Hi Jennei,

I visit the Addisons Board often because there are alot of very informed people there.  Dick is a Bio-Chemist Professor and does his best to keep everyone straight scientifically and iron out problems people have so endo’s can be asked the right type of question.  Cortisone Acetate crops up quite alot and here is one of his responses:

Lisa,

It is our adrenal CORTEX that has gone to hell, not the medulla. Prednisone is a direct acting glucocorticoid (replacemnt for cortisol, which is also called hydrocortisone and hydrocortone (I will call all of these HC)). Prednisone needs no metabolic activation to produce its physiologic effect and neither does the natural hormone HC. This is not true of cortisone also called cortone. This drug is sold as cortisone acetate (mostly). Two biochemical (metabolic) conversions are necessary to get it to HC. But part of it is diverted and metabolized in other ways. As a result it is not as potent and it has some side effects. So, it is not a very good replacement for the HC which are adrenals do not make. I don’t know why the Canadian docs prescribe it. Probably some Prof. at McGill started teaching that it was good years ago (it was once all they had) and its like the Queen and no one wants to contradict him. You know its like somebody saying well, my grandpappy and pappy always used a shovel to swat flies, so why shouldn’t I? There is a lot of stupid thoughtless tradition like this in science and medicine, unfortunately.

I hope this helps. Keep asking questions, and Aspen, take care of yourself. You are going to have to go to Sacramento or SF to find a good endo, I’ll bet. Rats!

Dick

I would have thought the fact that the inefficiencies of the body having to convert it twice before getting HC would cause endo’s to pause before giving it to children.  How can they be sure a childs metabolism will not fluctuate and cause these inefficiencies to yo-yo as well.  I would think the tendency would be to over medicate to ensure against snake bit.  As we know endo’s do this for hydrocortisone as well but slow growth, weight problems and immune suppression are the result.  I think your endo need to answer some hard questions as to why he/she chooses this route of treatment vs hydrocortisone that the body has direct access to.  Whoever is manufacturing this stuff cannot be making any money from it and given all the mergers past and present and the better treatments available will probably discontinue it in due course. TC

ShaunP.

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