pituitary.org.uk

Hi
Just a quick comment about coping with stress.
Cortisol is called the stress hormone because it's part of the body's response to stress. It does lots of things but the most important is probably to raise your blood glucose so your brain and other parts of the body have enough energy to respond to a threat; be it physical (infection, surgery, a loud bang or someone with a knife) or mental. This action has a timescale of about an hour.
The body's immediate energy demands are met by adrenaline (epinephrine is an alternative name) and glucagon; unfortunately adrenaline production in the adrenal glands is dependent on the manufacture of cortisol, replacement levels are not enough to allow this to work. Also ACTH appears to have a role as well. This means that loss of ACTH causes major problems for the stress response of the body - part works, part doesn't and as a result things can go very lopsided.
In general we all find our response to stress has changed by damage to the pituitary, the scale of the change seems to be down to individual circumstances since each of us seems to have differences in our response to replacement and precisely what is going on.
Take care of your selves
Tim

Hi
Thanks Tim this is a nice clear explanation of why cortisol is needed. I hadn't thought about the link with adrenaline. I have noticed since surgery that I don't get particularly excited about things or worked up about things as much as before. I can worry mentally but somehow the physical feeling of butterflies in the tummy etc doesn't happen any more. So maybe although my 9am cortisol is sufficiently high for me to not be on hydrocortisone, there is a problem with the chain of response somewhere....
RB I fully understand about your Dad needing to recover after being 'busy' and that being busy now entails doing far less than before. This is all very frustrating isn't it. And so hard to explain to people who are not going through it.
best wishes to all
Plum

Hi guys,
I can sympathise about stress leaving you feeling absolutely wiped out. I call it post-party-let-down and it often happens to me, too, so that I need an afternoon nap (or even a morning nap) the day after a big day out. I get chilled and sleepy and just have to crawl off under the duvet. Even positive stress will burn through adrenaline faster than usual. Usually, the human body stores a big adrenaline reserve in the central core of the adrenal glands, but most people with long-standing steroid-dependence find that this adrenaline reservoir gradually packs up as well, as Tim says.
You are still generating some adrenaline from peripheral nerve endings, however, and raised adrenaline gets the kidneys going, so you will be tending to flush sodium out just a little bit faster than usual.
It might be worth trying a little salt loading to see if that helps? This doesn't have to mean munching through high-calorie foods like crisps and salted peanuts. You can go straight to the anchovy fix if you like the taste of them (on a fork, out of a drained jar, standing over the kitchen sink). Or you can add a pinch of salt to lemonade/fizzy water – or even coffee or orange juice – without the taste becoming unpleasant. If it tastes yummy, you need it. Hummus is also yummy as a salt-fix and can be spread on cucumber slices or lettuce for those who are counting the calories.
People with primary adrenal failure have a less stable salt balance and are more sensitive on this, but a mild tendency for sodium run low also applies to people with pituitary steroid-dependence because cortisol is a secondary regulator that helps to control the salt balance. If salty foods or beverages make you wrinkle up your nose, then you probably don't need them. But if they taste good, then your cravings are guiding towards a nutritional need.
Not saying this is going to be a solution for everyone, just something to try that may help you get through the post-stress crash a bit faster.
Best
Kit-Kat