ACTH Stim test after stopping abiraterone & prednisone

[Alturia]

Has anyone had an ACTH Stimulation test after stopping abiraterone and Prednisone to test for adrenal insufficiency? I ended 24 months of eligard, abiraterone, and Prednisone on June 4. My endocrinologist (who I had prior to prostate cancer) pushed me to have a cortisol test on June 6 even though I told her that wasn't enough time for my body to recover and start producing much cortisol. So of course the cortisol level was below the normal range at 2.7ug/dl. She immediately wanted me to get an ACTH Stim test to determine if I had adrenal insufficiency. I decline and told her I would have another cortisol test in 30 days. The cortisol test I had on July 8 was within the normal range, 7.2ug/dl. That means the cortisol level increased 266% in 30 days. But the Endo said it was still too low and should be between 10-14ug/dl and again wanted me to have an ACTH Stim test. I told her that based on the 266% increase in cortisol levels, the likely increase in cortisol in the next 30 days and the fact that I have absolutely no symptoms that I don't believe I have adrenal insufficiency and that after 2.5 years of being poked, prodded, cut, stuck with needles and bombarded with radiation, I am done testing unless I develop symptoms or there is some other compelling evidence of adrenal insufficiency. But I can't help but wonder if I am cutting off my nose to spite my face and I should have the ACTH Stim test.

[Derf4223]

Sounds like you are doing OK. I'm scheduled for the same test after a 1 month prednisone taper program, soon. See this thread for more healthunlocked.com/advanced...

[Tall_Allen]

What was your tapering schedule when you tapered off prednisone?

[Alturia in reply to Tall_Allen]

I tapered over 6 weeks. My original Prednisone dose was 5mg. For 2 weeks I took 5mg every other day. Then 2 weeks 2.5 mg very other day. Then 2 weeks of 2.5mg every 3 days.

[Tall_Allen in reply to Alturia]

Sounds good to me! Do you have symptoms if adrenal insufficiency (high BP, low potassium, edema)?

[Alturia in reply to Tall_Allen]

Nope, no symptoms at all. No nausea or dizziness. BP is fine 114/69. No edema. Potassium normal at last blood test. I need to learn to trust what my body is telling me.

[Tall_Allen in reply to Alturia]

💯It sounds like this cortisol level is normal for you.

[Clark6965]

I had a Gleason 9. Radiation and eligard for 36 months. Six years since diagnosed. Off eligard over two years . Psa undetectable. Get up 4 or 5 times a night to pee. Testosterone still very low.

[gsun]

Your endo probably owns the testing lab.

[garyjp9]

My cortisol levels have never recovered after 2+ years of Abi/Prednisone, and so I did have an ACTH stim test. That result was also extremely low, indicating the problem was originating in my pituitary glad. But your cortisol level is good and may even rise further. If you have not symptoms (which I did), I would agree with you the stim test is unnecessary at this time.

[Alturia in reply to garyjp9]

Thanks very much for that information