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Date Posted: 15:43:39 04/02/11 Sat
Author: Paul B.
Subject: "Lose" the message about "adrenal failure"
In reply to: SweeneyTodd 's message, "Blanked post" on 16:01:59 03/26/11 Sat

For starters, it's not "adrenal failure", it's "adrenal suppression". Providing an external source of corticosteroid is commonly done for people with rheumatic disease such as Rheumatoid Arthritis, Lupus or Polymyalgia Rheumatica.

Once you supply more than the body needs, the adrenal glands are no longer stimulated by the brain (ACTH) to produce cortisol so they cease to do so. If this situation persists for longer than a week, they actually start to shrink - they no longer "feel needed" - and if the exogenous supply suddenly ceases and they are again stimulated to "produce", they are temporarily unable to fill the need - until they grow back again.

Excess steroids (or chronic stress causing increase in endogenous production by the adrenals) in children can suppress growth - at least for the time that it continues.

These things might be a concern for the use of topical (external) steroids over a substantial body area, but are completely and utterly irrelevant to use in the way required on the specific tight area of the foreskin - much less than a square inch of total area (not to be confused with the area of the whole foreskin). Because only a tiny dab of the ointment is applied - never so much as to produce a "greasy" feeling afterwards, the standard prescription 15 gram tube (and adrenal suppression is only a concern when - much - more than this amount is to be used) should last more than a year!

The only thing worse than having patients "spooked" by reading the PI (Product Information) that comes with pharmaceuticals, is having doctors unable to comprehend the basic therapeutic principles.

>Paul B's opinion of hydrocortisone is that it is
>better than nothing. However, do remember it can
>cause adrenal failure if you use it in big quantities
>and too often for too long. You do not want
>that....... The 1% Betamethesone/betonovate? will
>help you much more but obviously as a STRONGER STEROID
> it has more potential for adrenal failure
>indications.

>You can still stretch without creams, but remember the
>steroids have a skin thinning effect...... once you
>stop applying regularly the skin will build
>again..............

Generally true.

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