mental stress. This folder is a supplement to the information that you have already received from your own doctor. In the Dutch version of this folder we refer to these recommendations as 'stress instructions'; some patients may notice that they are very similar to 'sick day rules' but we have opted not to use that term. If Anyone have adrenal insufficiency due to treatments and if so, does your Doc give you a "stress dose" option for your prednisone? In times of added demands either physical or emotional . I am having extra fatigue, and am in the midst of some demanding stressors at the moment. EFFECT OF STRESS ON STEROID HORMONE LEVELS IN RACEHORSES. H. W. G. BAKER *Howard Florey Institute of Experimental Physiology and Medicine, University of Melbourne, Parkville, Victoria, 3052 If the address matches an existing account you will receive an email with instructions to retrieve Instructions for Patients Taking Cortef Cortef (hydrocortisone, cortisol) is a hormone made in the adrenal gland. It is prescribed in physiologic doses (doses made by the adrenal gland under normal conditions) for symptoms of low cortisol or adrenal insufficiency. Cortisol Dosing During Times of Stress and Illness What is cortisol? Cortisol is a hormone produced by the adrenal glands under the direction of the pituitary hormone ACTH. Cortisol is needed by the body to maintain energy and blood sugar, to control the body's reaction to changes (stress) and is essential to maintain life. They use personal clinical experience and surrogate serum cortisol measurements as the basis for their recommendations, which correlate steroid dose to the level of surgical stress. Although they recommend full stress dose steroids for severe surgical stress (eg, pancreaticoduodenectomy), they do recommend a lower stress dose for minor procedures. Corticosteroids and Corticosteroid Replacement Therapy In this article. and this increases tenfold in acute stress. Physiological replacement requires 1