Stress Dose (definition)

Stress dose:

A “stress dose” is an increase in the amount of corticosteroids taken in response to a stressful situation or illness. This is a treatment for adrenal insufficiency, and must be prescribed by a doctor.

Occasionally, a stress dose is taken preemptively in anticipation of exercise or increased physical activity or predictable emotional distress (i.e., before a potentially dramatic social encounter, like a funeral for someone very close to you)

Basically, any time a normally healthy person’s body would be automatically producing more cortisol in response to stress, someone with adrenal insufficiency needs to manually take corticosteroids to make up for that lack of natural secretion.

Endocrinologists seem to have different opinions on the proper implementations of stress doses, including frequency and dose size. Having been to a handful of different endocrinologists over the years, I have experienced the most liberal and conservative of implementations of stress dosing and overall corticosteroid use. I am currently seeing an endocrinologist who is somewhere in the middle on this.

Every patient is different, and should consult their doctor to determine if, when, and how they should stress dose.

In my case, I have been properly instructed on how to implement stress doses on my own. Having done this for years, I am pretty well trained on picking up my body’s cues and responding appropriately. My endocrinologist trusts me to make the right judgment calls, and I report it to him when I do need to stress dose so he can keep track as well.


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