If you or someone you know has adrenal insufficiency, you probably understand how difficult it is to regulate glucocorticoid replacement therapy. That’s because the body normally has various levels of cortisol throughout the day as well as in response to stressors. Glucocorticoid over-treatment may result in weight gain and metabolic impairment, with dose reduction the most common recommendation. More recent research is pointing to new methods, including multiple doses throughout the day or once-daily time-released treatment.
Scientists at Sapienza University of Rome investigated the effect of modified-release hydrocortisone treatment on metabolism and immunity in a single-blind randomized controlled trial. They reported in The Lancet that individuals who switched from standard glucocorticoid treatment to once-daily modified-release hydrocortisone treatment had significant weight reduction, more normal immune profiles, less susceptibility to infections and increased quality of life as compared to those on standard treatment.
The study provides support for further investigation of the modified-release regimen. More long-term studies, possibly with controlled dosage and double-blind design, will elucidate if this new treatment regimen should become standard for individuals suffering from adrenal insufficiency.