I had surgery for Cushing's, why do I have to take steroid (cortisol) replacement (hydrocortisone (Cortef), prednisone or dexamethasone)?

This is the best outcome after pituitary surgery. It means that the tumor has been removed completely and that the rest of the gland is still suppressed (relatively "asleep"). It may take several months for the normal ACTH producing cells to regain function.

In the mean time, steroid replacement is necessary to protect against adrenal insufficiency (steroid is necessary for normal life). At a later date, the need for continued steroid replacement is determined by blood tests. If a person has to take steroid replacement (hydrocortisone, prednisone, dexamethasone) he/she should wear a Medic Alert bracelet or necklace, which identifies the need for steroid treatment.

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