At my endo visit last week I received the results of my DEXA (bone density) scan. Although the neck of femur results were not alarmingly lower than three years ago, the result of the lumbar spine component of the DEXA scan was. It had dropped quite dramatically. He said he didn’t want to believe it. .

Consequently the endo wants me to space my twice daily doses of Prednisolone to 12 hours apart. Previously I had been roughly following the circadian timing, (depending on when I woke), so about 2-4am and then about 7-8am. Now he wants me to take the larger dose at dinner time 6-7pm (3.5mg) and when I wake up to take the smaller dose (2.5mg).

The trouble is, I feel that this goes against all that I have been thinking in the last couple of years in regards to refining cortisol intake times to maximise overall health. As we know in normal body rhythms we tend to produce growth hormone at night and cortisol during the day. It is not normal to have high levels of cortisol overnight....but doctors don’t seem to put much store on this.

Also suddenly, after all these years of asking my endo’s of the relationship between taking steroids and possible bone mass loss, (as well as other systemic implications) and them saying that at these doses there is NO affect...he didn’t even want me to raise my dose for a few days in case it worsened my bone density. My adrenal levels have been up for several weeks and I had been feeling very unwell for weeks and was diagnosed with viral pneumonia last week. I feel so tired.

Any ideas as to how I could still separate out my dose - by 12 hours, but make it more body-friendly in the long-term?