Why steroids are given in the morning? What will happen at night?
We know, ACTH releases from pituitary and it stemulates Cortisol release from Adrenal Gland.
ACTH is the highest release in the middle and Cortisol in Early Morning.
Negative Feedback Mechanism works between Cortisol and ACTH.
Given Steroid at night, it will damage HPA-axis (Hypothelamic Pituitary Adrenal axis), which will inhibit ACTH releases.
So in the morning Steroid is given so that Normal Circudiian rhythm is intact. And in the night the ACTH release is done on the body's own rules.
If high dose steroid prolonged duration is used at night, the adrenal gland will remain supplemented, and if the sedan steroid withdrawal, the adrenal failure will be done.
If Steroid is given in Evining, then it develops insomnia as a common side effect.
