Weaning hydrocortisone

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Once the goal of optimzing thyroid has been achieved, for most people
it is time to wean hydrocortisone replacement.

The first indication of readiness to reduce hydrocortisone may be a
pattern of forgetting a dose when it is due.

The safest approach to weaning hydrocortisone is to reduce at the rate
of 2.5 mg every two weeks. The dose from which the reductions are
made will be very individual. The initial approach would be to reduce
the dose prior to the one that is being forgotten.

Track daily average temperatures throughout the weaning process. If
temperatures wobble and do not correct within a few days, return to the
previous dose and wait another two weeks before attempting a
reduction.

If at any time low cortisol symptoms appear, return to the previous dose
and wait another two weeks before again attempting a reduction.

During weaning -- and as long as a year after weaning has been
completed -- it is possible to require stress dosing with hydrocortisone
for unusual circumstances such as illness or trauma.