Illness is the most common reason that people need to stress dose.
When you’re stress dosing, make sure you drink plenty of fluids to avoid dehydration, and give your body ample time to rest.
Additionally, be on the lookout for any new or worsening symptoms that warrant medical attention, such as dizziness, extreme fatigue, or low blood pressure, says Raul Herrera Pena, a physician and surgeon and an assistant professor of diabetes, endocrinology, and metabolism at the University of Minnesota Medical School in Minneapolis.
Fever
Fevers generally warrant doubling or tripling your typical glucocorticoid dose.
How much extra you need depends on your temperature, says Dr. Herrera.
- For fevers above 100.5 degrees F, double your dose for the entire day. For instance, if you normally take 20 milligrams (mg) of hydrocortisone daily (15 mg in the morning and 5 mg in the afternoon), take 40 mg daily (30 mg in the morning and 10 mg in the afternoon).
- For fevers above 102 degrees F, triple your dose for the entire day. If you normally take 20 mg of hydrocortisone daily (15 mg in the morning and 5 mg in the afternoon), take 60 mg daily (either 45 mg in the morning and 15 mg in the afternoon, or 20 mg every 8 hours).
Vomiting
Triple your glucocorticoid dose in the event of vomiting, since vomiting makes it harder for your body to absorb your medication.
Pay attention to the time at which you take your dose. If you vomit within 30 minutes of dosing, the medication probably wasn’t absorbed. In that case, take another triple dose. If you vomit again, take injectable hydrocortisone immediately (which you should have on hand with assistance from your physician) and go to the emergency room or call 911.
Diarrhea
Triple your glucocorticoid dose in the event of diarrhea, since diarrhea can also make it harder for your body to absorb your medication. Try to sip fluids, preferably something with electrolytes, to stay hydrated, too.
What About Mild Cold Symptoms?
You generally don’t need to stress dose if your symptoms are limited to a runny nose, dry cough, or mild sore throat. But if you have questions or feel unsure about the best course of action, it’s always worth a call to your healthcare provider.