I had a cortisol blood test this morning and my result has come back at 59 nmol. Can anyone tell me what this means please?

[DAsthmaD]

prednisoline weaing.

[floating_]

Also interested to know, mine came back as 24nmol/l.

[Angelgoth]

mine was 14nmol

[floating_ in reply to Angelgoth]

Did they explain what it meant?

[DAsthmaD in reply to floating_]

Hi. I saw the results on the NHS App. I imagine I will get Call next week.

[DAsthmaD in reply to Angelgoth]

What did they say/do about it?

[DAsthmaD in reply to DAsthmaD]

Have been referred to an Endocri neologist.

[Angelgoth]

got diagnosed with adrenal insufficiency, I'm also on long term pred. I got a phone call from my doctor the next day. you will probably receive a phone call and maybe sent for more tests. I had a random blood tests for something else and they just happened to check my cortisol levels aswell which were very low.

[Lysistrata Administrator Community Ambassador]

That's way below the normal, assuming it was taken around 8-9am (levels vary throughout the day so eg 11am is naturally lower). It should mean you're diagnosed with adrenal insufficiency without further testing - though please be aware that when it is steroid induced, there is a possibility of recovery which is not the case for other causes. This link is American but may help: ucsfhealth.org/medical-test... "Normal values for a blood sample taken at 8 in the morning are 5 to 25 mcg/dL or 140 to 690 nmol/L."

This post I wrote may be helpful to you though not all will be relevant - but it should hopefully answer questions that you may have and you're often not told: healthunlocked.com/asthmauk...

Did they tell you anything about what's next? Please make sure that for now, you don't stop or reduce steroids any further (presumably you were off steroids for the test)?

[runcyclexcski in reply to Lysistrata]

>>>"Normal values for a blood sample taken at 8 in the morning are 5 to 25 mcg/dL or 140 to 690 nmol/L."

Yeah, mine was 170 nmol/L (==170 nM), which they told me was "OK" then recommended to keep tapering further down from 5 mg

[Lysistrata Administrator Community Ambassador in reply to runcyclexcski]

At that level they should have done a short synacthen test before pushing it down. As per my post, there is a grey zone above 140-150 where further testing is needed. I was diagnosed with adrenal insufficiency with initial results in the 200s because I didn't respond in the short synacthen test.

[runcyclexcski in reply to Lysistrata]

Hm, they never mentioned the synacthen test to me! Thanks for the tip!

I've tried going from 5 to 4 for the last 5 days and feeling very tired all the time. But this is what I also felt when going from 7.5 to 5, so I was hoping I will get used to it.

[Lysistrata Administrator Community Ambassador in reply to runcyclexcski]

Be careful around this level - it's the physiological replacement level (equivalent to 20mg hydrocortisone). If you have any illness, including an asthma flare, you may need to stop going down and go back up again.

Can you ask to see an endocrinologist? Some asthma specialists try to manage adrenal insufficiency, or testing for it, themselves and they probably shouldn't really - they're often not great at it, can interpret the tests wrongly and it isn't really their area, even if caused by steroids for asthma. Plus I feel they wouldn't exactly like it if endocrinologists said oh well this patient is under us for diabetes already, we can manage their complex asthma too.

[runcyclexcski in reply to Lysistrata]

Thank you for the great advice, Lysistrata. "Asking" to see an endocrinologist might be involved -- my GPs do not like to be told what to do. It took me 2 months to convince them to prescribe 1 mg tablets for the slow taper. With the asthma specialist, I am now at the "once a year" review stage. I see him privately if I have an urgent need, so I could have asked when I had a chance when I saw him a month ago. I guess I could email the asthma nurses and ask about the synacthen test and/or an endocrinologist referral.

It was hard to go down from 10 to 7.5, but my nurses said that "should try to stick with it". I definitely got more chest tight when doing 10-7.5, but it resolved in 2 weeks. This i what I was hoping for this time. And I have my long-awaited vacation scheduled for the taper, "great".

[DAsthmaD in reply to Lysistrata]

Hi. Thank you. I am on a weaning programme. Currently down to 5mg. I had stopped them for the 7am blood test. Have been referred to Endocrinologist.

[runcyclexcski]

See Lysistrata's answer regarding normal values. Mine was 170 nM.

Physically, 59 nM means that every cubic micrometer of your blood contains approx 59*0.6 = ~35 molecules of cortisol (if one assumes Avogadro's number to be ~0.6*10²⁴). So, in 1 liter of your blood there are about 35*10¹⁵ molecules of cortisol. Large number, but lower than they consider normal.

[DAsthmaD in reply to runcyclexcski]

Thank you. Most informative.