at night and be a good husband to my wife. But I'm having what seem to be intense vascular issues in my face where I'm still dealing with facial swelling (my face and cheeks looks like I'm 50lbs heavier than I am), bloodshot eyes and bad facial redness -- I presume when my cortisol reserves are low, particularly at the end of the day or when I'm under a lot of stress at work.
Has anyone dealt with these symptoms before and do you have any advice based on the symptoms and dosing schedule I've provided? Thank you very much for your help. I'm desperate for help to optimize my dosing. Appreciate all the help this community provides to patients.