Often the overwhelming fatigue that accompanies lupus is due to low adrenal function, and it must be *supported* by the additional cortisol from prednisone. One the body is back to regular function, prednisone is *very slowly* cut back so that the adrenal glands can repair and phase themselves back into functioning correctly.
I hadn't heard of anyone switching to hydorcortisone for the slow phase out period, but it makes just as much sense.
I don't think you can tell the difference between medically induced and autoimmune -- it's all messing around with our hormones and they are so interconnected with everything else that we don't yet know exactly the cause/effect/etc. Maybe you could tell the difference if you were tested before autoimmune and before medication, but how likely is that testing to happen?
I was on 15-20 mg for over 5 years, but as my body began to heal and the inflammation become controlled, I was able to slowly cut back and my adrenal function returned to normal and I no longer take any prednisone!
Hope it works that way for you as well,
Lynnwood, Lupus & Sjogren's ModeratorDIAGNOSING-LUPUS & LUPUS-RESOURCES
"Life is far too important to be taken seriously" - Oscar Wilde