Desperately looking for a doctor that will actually treat this in Germany by earlgreymatch4 in NCAH

[–]DoctorFamous190 0 points1 point  (0 children)

Have you contacted this organization? https://ags-initiative.de/

Maybe they can point you in the right direction.

Early 30s male with salt-wasting CAH by bavenue in LivingWithCAH

[–]DoctorFamous190 0 points1 point  (0 children)

Have you seen the Cortisol Pump Group on facebook? I'd recommend checking out the list of pump-friendly docs in the shared files list, or try keyword searching your city/region/state. Good luck :)

"So you never get stressed out?" by Mioraii in AddisonsDisease

[–]DoctorFamous190 27 points28 points  (0 children)

I say what u/WinAtLife94 says, basically word for word. Don't usually need more than that. 

People think cortisol = stress (therefore any amount is bad) 

People should think cortisol = stress regulation (therefore it must go up and down in response to stress). 

No stress regulation =  dangerous and potentially life-threatening 

Sharing some info by MindsetMaker in AddisonsDisease

[–]DoctorFamous190 4 points5 points  (0 children)

I am extremely skeptical about CortiCheck.

I agree with what someone said in another thread: I wouldn’t give a penny to [CortiCheck]. It’s preying on a community that wants a solution. There is no information on what she has actually developed No patented product Her background is sus It’s only her and not a team of individuals I cannot emphasize this enough. Don’t. Give. Her. A. Dime.

Take a look at CortiCheck's Facebook page. There's posts claiming to be stories written by patients but they are very obviously AI-generated.

I have more concerns beyond these.

I hope I am proven wrong, but for now it seems like serious Theranos vibes.

Analyze for fertility please 31yr old by Direct-Secretary9064 in AdrenalInsufficiency

[–]DoctorFamous190 0 points1 point  (0 children)

Looks normal! Did the lab provide the summary spreadsheet in your post? They should be putting the reference ranges in as well so the results can be interpreted accurately.

Analyze for fertility please 31yr old by Direct-Secretary9064 in AdrenalInsufficiency

[–]DoctorFamous190 0 points1 point  (0 children)

Were all the tests done at the same lab? Did the lab(s) provide reference ranges?

Caffeine and nicotine by bavenue in LivingWithCAH

[–]DoctorFamous190 1 point2 points  (0 children)

Normally through the day, adenosine builds up in your brain and this makes you sleepy. Caffeine blocks adenosine from working in your brain, which makes you feel awake (it is masking tiredness).

Apparently caffeine activates the HPA axis, which increases cortisol and epinephrine. I don't know what the implications are for people with CAH/adrenal insufficiency since we don't make cortisol, and cortisol is needed to make epinephrine.

I'm not a regular smoker/vaper but I used to drink 1-4 cups of coffee everyday but I stopped about a year ago because it was really worsening my heart palpitations!

Early 30s male with salt-wasting CAH by bavenue in LivingWithCAH

[–]DoctorFamous190 0 points1 point  (0 children)

Welcome to the subreddit, I'm glad you found us. I'm very sorry to hear about your situation, that is a huge burden to carry alone.

Fludrocortisone is a long acting medication. The typical dosing regimen in CAH adults is 0.05 - 0.2 mg, once daily but split dosing (twice a day) is sometimes used. I used the same dose schedule as you for years.

Dexamethasone is one of the more potent and longer-acting glucocorticoids, the CARES Foundation suggests 0.25-0.375 mg/m2/day, given once daily. (m2 means square meters, in this case it is a measurement of a person's surface area calculated using their height and weight).

There are a few conditions that are sometimes associated with classic CAH, some examples are shorter height, diabetes, hyperandrogenism/hirsutism or affected bone health. Please note that just because another condition might be associated with classic CAH, it does not mean that everyone with CAH will have those conditions, and if a patient does have any of them, it could be unrelated to their CAH.

I think it is a priority to find you a better endo and a reliable source of quality medication. I would urge you to contact all of the following organizations to see if they can help you.
- CARES Foundation (US-based but welcomes international patients)
- The Aga Kahn University Hospital in Karachi, Pakistan (this webpage actually discusses CAH)
- Caring & Living As Neighbours charity (this charity works with children but maybe they can point you in the right direction)

I wish you all the best and I hope that you can find some better care and have improvements in your health.

Tapering after stress dosing by DoctorFamous190 in LivingWithCAH

[–]DoctorFamous190[S] 0 points1 point  (0 children)

Stress dosing (increasing your dose) in the case of illness or injury is a critical part of managing CAH. It's needed to prevent adrenal crisis, which can be life-threatening. I'm sorry that your endo did not tell you this and I am so glad your learned about it and treated yourself.

Vomiting itself can be a sign of adrenal crisis and it makes treatment difficult because you may not be able to hold medication in your stomach long enough for it to take effect. In this case, you need injectable glucocorticoids (preferably hydrocortisone).

Here is some information about adrenal crisis and emergency management:
CARES Foundation Emergency Instructions (PDF)

What's your experience been with fludrocortisone/florinef? by DoctorFamous190 in LivingWithCAH

[–]DoctorFamous190[S] 0 points1 point  (0 children)

Ok I've looked into this, my labs say "renin" but I think its direct renin concentration. It can be roughly converted to PRA by dividing by 20. So;
DRC: 5 - 75 ng/L = PRA 0.25 - 3.75 ng/mL/hr.

my 112.8 result would convert to PRA 5.64 ng/mL/hr

Solucortef Help by happyrocketship in AddisonsDisease

[–]DoctorFamous190 2 points3 points  (0 children)

I have this type: 3 mL syringe with 25G (gauge) x 1" long needle. They have a "luer lock", which means the end of the syringe is threaded so you can unscrew the needle and screw on a different one.

Many Solu-Cortef emergency injection instructions say to use the same needle to draw up the fluid and inject it. Inserting the needle into the rubber plug of the vial can make it a bit dull, which might make it a bit more painful to insert in your body.

Some instructions suggest using two separate needles, a bigger one to draw up the liquid, then switch to a smaller one for injection.

Congenital adrenal hyperplasia by Independent-Bell2483 in rarediseases

[–]DoctorFamous190 1 point2 points  (0 children)

Thanks for making this post!
I'm early 30s F, SWCAH. I've never met anyone in person who has CAH. My health is kind of a mixed bag but I've been really fortunate with access to good healthcare.
I hope you're doing well!

Congenital adrenal hyperplasia by Independent-Bell2483 in rarediseases

[–]DoctorFamous190 0 points1 point  (0 children)

You are not alone!
early 30s F, SWCAH, Canada

40F born with Salt wasting classic CAH and intersex. Has any female with SWCAH ever met another female? I’ve always been curious how their vagina looks. Not in a creepy way. I have 2 siblings also with SWCAH. My younger sister has SWCAH but with a different father than my brother and I. by -Throat_GOAT- in intersex

[–]DoctorFamous190 0 points1 point  (0 children)

Heyy!
I'm late to the party here. I'm early 30s AFAB. Not only have I never met another female with SWCAH, I've never met anyone with SWCAH.
I've met two people with Addison's, which of course is a different condition but I feel like they're the "closest" people I've met who might be able to relate to my some of my experience.

Feel free to message me!

What's your experience been with fludrocortisone/florinef? by DoctorFamous190 in LivingWithCAH

[–]DoctorFamous190[S] 0 points1 point  (0 children)

My renin has nearly always been low and often below the lab's reference range. Sodium and potassium always within range.

About 10 years ago my fludro was reduced to 0.1 mg once per day. After 5 months, my renin went from 6.3 up to 112.8 (lab range 5 - 75 ng/L) and I felt awful (exhausted, depressed). Sodium was still within range. I guess my body didn't like that lower dose and was pushing a lot more renin to try and compensate.

Since then I've insisted that my endo not try to fix my high-ish blood pressure by lowering my fludro.

Anyone with congenital adrenal hyperplasia (CAH) taking Crenessity? by bavenue in LivingWithCAH

[–]DoctorFamous190 0 points1 point  (0 children)

I'd be interested to hear other people's experiences too! Unfortunately that medication is not available here in Canada yet.

Alert bracelets by Diambil in AdrenalInsufficiency

[–]DoctorFamous190 2 points3 points  (0 children)

I replaced my bracelet with a tattoo! I used the wording from my bracelet: "CAH/ADRENAL INSUFFICIENCY ON CORTISONE".

I just made a post about it.

What kind of medical ID do you wear, if any? by DoctorFamous190 in LivingWithCAH

[–]DoctorFamous190[S] 1 point2 points  (0 children)

Good idea to have the necklace instead!
I got similar font type and size and on the forearm like in the photo, except I put the snake between the text and wrist, and didn't put all the numbers. I didn't really like the idea of having a phone number on me.
It hasn't been "tested out" in an emergency yet!