Q: A group member who is 83 years of age asks whether there is a best time to take his cortisone as he has never been told when to take his tablets by his doctor or hospital, sometimes he forgets to take them so he has them later, and he has come to no harm.

A: The morning dose of hydrocortisone should normally be taken on waking before the patient gets out of bed. I advise my patients to have the tablets with a glass of water by the bed and to take the morning dose before getting up. Sometime people need a midday dose and their evening dose should be taken around the time they have their evening meal but not much later than 7pm. Patients should not under any circumstances omit their tablets. He may feel well for a short while in common with a number of people, if he omits his tablets, but he is at great risk of being precipitated through minor stress into adrenal crisis. He must take his tablets regularly.