I personally have only been diagnosed a couple months ago with
secondary shown via an insulin tolerance test. I got a severely blunted
cortisol response.

They told me to go straight onto 20mg, but being cautious and drug
sensitive, I decided to try starting VERY low, like 5mg a day. I paid
for it, as within about 4 days, my own production must have stopped,
because I ended up with a crash and in ER one morning. I knew that
morning i didnt have enough cortisol in me, and took another 10mg
straight away. I was taken to ER, but i gradually got better as i was
there from the increase in HC. I took another 2.5 every few hours too,
and by the time i went home i was alot better. From then on i started
20mg a day.

I would suggest starting at at least 10mg, even 15mg. either of those
are very low, and depending on the severity of your secondary, may not
be enough. Im now on 35-40mg as it seems to be the only dose that works
for me so far. Hoping to be able to lower it or change to a longer
acting steroid in the near future.

Good luck with finding your dose!

--- In Hypopituitary_Support@yahoogroups.com, "birrdyy" <birrdyy@...>
wrote:
>
> Does a secondary need to worry about ramping up on HC or can they go
> straight to 20?
>
> Thanks.
>