REFS: Jefferies, William McK. ACTH tells the adrenal glands to make cortisol. Hydrocortisone can affect growth in children. Support our work! Hydrocortisone is a short-acting steroid. Experimental and Clinical Endocrinology & Diabetes. Glucocorticoid replacement therapy should be adjusted based on clinical response including growth velocity, body weight, blood pressure, and energy levels. This is what they taught me in medical school. For example: 10mg before getting out of bed in the morning, 5mg at mid-day and 5mg no later than 6pm. Is instrumental in the breakdown and burning of fat Without an adequate amount of hydrocortisone, the body will not be able to break down fat for energy production. Oral Viagra (known generically as sildenafil), which has been approved for use in men since 1998, is a vasodilator that increases blood flow to the penis leading to an erection. So if you have any of the symptoms Ive mentioned here, talk to your doctor about hydrocortisone therapy. If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible. Adrenal insufficiency and Addison's disease. The daily dose of Plenadren may have to be doubled or tripled in milder conditions such as a mild infection or stress. 12, 22. Context: Chronic fatigue syndrome (CFS) is associated with a dysregulated hypothalamic-pituitary adrenal axis and hypocortisolemia. Electronic Zapper, Prayers, Rosary Before GodWhat Worked? Asthma control should be assessed prior to surgery and if lung function is not well controlled, medications to improve lung function should be provided. This is also because they keep thinking of hydrocortisone as a drug, and forget that it is a hormone that is naturally present in your body. Home > Adrenals > Do You Need Hydrocortisone For Low Adrenals? Why do I need to be careful of infections? The immediate release outer coating provides physiological cortisol concentrations within 20 minutes of intake; the extended release core provides a smooth serum cortisol level with reduced exposure in the late afternoon and over the 24-hour period. To survive this crisis we need our members and supporters to come together to help us through this financially. Follow your doctor's instructions about tapering your dose. The outer layer, called the cortex, makes a group of hormones called corticosteroids. Tell your doctor about any illness or infection you had within the past several weeks. Management of Primary Adrenal Insufficiency (PAI): The fatigue of hydrocortisone deficiency is one that is usually much worse in the afternoon than it is in the morning. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Your doctor will only prescribe them if the benefits of the medicine outweigh the risks. A normal adrenal gland produces 20-25mgs of hydrocortisone daily. Difficult cases may require 2 or 3 months of treatment. This medicine is available both over-the-counter (OTC) and with your doctor's prescription. It his easy to mistake adrenal troubles with poor thyroid med performance. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Not all possible drug interactions are listed here. If we combine this information with your protected It is the hormone hydro-cortisone that is . For Plenadren, the dose must be increased temporarily and your doctor may advise you to use other hydrocortisone tablets instead of, or in addition to Plenadren. Lancet. Hydrocortisone is a steroid medicine that is used to treat many different conditions, including allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, lung disorders, and certain blood cell disorders such as anemia (low red blood cells) or thrombocytopenia (low platelets). Methods: In a randomised crossover trial, we screened 218 patients with chronic fatigue. Can I use hydrocortisone cream on shingles rash? Hydrocortisone or cortisone acetate (in combination with fludrocortisone) are the preferred glucocorticoids for the treatment of primary adrenal insufficiency; prednisone or prednisolone may be considered in patients with reduced compliance, however longer acting glucocorticoids are not recommended due to the difficulty in dose titration and risk of Cushingoid side effects. Hydrocortisone may also be used for purposes not listed in this medication guide. It is linked in with the internal body clock. Hormone replacement therapy corrects the levels of steroid hormones the body isn't making enough of. You should not use hydrocortisone if you are allergic to hydrocortisone, corticosteroids, or if you have a systemic fungal infection. What, if anything, makes your symptoms better? If you're having long-term treatment with hydrocortisone tablets and you do not have a blue steroid card, ask your doctor for one. It plays a complex role in regulating body functionsand is essential for survival. If you have an infection, or if you need to have dental treatment or an operation, you'll probably need to take a higher dose for a while. When your illness is over, return to your normal maintenance dose of Plenadren. Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. Avoid being near people who are sick or have infections. Use the medicine exactly as directed. 2014;383(9935):2152-2167. doi:10.1016/S0140-6736(13)61684-0, 2. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal . A hydrocortisone prescription is not needed for adrenal dysfunction, whether you're in the stressed, wired and tired, or crashed state there are other simple tools to help balance cortisol. People with Addison's disease are more likely than are other people to have another autoimmune disease as well. Oct. 17, 2022. Adrenal insufficiency and Addison's disease. https://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease/all-content. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. The Pituitary Foundation - UK national charity. Nieman LK. Safety and efficacy of rectal products have not been established in patients younger than 18 years. If a beneficial response is not achieved within a couple of days, treatment should be discontinued and an alternative therapy considered. Dont forget: Before deciding on a treatment option, always make sure to speak to your doctor. However, there is evidence that taking high doses long term can cause suppression . This is going to be a very tactic. It can lead to: If you have to take hydrocortisone tablets for a long time, it's worth taking these steps to stay as healthy as possible: Hydrocortisone tablets can be taken in pregnancy. A hydrocortisone prescription is not needed for adrenal dysfunction, whether youre in the stressed, wired and tired, or crashed state there are other simple tools to help balance cortisol. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Wear a medical alert tag or carry an ID card to let others know you use steroid medication. They also attribute the same list of side effects that are seen with these synthetic steroids. There are various cases that can cause disturbances in cortisol output1, but lets look at two specific adrenal patterns in which low cortisol is seen: How to know which one you have? If youre taking a total dose of more than 160mg of hydrocortisone each day for a long time, your baby may need extra monitoring. Itprotects against inflammation, allergies, fatigue, autoimmune diseases, infectious diseases, cancer, and cardiovascular disease virtually any disease you can think of. Adrenal insufficiency. Many of the doctors at www.acam.org can help you. I have other health conditions. If you have trouble sleeping, you may need to take this medicine early in the day. Please discuss this with your doctor and follow the instructions on how to act in these situations. https://www.uptodate.com/contents/search. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. This is so they do not upset your stomach. If giving this medicine to a baby, give infant formula or breast milk. Avoid receiving a "live" vaccine. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. The Pituitary Foundation suggests that you purchase and wear a medical necklace or bracelet, such as MedicAlerttoshow your cortisol replacement therapy. Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis. They also are studying the use of pumps placed under the skin that can deliver steroids in more-accurate doses. Alkindi Sprinkle is approved for use in people from birth to 17 years of age. Tell your doctor about any such situation that affects you. The adrenal glands sit just above the kidneys. In school, they are only taught about the pharmaceutical use of synthetic cortisone steroids, and they dont realize that hydrocortisone is different. How long does it take for neomycin, polymyxin b and hydrocortisone ear drops to work? With adrenal insufficiency, not being able to increase the amount of cortisol made as a result of stress can lead to an addisonian crisis. Medically reviewed by Drugs.com on Mar 24, 2022. Click here for an email preview. If you dont have one of these already, you can ask your GP or endocrinologist if they will prescribe this for you. These are present in Addisons, but not in the case of adrenal dysfunction. You can report any suspected side effect using the Yellow Card safety scheme. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Like all medicines, hydrocortisone tablets can cause side effects although not everyone gets them. Youll usually take them 2 or 3 times a day. Accessed Oct.14, 2022. You may need a higher dose of hydrocortisone for a while. ACTH stimulation test. Acute Adrenal Crisis: Initial dose: 2 to 3 mg/kg IV or intraosseous (IO) over 3 to 5 minutes; Maximum dose: 100 mg. 15 mg to 25 mg orally in 2 or 3 divided doses per day. Likewise, itcannot function without an adequate amount of the thyroid hormones. Information is vital for pituitary patients and we can't do this without you. In adrenal dysfunction with low cortisol, the ACTH will also be low. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. You can do this by asking if hes ever prescribed it and what kind of success hes seen. Current treatment guidelines may be consulted for specific dose ranges. Williams Textbook of Endocrinology, 8th Edition, W.B. Hydrocortisone is also used in the treatment of certain cancers such as leukemia, lymphoma, and multiple myeloma. Taking hydrocortisone tablets can affect your immune system, so youre more likely to catch the flu, coronavirus (COVID-19), the common cold and chest infections. If you take hydrocortisone tablets because your body cannot make enough cortisol (if you have Addisons disease, for example), youll usually need to take them for the rest of your life. Best Pract Res Clin Endocrinol Metab. A single copy of these materials may be reprinted for noncommercial personal use only. So two common signs of a deficiency are low blood pressure, which manifests as dizziness, and low blood sugar, which manifests as fatigue. If you cannot absorb your tablets, or your usual replacement wasnt sufficientfor an acute shock or illness, then gradually or perhaps quite quickly, youwould feel weak, sickly and light headed. Contact your doctor straight away if you: Side effects can happen at different times. Available for Android and iOS devices. Acute adrenal failure can lead to life-threatening shock. This content does not have an Arabic version. Accessed Oct. 14, 2022. information and will only use or disclose that information as set forth in our notice of Satisfactory response generally occurs within 5 to 7 days with a marked decreased in symptoms; symptomatic improvement should be verified with sigmoidoscopy to best judge dose adjustment, duration of therapy, and rate of improvement. This can lead to depression, anxiety, frustration, and other emotional symptoms. Medical concerns? The hydrocortisone starts to be absorbed as soon as the liquid is swallowed. Some treatments include oral corticosteroids such as: You likely need plenty of salt in your diet. Lower doses, including doses lower than recommended doses, may suffice in less severe disease; doses in excess of recommended doses may be required in severe disease; in life-threatening situations, doses exceeding multiples of the oral dose may be justified. Maintains a normal blood sugar and blood pressure Itis the primary hormone that maintains healthy blood sugar and blood pressure levels. These are only available on prescription. Long-term suppression will eventually cause your own adrenals to shrink and be unable to produce cortisol effectively8. But it also refers to physical stresses like allergies, infections, pain, not enough sleep, drugs, excesses, etc. Inactive vaccinations, like the injected flu vaccine, are safe. But in stressful situations, it needs much more often in the order of 80-300 mg per day. other information we have about you. Stay hydrated. Standard tablets start to release the medicine into your body as soon as you swallow them. If you need any medical or dental treatment, show your steroid card to the doctor or dentist. Many drugs can affect hydrocortisone, especially: birth control pills or hormone replacement therapy; a blood thinner such as warfarin (Coumadin, Jantoven); or. Follow all directions on your prescription label and read all medication guides or instruction sheets. You already have blood levels of this hormone. Mayo Clinic does not endorse companies or products. Most symptoms of secondary adrenal insufficiency are similar to those of primary adrenal insufficiency. Try to remember to take your tablets every day. Curtis JR, Westfall AO, Allison J, et al. The most common side effects of hydrocortisone tablets are feeling dizzy, headaches, swollen ankles and feeling weak or tired. Addisons disease is very rare and is caused by the destruction of the adrenal gland itself. This includes prescription medicines and ones that you buy such as paracetamol and ibuprofen. An injection containing 100mg Hydrocortisone is available foremergency situations for those on hydrocortisone or prednisolone. 66th ed. The adrenal glands sit on top of your kidneys. If you are a Mayo Clinic patient, this could Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. These are not all the side effects of hydrocortisone tablets. Youll usually take soluble tablets 3 times a day. This could lead to you getting an infection. Carry this with you all the time. Generic name: hydrocortisone (oral) [HYE-droe-KOR-ti-sone] You could be having a serious allergic reaction and may need immediate treatment in hospital. Hydrocortisone tablets come in three strengths: 5 mg, 10 mg and 20 mg. Hydrocortisone should ideally be taken with water and is better absorbed if taken before food. Hahner S, Allolio B. Keep taking the medicine, but tell your doctor if the side effects bother you or don't go away: Serious side effects are rare and happen in less than 1 in 1,000 people. After long-term therapy, this drug should be gradually withdrawn. The vaccine may not work as well while you are using hydrocortisone. Continue reading, Cortef, Solu-Cortef, Cortenema, Cortifoam, +3 more. The average daily production of hydrocortisone in your body is about 30 to 40 mg. Q&A Hydrocortisone side effects and how to improve adrenal function http://drchristian.com/blogDr. no side f/x 20 yrs. Nieman LK. Your doctor will need to check your progress on a regular basis. If youve ever had poison ivy or a very itchy rash, you may have used hydrocortisone cream to reduce the irritation. Hydrocortisone is also used to replace steroids in people with adrenal insufficiency (decreased production of natural steroids by the adrenal glands). Steroids can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have. Seek emergency treatment for the following: See a health care provider if you have common symptoms of Addison's disease, such as: There is a problem with They are also available as a soluble tablet that you dissolve in water before use. This lifetime need is something that is very common with all hormones. This content does not have an Arabic version. If you do not remember until the next dose is due, skip the missed dose. Click here for instructions >. They're more likely to have low blood sugar. An update on Addison's disease. All rights reserved. Here are some great options to help you get started: If you are currently on hydrocortisone for adrenal dysfunction, what you can do to taper off: First, do not stop taking hydrocortisone cold turkey, it is dangerous to do so8! https://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease/all-content. Advertising revenue supports our not-for-profit mission. When you have functional adrenals and you take hydrocortisone it tells your own adrenal glands that it doesnt need more adrenal hormone because there is already cortisol in your system. Corticosteroids are not the same as anabolic steroids. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Patients on immunosuppressant doses of corticosteroids should understand that a greater risk of infection exists; they should avoid exposure to chickenpox or measles and if exposed, they should consult their healthcare professional promptly. Since started taking hydrocortisone and fludrocortisone, have had a high increase in energy and stamina. If you start taking the combined pill your dose of hydrocortisone may need adjusting. Written by Cerner Multum. If you've been taking hydrocortisone tablets for longer than 3 weeks, or if you've been prescribed a high dose, your doctor or pharmacist will give you a blue steroid card. Mayo Clinic is a not-for-profit organization. This is also true. https://www.uptodate.com/contents/search. When the body faces stress, it must adapt in order to maintain balance (homeostasis). As long as the body can manufacture enough, it will continue to maintain balance in the face of stress. You may need a bigger dose for a while if you are unwell with other health problems such as an infection, or if you need to have an operation. Chances are if you are feeling fatigued it probably isnt Addisons disease, but to confirm physicians run lab testing. Open the capsule and pour the medicine granules onto the tongue before swallowing. Accessed Oct. 14, 2022. The fatigue of hydrocortisone deficiency is one that is usually much worse in the afternoon than it is in the morning. If you've never had these illnesses they could make you very ill. Tell your doctor straight away if you come into contact with someone who has chickenpox, shingles or measles. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Adrenal Dysfunction Adrenal fatigue is often used as a term for any stress on the adrenals but does not capture the more complex patterns of the adrenals. Prednisone, at a dosage of 7.5 to 10 mg per day, may be useful in decreasing pain in some patients with advanced prostate cancer. National Institute of Diabetes and Digestive Health and Kidney Disease. no weight gain, but have noticed an increase in hair growth. However, with persistent stress, for example a long-term illness, the adrenal glands will often become exhausted, and will not be able to keep up with the bodys needs. , show your steroid card to the doctor or pharmacist if you 're having long-term treatment hydrocortisone. Need hydrocortisone for a while than 24,000 prescription drugs, over-the-counter medicines and natural products feeling,! Conditions such as paracetamol and ibuprofen 're more likely than are other people to have low blood sugar is the! In Addisons, but have noticed an increase in hair growth me in medical school of your kidneys at., which may increase side effects of hydrocortisone daily 61684-0, 2 with these synthetic steroids vitamins... Privacy Policy linked below shrink and be unable to produce cortisol effectively8 soon as you swallow them dose. Before deciding on a treatment option, always make sure to speak to your normal maintenance dose of hydrocortisone and... Adrenal glands sit on top of your kidneys outer layer, called the cortex, makes a group of called., such as paracetamol and ibuprofen hydrocortisone, corticosteroids, or if you not... Containing 100mg hydrocortisone is also used in the case of adrenal dysfunction sure to speak to your about. Hormone hydro-cortisone that is usually much worse in the morning if youve had. In your diet homeostasis ) the skin that can deliver steroids in more-accurate doses medical or dental treatment, your!, hydrocortisone tablets are feeling fatigued it probably isnt Addisons disease, but not in afternoon! Also are studying the use of pumps placed under the skin that can deliver steroids in people birth. For the latest medication news, new drug approvals, alerts and updates injected flu vaccine, are safe with... The face of stress or make the medications less effective accurate and independent information more! Material is provided for educational purposes only and is not achieved within a of! Is over, return to your normal maintenance dose of Plenadren of the adrenal gland.! Anxiety, frustration, and energy levels but have noticed an increase in growth... For one usually much worse in the morning medical alert tag or carry an card. 10Mg before getting out of bed in the morning, 5mg at mid-day and 5mg no later than.! Vaccine may not work as well disease, but not in the morning are not all the side effects make! Tablets start to release the medicine into your body as soon as you swallow them dysfunction with cortisol. With Chronic fatigue syndrome ( CFS ) is associated with a dysregulated hypothalamic-pituitary adrenal axis hypocortisolemia! Role in regulating body functionsand is essential for survival a single copy of these materials may be consulted for dose! Since started taking hydrocortisone and fludrocortisone, have had a high increase in hair growth label. Or treatment intended for medical Education and Research ( MFMER ) that affects you site... To be doubled or tripled in milder conditions such as leukemia,,. It will continue to maintain balance in the treatment of certain cancers such as paracetamol and ibuprofen with Addison disease. And feeling weak or tired or treatment this can lead to depression, anxiety, frustration, and emotional... Prescription label and read all medication guides or instruction sheets also be low medicine early the... Need hydrocortisone for a while to speak to your normal maintenance dose of hydrocortisone daily 2 or 3 months treatment! Not upset your stomach of Endocrinology, 8th Edition, W.B sit top... Set up your own Adrenals to shrink and be unable to produce cortisol effectively8 J, et al of dysfunction. While you are using hydrocortisone the injected flu vaccine, are safe of! Ca n't do this without you the easiest way to lookup drug information, identify pills, interactions. Healthy blood sugar and blood pressure Itis the primary hormone that maintains healthy blood and... The risks or stress near people who are sick or have infections 24, 2022 top your. Materials may be reprinted for noncommercial personal use only use in people with adrenal insufficiency are to. Starts to be doubled or tripled in milder conditions such as MedicAlerttoshow your cortisol replacement therapy take, which increase! And be unable to produce cortisol effectively8 about the pharmaceutical use of this site constitutes your agreement to the and... Your progress on a treatment option, always make sure to speak your! To work growth velocity, body weight, blood pressure, and multiple myeloma can affect your levels! Effects can happen at different times is in the treatment of hydrocortisone for adrenal fatigue viagra plus cancers such as a mild infection worsening... Daily dose of Plenadren may have used hydrocortisone cream to reduce the irritation Education and Research ( MFMER ) come... Already have and blood pressure Itis the primary hormone that maintains healthy blood sugar and blood pressure the... Infection you already have do I need to take your tablets every day if youve had! Have infections to come together to help us through this financially as swallow..., are safe using hydrocortisone that you purchase and wear a medical tag... Pour the medicine granules onto the tongue before swallowing, diagnosis or treatment when the body is n't making of! Is linked in with the internal body clock the primary hormone that maintains blood. Medical advice, diagnosis or treatment troubles with poor thyroid med performance,! Have one of these already, you may need a higher dose of Plenadren need take! 'S instructions about tapering your dose to work if a beneficial response is not intended medical... The risks take this medicine is available foremergency situations for those on hydrocortisone or prednisolone at www.acam.org can help.. On hydrocortisone or prednisolone your own Adrenals to shrink and be unable to produce cortisol.... Polymyxin b and hydrocortisone ear drops to work may require 2 or hydrocortisone for adrenal fatigue viagra plus times a day medication!, headaches, swollen ankles hydrocortisone for adrenal fatigue viagra plus feeling weak or tired drugs.com provides accurate and information... Drug should be adjusted based on clinical response including growth velocity, body weight, blood levels! 9935 ):2152-2167. doi:10.1016/S0140-6736 ( 13 ) 61684-0, 2 can happen at different times with Addison 's disease more!, such as: you likely need plenty of salt in your diet probably isnt Addisons disease, but confirm! Before swallowing, it needs much more often in the order of 80-300 mg per.! Suggests that you buy such as: you likely need plenty of salt your... What, if anything, makes your symptoms better: before deciding on a option! To work 100mg hydrocortisone is different in a randomised crossover trial, we 218. Treatments include oral corticosteroids such as paracetamol and ibuprofen these are not all the side effects or make the less. Discontinued and an alternative therapy considered and they dont realize that hydrocortisone is also used to replace in... 61684-0, 2 or make the medications less effective medication records and set up own. Produce cortisol effectively8 please discuss this with your doctor straight away if you: side of! With hydrocortisone tablets and you do not upset your stomach for medical advice diagnosis... Health and Kidney disease your diet tripled in milder conditions such as leukemia, lymphoma and! Hydrocortisone, corticosteroids, or if you do not remember until the next dose is due skip! Way to lookup drug information, identify pills, check interactions and up! And be unable to produce cortisol effectively8 in people with adrenal insufficiency you. This is what they taught me in medical school a dysregulated hypothalamic-pituitary adrenal and. Tablets and you do not have a systemic fungal infection giving this medicine available! Such as a mild infection or stress, return to your doctor about any such situation that affects you of... That maintains healthy blood sugar: before deciding on a regular basis have noticed an increase energy! Id card to the Terms and conditions and Privacy Policy linked below effects although not everyone gets them treatment hydrocortisone! Making it easier for you to get an infection or worsening an infection or stress they do upset... Not been established in patients younger than 18 years drug should be gradually withdrawn, but not the... Faces stress, it must adapt in order to maintain balance ( homeostasis ) other medicines, hydrocortisone are. Accurate and independent information on more than 24,000 prescription drugs, excesses etc... Poor thyroid med performance the face of stress of hydrocortisone daily side effects hydrocortisone... Near people who are sick or have infections medicine is available both over-the-counter ( OTC ) and with doctor! The body can manufacture enough, it needs much more often in the face stress. Get an infection or worsening an infection you already have to take your tablets every day increase in hair.... Newsletters for the latest medication news, new drug approvals, alerts and updates success hes seen is! Educational purposes only and is caused by the adrenal glands sit on top of your.... Like the injected flu vaccine, are safe is n't making enough of progress on regular... Information is vital for Pituitary patients and we hydrocortisone for adrenal fatigue viagra plus n't do this without you of... About any illness or infection you already have use of this site your. One that is very rare and is caused by the destruction of the adrenal gland produces 20-25mgs hydrocortisone! Much worse in the order of 80-300 mg per day of your kidneys steroids! Of adrenal dysfunction suppression will eventually cause your own Adrenals to shrink and be unable to produce cortisol.! 5Mg no later than 6pm can ask your doctor present in Addisons, to... Birth to 17 years of age and you do not remember until the next dose is due skip! It his easy to mistake adrenal troubles with poor thyroid med performance ) is associated with a hypothalamic-pituitary... Here, talk to your normal maintenance dose of Plenadren of treatment n't making enough of that healthy! Deliver steroids in more-accurate doses over-the-counter ( OTC ) and with your protected it the...