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Waking up adrenals after pred?
I was on prednisolone for around 18 months for an inflamatory lung problem (caused by another medication). I tapered down the pred, and finally stopped at the end of january. During the taper, I have suffered from extreme fatigue, which is still there. I have seen countless doctors, who suggested depression and various other things. However, I recently asked for a cortisol test, which came back low. Repeat test also low. Doctor simply reported the result, but does not seem to know what to do about it.
Where do I go from here? Will the adrenals eventually kick back in, or am I looking at having to permanently take the drug which caused the problem in the first place?
Where do I go from here? Will the adrenals eventually kick back in, or am I looking at having to permanently take the drug which caused the problem in the first place?
Best Answer
Your doctor is an idiot. A single morning test doesn't give enough information.
Thanks for the replies. I contacted my GP, and found out my repeat test level was 268 nmol/l. The reason the test was at 9am rather than 8 is because that is what time the nurse at the practice starts work. What difference does fasting make to the result?
The doctor was a bit clueless about any of this, and was not even able to tell me what the normal range is: she commented that as long as there is some cortisol there, that is usually good enough. She did at least say she would write a letter to endocrinology.
Thanks for the vit B5 suggestion. I have purchased some recently, so will start taking it.
The doctor was a bit clueless about any of this, and was not even able to tell me what the normal range is: she commented that as long as there is some cortisol there, that is usually good enough. She did at least say she would write a letter to endocrinology.
Thanks for the vit B5 suggestion. I have purchased some recently, so will start taking it.
I am not sure how low the scores were. The tests were fasting blood tests done at 9am.
How low is low, when was the test done (time of day) and were the tests serum (blood) or saliva)?
You had a couple of tests, which is good, and IMHO, adrenals are lazy little things that once they are on vacation, they are very reluctant to come back. You tapered and that is supposed to wake them back up but it seems that perhaps they are in a state of atrophy from the course of steroids.
You had pred - that is not the drug of choice for long term replacements - it is cortef, which is soon to be replaced by duo-cort (I personally cannot wait!). Cortef has a shorter half life so the damage is not as much, unless of course you take a lot and many times a day... Duocort is made to take once a day and mimic a normal body. It is not available in most places now.
You now need a stimulation test to see if your adrenals will work under stress otherwise when you get sick, you may be in trouble. Get to an endo that knows adrenals and get testing. The one you have sounds dudly.
You had a couple of tests, which is good, and IMHO, adrenals are lazy little things that once they are on vacation, they are very reluctant to come back. You tapered and that is supposed to wake them back up but it seems that perhaps they are in a state of atrophy from the course of steroids.
You had pred - that is not the drug of choice for long term replacements - it is cortef, which is soon to be replaced by duo-cort (I personally cannot wait!). Cortef has a shorter half life so the damage is not as much, unless of course you take a lot and many times a day... Duocort is made to take once a day and mimic a normal body. It is not available in most places now.
You now need a stimulation test to see if your adrenals will work under stress otherwise when you get sick, you may be in trouble. Get to an endo that knows adrenals and get testing. The one you have sounds dudly.
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I am sorry no one seems to know how to treat you. Here is what you do. Take 1000 mg of vitamin B5 daily (adrenal fatigue depletes B5). Also take adaptogens to boost adrenal function. Your doctor may also want you to take Isocort. These are all natural substances.
By the way, when my problem developed, my HMO lung doctor also had no suggestions to make. So I went to a REAL doctor, who diagnosed me immediately and then ran the test to confirm. My real doctor is a physician who also practices alternative medicine. In my case, because of the rising cortisol, in addition to sever fatigue, I also was subject to anxiety and panic attacks. He treated those as well. But I am now recovering and the fatigue has been lessening gradually. It can take more than a year to cure you.