Hydrocortisone Day Curve (HCDC)
To establish the correct dose and distribution of hydrocortisone replacement therapy throughout the day.
Stop all oestrogen therapy 6 weeks prior to test.
No need to fast.
Take normal morning hydrocortisone and patient should note down actual time taken.
Red top Vacutainers.
Take blood at the following times:
- Blood sample on arrival, noting time of sample and time and dose of hydrocortisone.
- Pre lunchtime (2nd) dose
- 1 hour post lunchtime (2nd) dose
- pre evening (3rd) dose
- post evening (3rd) dose or at 6pm.
Aim for adequate cortisol levels throughout the day (peak <900 nmol/l, trough >100 nmol/l).