I don;t agree with 40-60 mg required for replacement cortisol. You may need a few people on that high does, but I think 20-30 mg is a better guess. People are getting cushing and sicker do to to high of a dose.
I was place on 30-50 mg of hydrocortisone and believe me I had a basketball stomach...once I came down to the correct dose of 20-25 (at one time) I lost that basket ball and felt better. I believe DR's are over dosing there patients that are on replacement cortisol.
It is the fear of going down what makes us over dose on hydrocortisone and the misunderstanding of how it works.
Dr's have no clue.
It funny when I gained 30 lbs from the cortisol replacement the Dr (specialist) told me to go home and eat 1200 cals aday....what a joke I was only eating 1000=1200 aday. Once I learned to listen to my body I was able to go to 20=25 mg daily and loose the weight and felt so much better.
Now down to 9 mg of hydrocortisone and healing.
I have to say I have Auto Immune Addison. SO this is my story...Of what I have taken notice over the 4 years. A person who lost their adrenal glands can have a totally different experince.