Your adrenal gland makes different varieties of hormones such as cortisol, adrenaline, aldosterone, etc. These glands are present above your kidneys. When these glands do not make enough of steroids, you may start craving for salt-rich foods. This is because some of these adrenal hormones control sodium levels of your body. So, if excessive levels of sodium are discharged from your urine, there is an imbalance of this salt in your system. If left untreated, adrenal insufficiency can lead to damages to your kidneys, impaired mental wellbeing – showing up as depression or other forms of mood shifts, etc. Prednisone and hydrocortisone are drugs commonly used for treating such conditions. It becomes essential to understand how these two drugs compare against each other.

Adrenal insufficiency can be of multiple forms; the primary form of this endocrine condition is attributed to a damage or malfunction of your adrenal glands. The other forms – for instance, secondary form of adrenal insufficiency is due to the improper functioning of your pituitary glands. The tertiary (and not a very common form of this condition) may show up when you are living with a hypothalamic disorder. The signs of adrenal insufficiency are quite distinct; these include loss of bodyweight, spells of dehydration (marked by parched throat, lips or tongue) as well of loss of coordination. A few other signs include orthostatic low pressure (drop in pressure levels when you are standing), muscular pain, abdominal discomforts such as nausea, vomiting, etc.

What is hydrocortisone?

This is a man-made from of cortisol (a hormone). It is a widely used drug for the treatment of adrenal insufficiency. The chief use of this drug is to work as a replacement for cortisol – a hormone your body makes naturally. It is prescribed when your adrenal glands are removed or if you are living with conditions like Addison’s disease. This steroid is also used when your pituitary glands are not functioning at optimal levels. Hydrocortisone is available in sustained release as well as soluble versions. It has to be taken as per the advice of your treating physician.

Hydrocortisone may trigger a few side effects; key among them are – inflammation of ankles, migraines, dizziness as well as drowsiness. In most instances, tiredness or weakness may also ensue. Those who have had prior spells of infections in the eyes, infectious conditions like measles or chickenpox, slow healing rates of injuries / wounds, hypothyroid conditions or thinning down of bones – must tell their caregiving team about such problems.

What is prednisone?

Prednisone is also a steroid based drug. It is used for a wide range of clinical conditions – such as, blood related disorders like anemia, autoimmune conditions like arthritis, tumors as well as allergic reactions such as acne or rashes. The drug suppresses your immune system and arrests typical allergic reactions like swelling, inflammation or itchiness. Prednisone is ranked as one of the most highly prescribed meds in the US.

Like hydrocortisone, this drug is also likely to cause a few unwanted and adverse reactions. Its key adverse side effects include nausea, vomiting, dizziness, pain in abdomen, etc. It may also cause a marked drop in your appetite levels; in some people, it may trigger sleeplessness (insomnia) or other sleep-related conditions, swelling of facial parts such as chin, jaws, etc.

Prednisone versus hydrocortisone – For adrenal insufficiency

Foremost of all, hydrocortisone is not as strong as prednisone. Owing to this fundamental difference, the former may not work for everyone with hormonal deficiencies. Prednisone has a very long half-life – i.e., as compared to hydrocortisone. Due to this, prednisone can stay in your system for a fairly longer span of time. This is also one of the reasons why you may witness more side effects when you take this steroid.

On the other hand, hydrocortisone has a relatively shorter half-life. It is often administered over a very short span of time. It also acts faster than many other steroids used for correcting adrenal insufficiencies. Its fast actions (and shorter half-life) do not come in the way of your daily routine; owing to this, there are not so many adverse side effects or unwanted reactions.

Precautions needed while taking prednisone

People living with erratic periods, spells of fits, convulsions or epileptic seizures must stay away from taking these steroids. Also, those with internal injuries, ulcers or bleeding must talk to their caregiver before starting their treatment plan. Skin conditions such as thinning of the epidermal layer can get worse when you take prednisone. Consult with your dermatologist (i.e., a qualified skin specialist) if this steroid forms part of your long-term medication plan. If you are living with diabetes or other blood sugar related conditions, you may need to check your blood sugar levels on a regular basis; such precautions are needed as prednisone can lead to a spike in your sugar levels – especially, within a short span of time. So, those who experience persistent episodes of being thirsty or having to pee often must talk to their caregiver about such signs.

Precautions needed if you are consuming hydrocortisone

Those with mental conditions such as being anxious, feeling depressed, being restless or any mood shifts must talk to their mental health caregiver prior to starting your medication plan. People with eye conditions such as glaucoma, inflammation, changes in inner eye pressure levels or discoloration of eyes must take added precautions. Hydrocortisone is likely to conceal the typical signs of an infection. So, when you encounter symptoms of a likely infection – viz., soreness of throat, sneezing, tremors or shakes, runny nose or stuffed nose – you must seek medical help on an emergency basis. It is a safe practice not to get close with people who are infected or to visit places which are likely to be already infected – say, a healthcare setting or a clinic.

In sum, prednisone and hydrocortisone are drugs used for the restoration of your adrenal balance. Either of them is prescribed for endocrinal conditions such as adrenal insufficiency. However, prednisone – owing to its potency – may trigger a few severe side effects. On the contrary, hydrocortisone is not as potent as prednisone. However, it is always consider safe to consult with your caregiver about these two drugs, and also adhere to your medication plan – i.e., as prescribed by your treating physician.

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