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Adrenal fatigue after Yervoy

Forums General Melanoma Community Adrenal fatigue after Yervoy

  • Post
    Sharon
    Participant

      My husband was on and off steroids durning his Yeavoy treatments.  There is no sign of Melanoma PTL!  He has been seeing an Endrocrinlogist and is taking Hydrocortisone as he is not making his own steroids.  He has tried reducing the amount slowly for sometime now and he just drags and has a hard time eating which are the results of Adrenal fatigue. He is curently on 20mg had been on 7 for a while but just was not able to function on that. Wondering if others have had the same problem and at this point he may need to take them the rest of his life.

      My husband was on and off steroids durning his Yeavoy treatments.  There is no sign of Melanoma PTL!  He has been seeing an Endrocrinlogist and is taking Hydrocortisone as he is not making his own steroids.  He has tried reducing the amount slowly for sometime now and he just drags and has a hard time eating which are the results of Adrenal fatigue. He is curently on 20mg had been on 7 for a while but just was not able to function on that. Wondering if others have had the same problem and at this point he may need to take them the rest of his life. If any of you can offer any help ideas or what else we could do I would really appreciate any help you can offer.  Thank you Sharon 

    Viewing 14 reply threads
    • Replies
        NYKaren
        Participant
          Hi Sharon,
          Yes, I am going through the exact same thing. Is he still having Yervoy side-effects? I only got over colitis after 2 doses of Remicade
          When I was finally tapered off prednisone, I was feeling horrible. The Endocronologist diagnosed adrenal failure. So I was put on hydrocortisone. I had to get medic alert bracelet and carry liquid cortisone and needles as this can be very serious. Some important facts:
          Your husband should have a brain/pituitary MRI to rule out pituitary involvement.
          He should only taper only after having a blood cortisol test, early morning, fasting, skipping the previous afternoon’s and that morning’s steroid dose. (the body makes different amounts of cortisol according to time of day.)
          These items are important–he needs to be under the continuous care of an Endo who is hopefully associated with your melanoma center or at least one who his onc recommends Mine is tapering me from 20 to 15 to 10 and after a week on ten is doing bloods before tapering lower. SO, hopefully soon I’ll be off and hopefully your husband will too. Sorry this is so much info, if u want to talk my email is [email protected].
          NYKaren
          Participant
            Hi Sharon,
            Yes, I am going through the exact same thing. Is he still having Yervoy side-effects? I only got over colitis after 2 doses of Remicade
            When I was finally tapered off prednisone, I was feeling horrible. The Endocronologist diagnosed adrenal failure. So I was put on hydrocortisone. I had to get medic alert bracelet and carry liquid cortisone and needles as this can be very serious. Some important facts:
            Your husband should have a brain/pituitary MRI to rule out pituitary involvement.
            He should only taper only after having a blood cortisol test, early morning, fasting, skipping the previous afternoon’s and that morning’s steroid dose. (the body makes different amounts of cortisol according to time of day.)
            These items are important–he needs to be under the continuous care of an Endo who is hopefully associated with your melanoma center or at least one who his onc recommends Mine is tapering me from 20 to 15 to 10 and after a week on ten is doing bloods before tapering lower. SO, hopefully soon I’ll be off and hopefully your husband will too. Sorry this is so much info, if u want to talk my email is [email protected].
            NYKaren
            Participant
              Hi Sharon,
              Yes, I am going through the exact same thing. Is he still having Yervoy side-effects? I only got over colitis after 2 doses of Remicade
              When I was finally tapered off prednisone, I was feeling horrible. The Endocronologist diagnosed adrenal failure. So I was put on hydrocortisone. I had to get medic alert bracelet and carry liquid cortisone and needles as this can be very serious. Some important facts:
              Your husband should have a brain/pituitary MRI to rule out pituitary involvement.
              He should only taper only after having a blood cortisol test, early morning, fasting, skipping the previous afternoon’s and that morning’s steroid dose. (the body makes different amounts of cortisol according to time of day.)
              These items are important–he needs to be under the continuous care of an Endo who is hopefully associated with your melanoma center or at least one who his onc recommends Mine is tapering me from 20 to 15 to 10 and after a week on ten is doing bloods before tapering lower. SO, hopefully soon I’ll be off and hopefully your husband will too. Sorry this is so much info, if u want to talk my email is [email protected].
              Jim M.
              Participant

                Hi Sharon,

                 I was on Yervoy in 2008, before it was approved. I had the side effect of hypophysitis ( swelling of the pituitary gland). I was put on 10mgs of Hydrocortisone and have been taking it ever since. I tried unsuccessfully to taper off it several times, even a very gradual taper. I'd feel nauseated and wasn't able to continue. I have adrenal insufficiency and my pituitary doesn't produce the hormones on it's own. My endocrinologist at Moffitt Cancer Center said 50% of patients are not able to taper off Hydrocort. He added that if a patient isn't able to get off it within 2 years it's unlikely the patient will be able to taper off it later on.

                 I'm at the normal replacement level at 10 mgs. Maybe your husband can try a very gradual taper, like cut back 2 mgs each 6 weeks. If he can get to 10 mgs then he's not exceeding the normal hormone replacement. Several doctors told me Hydrocort can lead to bone loss. I took a bone density test and sure enough I'm borderline for osteoporosis (at age 55). I'm taking extra calcium and vitamin D. I was on a bisphosnonate but I didn't like the side effects; i e bloating. My recent Dexa scan ( bone density) improved. Regular exercise should help also.

                 I hope I've been of some assistance. Best of success and God bless.

                 Jim M.

                 stage 3C

                 NED: 4 years, 9 months

                Jim M.
                Participant

                  Hi Sharon,

                   I was on Yervoy in 2008, before it was approved. I had the side effect of hypophysitis ( swelling of the pituitary gland). I was put on 10mgs of Hydrocortisone and have been taking it ever since. I tried unsuccessfully to taper off it several times, even a very gradual taper. I'd feel nauseated and wasn't able to continue. I have adrenal insufficiency and my pituitary doesn't produce the hormones on it's own. My endocrinologist at Moffitt Cancer Center said 50% of patients are not able to taper off Hydrocort. He added that if a patient isn't able to get off it within 2 years it's unlikely the patient will be able to taper off it later on.

                   I'm at the normal replacement level at 10 mgs. Maybe your husband can try a very gradual taper, like cut back 2 mgs each 6 weeks. If he can get to 10 mgs then he's not exceeding the normal hormone replacement. Several doctors told me Hydrocort can lead to bone loss. I took a bone density test and sure enough I'm borderline for osteoporosis (at age 55). I'm taking extra calcium and vitamin D. I was on a bisphosnonate but I didn't like the side effects; i e bloating. My recent Dexa scan ( bone density) improved. Regular exercise should help also.

                   I hope I've been of some assistance. Best of success and God bless.

                   Jim M.

                   stage 3C

                   NED: 4 years, 9 months

                  Jim M.
                  Participant

                    Hi Sharon,

                     I was on Yervoy in 2008, before it was approved. I had the side effect of hypophysitis ( swelling of the pituitary gland). I was put on 10mgs of Hydrocortisone and have been taking it ever since. I tried unsuccessfully to taper off it several times, even a very gradual taper. I'd feel nauseated and wasn't able to continue. I have adrenal insufficiency and my pituitary doesn't produce the hormones on it's own. My endocrinologist at Moffitt Cancer Center said 50% of patients are not able to taper off Hydrocort. He added that if a patient isn't able to get off it within 2 years it's unlikely the patient will be able to taper off it later on.

                     I'm at the normal replacement level at 10 mgs. Maybe your husband can try a very gradual taper, like cut back 2 mgs each 6 weeks. If he can get to 10 mgs then he's not exceeding the normal hormone replacement. Several doctors told me Hydrocort can lead to bone loss. I took a bone density test and sure enough I'm borderline for osteoporosis (at age 55). I'm taking extra calcium and vitamin D. I was on a bisphosnonate but I didn't like the side effects; i e bloating. My recent Dexa scan ( bone density) improved. Regular exercise should help also.

                     I hope I've been of some assistance. Best of success and God bless.

                     Jim M.

                     stage 3C

                     NED: 4 years, 9 months

                    marysan
                    Participant

                      My husband has Stage 3C melanoma and had three Yervoy treatments with the last being Jan 2012. About 2 months later he became very weak, nauseated etc and we found out that he had no cortisol production, thyroid or testosterone.  He was put on replacment of all of these hormones. He had a brain MRI that confirmed hypophysitis.  He is now on .25 decadron, hydrocortisone 30 mg in am and 10 mg in pm.  We are trying to get him off the decadron and lower the hydrocortisone dose but he always feels worse and so tired.  I don't think any of the endocrinologists in the NY area have much experience with this side effect.  Any advice?  What is the desired dose of steroids?  He almost 7 months out of his last Yervoy treatment and now has what we think is a new recurrence on his leg. Surgery tomorrow. 

                      Does this mean the Yervoy failed? He had a totally negative PET 1 1/2 months ago.  Any advice on how to deal with the endocrine problems and side effects of terrible fatigue, some nausea etc.?

                      We live in the New York City area.

                      marysan
                      Participant

                        My husband has Stage 3C melanoma and had three Yervoy treatments with the last being Jan 2012. About 2 months later he became very weak, nauseated etc and we found out that he had no cortisol production, thyroid or testosterone.  He was put on replacment of all of these hormones. He had a brain MRI that confirmed hypophysitis.  He is now on .25 decadron, hydrocortisone 30 mg in am and 10 mg in pm.  We are trying to get him off the decadron and lower the hydrocortisone dose but he always feels worse and so tired.  I don't think any of the endocrinologists in the NY area have much experience with this side effect.  Any advice?  What is the desired dose of steroids?  He almost 7 months out of his last Yervoy treatment and now has what we think is a new recurrence on his leg. Surgery tomorrow. 

                        Does this mean the Yervoy failed? He had a totally negative PET 1 1/2 months ago.  Any advice on how to deal with the endocrine problems and side effects of terrible fatigue, some nausea etc.?

                        We live in the New York City area.

                        marysan
                        Participant

                          My husband has Stage 3C melanoma and had three Yervoy treatments with the last being Jan 2012. About 2 months later he became very weak, nauseated etc and we found out that he had no cortisol production, thyroid or testosterone.  He was put on replacment of all of these hormones. He had a brain MRI that confirmed hypophysitis.  He is now on .25 decadron, hydrocortisone 30 mg in am and 10 mg in pm.  We are trying to get him off the decadron and lower the hydrocortisone dose but he always feels worse and so tired.  I don't think any of the endocrinologists in the NY area have much experience with this side effect.  Any advice?  What is the desired dose of steroids?  He almost 7 months out of his last Yervoy treatment and now has what we think is a new recurrence on his leg. Surgery tomorrow. 

                          Does this mean the Yervoy failed? He had a totally negative PET 1 1/2 months ago.  Any advice on how to deal with the endocrine problems and side effects of terrible fatigue, some nausea etc.?

                          We live in the New York City area.

                          marysan
                          Participant

                            My husband has Stage 3C melanoma and had three Yervoy treatments with the last being Jan 2012. About 2 months later he became very weak, nauseated etc and we found out that he had no cortisol production, thyroid or testosterone.  He was put on replacment of all of these hormones. He had a brain MRI that confirmed hypophysitis.  He is now on .25 decadron, hydrocortisone 30 mg in am and 10 mg in pm.  We are trying to get him off the decadron and lower the hydrocortisone dose but he always feels worse and so tired.  I don't think any of the endocrinologists in the NY area have much experience with this side effect.  Any advice?  What is the desired dose of steroids?  He almost 7 months out of his last Yervoy treatment and now has what we think is a new recurrence on his leg. Surgery tomorrow. 

                            Does this mean the Yervoy failed? He had a totally negative PET 1 1/2 months ago.  Any advice on how to deal with the endocrine problems and side effects of terrible fatigue, some nausea etc.?

                            We live in the New York City area.

                              NYKaren
                              Participant
                                Where is your husband treated? The docs, including Endo. are the best you can find at Sloan Kettering.
                                Karen
                                marysan
                                Participant

                                  We live in New Jersey and did consult intiially with Dr. Chapman at MSK.  However, he said that most of the endocrinologists have limited experience with this issue.  I am now understanding that this is probably a permanent condition, but there is so little written about it…..and how to manage it.  I would like a second endocrine opinion from a doc that treats alot of Yervoy induced endocrinopathies and have yet to find one in my research. Any names would be most appreciated.  What is the desired dose of hydrocortisone replacement? Thanks for any help.

                                  marysan
                                  Participant

                                    We live in New Jersey and did consult intiially with Dr. Chapman at MSK.  However, he said that most of the endocrinologists have limited experience with this issue.  I am now understanding that this is probably a permanent condition, but there is so little written about it…..and how to manage it.  I would like a second endocrine opinion from a doc that treats alot of Yervoy induced endocrinopathies and have yet to find one in my research. Any names would be most appreciated.  What is the desired dose of hydrocortisone replacement? Thanks for any help.

                                    marysan
                                    Participant

                                      We live in New Jersey and did consult intiially with Dr. Chapman at MSK.  However, he said that most of the endocrinologists have limited experience with this issue.  I am now understanding that this is probably a permanent condition, but there is so little written about it…..and how to manage it.  I would like a second endocrine opinion from a doc that treats alot of Yervoy induced endocrinopathies and have yet to find one in my research. Any names would be most appreciated.  What is the desired dose of hydrocortisone replacement? Thanks for any help.

                                      NYKaren
                                      Participant
                                        Where is your husband treated? The docs, including Endo. are the best you can find at Sloan Kettering.
                                        Karen
                                        NYKaren
                                        Participant
                                          Where is your husband treated? The docs, including Endo. are the best you can find at Sloan Kettering.
                                          Karen
                                        marysan
                                        Participant

                                          My husband has Stage 3C melanoma and had three Yervoy treatments with the last being Jan 2012. About 2 months later he became very weak, nauseated etc and we found out that he had no cortisol production, thyroid or testosterone.  He was put on replacment of all of these hormones. He had a brain MRI that confirmed hypophysitis.  He is now on .25 decadron, hydrocortisone 30 mg in am and 10 mg in pm.  We are trying to get him off the decadron and lower the hydrocortisone dose but he always feels worse and so tired.  I don't think any of the endocrinologists in the NY area have much experience with this side effect.  Any advice?  What is the desired dose of steroids?  He almost 7 months out of his last Yervoy treatment and now has what we think is a new recurrence on his leg. Surgery tomorrow. 

                                          Does this mean the Yervoy failed? He had a totally negative PET 1 1/2 months ago.  Any advice on how to deal with the endocrine problems and side effects of terrible fatigue, some nausea etc.?

                                          We live in the New York City area.

                                          marysan
                                          Participant

                                            My husband has Stage 3C melanoma and had three Yervoy treatments with the last being Jan 2012. About 2 months later he became very weak, nauseated etc and we found out that he had no cortisol production, thyroid or testosterone.  He was put on replacment of all of these hormones. He had a brain MRI that confirmed hypophysitis.  He is now on .25 decadron, hydrocortisone 30 mg in am and 10 mg in pm.  We are trying to get him off the decadron and lower the hydrocortisone dose but he always feels worse and so tired.  I don't think any of the endocrinologists in the NY area have much experience with this side effect.  Any advice?  What is the desired dose of steroids?  He almost 7 months out of his last Yervoy treatment and now has what we think is a new recurrence on his leg. Surgery tomorrow. 

                                            Does this mean the Yervoy failed? He had a totally negative PET 1 1/2 months ago.  Any advice on how to deal with the endocrine problems and side effects of terrible fatigue, some nausea etc.?

                                            We live in the New York City area.

                                            Sharon
                                            Participant

                                              CT Scan shows no sign of cancer Praise the Lord! He is still on steroids and always will be takes 30mg a day Hydrocortisone. He is able to lead a normal life and is doing well.     

                                              Sharon
                                              Participant

                                                CT Scan shows no sign of cancer Praise the Lord! He is still on steroids and always will be takes 30mg a day Hydrocortisone. He is able to lead a normal life and is doing well.     

                                                Sharon
                                                Participant

                                                  CT Scan shows no sign of cancer Praise the Lord! He is still on steroids and always will be takes 30mg a day Hydrocortisone. He is able to lead a normal life and is doing well.     

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