Cortisol Recovery after Zytiga (abiraterone)

[jmarsh]

I completed Zytiga at beginning of June. I tapered appropriately from Pred. without issues.

I have been quite sore in my joints since I ended Pred. I requested a check of cortisol level with blood test last week. It has not returned to normal. I have also been able to reduce blood pressure med by half but haven't been able to eliminate yet. MO said I could go back on Pred if I want. I don't want to unless it gets worse.

Question - Have any of you experienced this? Did cortisol level eventually return to normal?

[Grandpa4]

I am a rheumatologist and we used to use a lot of prednisone. The data says that people who have been on prolonged course (years) of prednison can take up to 6 months or longer before their ACTH stim test is normal. We used to taper for months. A normal cortisol level is only part of the issue. Can you make more if stimulated. I must have bounced back quickly since my joint pain improved when I got off the meds. The question is, does prednisone have the same effect when abiraterone is around. I would think so but maybe not. None of the oncologist seems to worry about adrenal insufficiency.

[j-o-h-n in reply to Grandpa4]

What about water on my knee and beer in the joint?

Good Luck, Good Health and Good Humor.

j-o-h-n

[Grandpa4 in reply to j-o-h-n]

You might have to drink at home. Going to be tough to get up the joint with water in your knee.

[j-o-h-n in reply to Grandpa4]

I can make it............ I have nerve(s)....

Good Luck, Good Health and Good Humor.

j-o-h-n

[garyjp9 in reply to Grandpa4]

I have been off Abi + Pred for a year now, and my cortisol levels have still not recovered. I do have adrenal insufficiency. My doctor thought it would have recovered by now, but is now saying it might never recover. Apparently, the problem lies with the pituitary gland, not the adrenals themselves. I did taper slowly, over 2-3 months, apparently not slowly enough. I could feel myself hitting a wall of fatigue at the 2 mg mark. I am now taking daily hydrocortisone, which I was told is preferable to going back on prednisone. I still have the joint pains.

[jmarsh]

Thanks for your input. It's still early for me and I guess I will wait while longer before going back to a steroid.

Best of luck to you!

[TeleGuy]

How long did you take to taper off? I used my response to exercise as a guide. If it took me almost a week to recover I went up a notch or stayed constant until my tolerance improved. It took longer than I expected.

[jmarsh]

Probably around 4 weeks. Same here on having to go back up for a week or so. The pred was also helping with my blood pressure. I was trying to taper pred but also get off BP meds. After getting off Pred, I was only able to reduce BP med by half. I am hoping if cortisol gets back to normal, I can get off BP med completely too.