Educational Videos

Adrenal Insufficiency and High Dose Steroids

Introduction: Kathy Olevsky, VF Webinar Host 00:11
Introduction: Dr. Lynette Nieman 01:49
Webinar Outline 03:09
Adrenal Cortex Hormones 03:42
The right amount of cortisol is critical 05:16
How cortisol production is controlled by the body 05:55
What is the cortisol daily rhythm? 08:20
Secondary adrenal insufficiency (AI) 09:33
The most common cause of secondary AI 11:29
Frequency of signs and symptoms of AI 14:39
What determines the dose and type of steroid that is needed? 17:12
How does my doctor know if I have AI? 18:46
Tips for living on a high dose of (treatment) steroids 20:42
Tapering: When and how to safely stop steroids 23:40
Tips for feeling well on replacement steroids 28:06
Factors influencing choice/schedule of glucocorticoid replacement 29:41
Important things to do when taking replacement steroids 32:03
Kathy’s Patient Perspective on Steroid Therapy 33:08
Q&A: Is there a test for AI, and what type of doctor would do the testing? 38:19
Q&A: Should an endocrinologist help in the tapering process? 41:00
Q&A: Are there some patient with vasculitis who will have to be on prednisone the rest of their lives? Do you have comments for those patients? 42:36
Q&A: Why do emergency personal often refuse to give us our solucortef injections when we provide them in emergency situations, or when we ask for them to? I’d also like to know why so many endocrinologists do NOT think having an injection kit is necessary. (It truly IS a matter of life & death) 44:45
Q&A: What do patients need to know about AI surrounding surgery? Are there any risks, or particular precautions that should be taken? 49:02
Q&A: What needs to be done for an ER visit if you’re on steroid therapy? 51:27

Dr. Lynnette Nieman presents a valuable webinar about adrenal issues and steroid therapy. She talks about clinical features and causes of adrenal insufficiency, and what you need to know about taking steroids.

Lynnette Nieman, MD, FACP
Senior Investigator
Diabetes, Endocrine and Obesity Branch
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Chief, Endocrinology Consultation Service
National Institutes of Health

Dr. Lynnette Nieman is a Senior Investigator at the National Institutes of Health (NIH) in Bethesda, MD, USA and head of the Endocrine Consult service at the NIH Clinical Center. Dr. Nieman is an active clinical investigator, with eleven protocols. Her research interests include disorders of cortisol deficiency and excess, and female reproduction.  She has authored more than 280 publications and sponsored three investigational new drug applications, one of which was licensed in the US and Europe. She has received the NIH Director’s Award, NIH Clinical Teacher of the Year Award and the Endocrine Society’s Distinguished Physician award and has provided Congressional testimony. Dr. Nieman served as the President of the Endocrine Society from March 2017 to March 2018.


Here’s an option if you don’t watch the full video.
Below are 1-2 minute video highlights from this presentation.

Why do some emergency physicians not give Solu Cortef injections upon request?

Should I see an endocrinologist to taper off steroids?

Is there currently a test for adrenal insufficiency?

Will I always be on steroids?