Adrenal glands

[Invention]

How long can a person go on without their adrenal.glands working?

[SheffieldJane]

The function is pretty necessary invention. Why are you worried?

[Hidden]

Are you sure you are in the right site/forum?

[Pollyanna16]

I dint think you can! I am on 15mg hydrocortisone as my adrenal glands are being “investigated” as blood tests show they are pretty rock bottom after 8 years on Pred 😢

[Invention in reply to Pollyanna16]

I'm still trying to learn. Did you have the blood tests, while you were off the pred. Otherwise, wouldn't they show you with little cortisol, because the prednisone knocks it out, and takes over, while you're on it. I did find I'm in the wrong forum, as I should probably be in COPD forum, as that is what I have, along with asthma. Although, when talking about the adrenal glands, and prednisone, I wouldn't think it matters what the disease is. I stopped an inhaler with steroids, and have been really sick and in withdrawl for 10 days. And then I get anxiety, worrying about if my adrenal glands are functioning good enough, or at all. I need to get a test. Thank you for your help!

[Hidden in reply to Invention]

It's a Synacthen test that is usually given after long term pred use. You certainly shouldn't sit at home worrying. At least go to see your gp to discuss it.

[Pollyanna16 in reply to Invention]

My Rheumatologist stopped my pred, which was by then only 2mg & put me on 15 mg hydrocortisone per day. I had a blood test for adrenal function which showed a figure of only 61 which is worryingly low. Last week I then had a short synacthen test, whilst still on hydrocortisone, & am awaiting the result. I had been on pred for PMR for 8 years by the way. Crossing everything I won’t have to be on HC forever, but not in the least confident 😢

[PMRpro Ambassador]

It's much the same as thyroid function really - your body needs what they produce to function and without any adrenal function you slowly can become quite ill. The problem is you need their input in stress situations and then you coud become ill more quickly but - again like thyroid function - it is relatively easy to cover with replacement therapy using hydrocortisone which you are already on. You also need a bit more awareness to know how to deal with stressors on your body of all sorts.

Is that in addition to pred for the PMR? If you are currently on pred that makes it more complicated to assess how much function you have.

[Invention in reply to PMRpro]

I am not on any steroids as of 11 days right now. I've been in withdrawl, and really sick, from just stopping an inhaler with fluticasone furoate, 200 mcgs. I didn't think I would get this sick, as it is not as high a dose of steroids, as I was on last year taking prednisone for 13 days, which I tapered from. I had terrible withdrawl, to at one point I thought I might die. I got just about every side effect you can get. I never want to take that drug again. Doctor gave me impression I should not have had the problem, as it was a short run of 40, then 30, then 20, then 10. I don't care what the doctor thinks, I know what I went through, and it was terrible. But, I would not have thought I would be having trouble like I am just getting off the inhaler. Anyway, sorry this got so long. Thank you for your input!

[Hidden in reply to Invention]

You do need to seek medical advice asap.

[Invention in reply to PMRpro]

Also, that is why I'm worried about adrenals. Because, I am afraid to ever be on steroids ever again. When you said they will slowly make you sick if not working, what kind of time are you speaking of for cortisol not being produced

[PMRpro Ambassador in reply to Invention]

Weeks to much longer usually - it depends on how much function you still have and most people have some, enough for day to day function. Stress situations are the problem.

You must speak to your doctor about your concerns. The forum can't do more than talk about general cases and that isn't always much help.

[Cross-stitcher]

The adrenal glands produce several hormones with very different functions. I am unclear whether long-term use of Prednisolone stops all adrenal activity, or only the production of the glucocorticoid cortisol, which has great importance in the normal regulation of the immune system. As PMRpro says, "Without any adrenal function you slowly can become quite ill". However, I think that taking Pred will not stop many of the important functions such as the production of adrenaline and aldosterone and also the sex hormones (androgens) such as DHEA which are later converted to testosterone and oestrogens. So, as we taper off Pred, we just have to restart the production of cortisol. Can anyone with better medical knowledge confirm this, please?

[PMRpro Ambassador in reply to Cross-stitcher]

I think only the glucocorticoids are suppressed although it probably unbalances other functions and that is a problem while the entire HPA axis is settling down with each reduction step, it can be a rather bumpy journey!

[Invention in reply to Cross-stitcher]

Thank you. I just wish I understood this better!

[Hidden in reply to Invention]

It's a complex set of processes that probably differs from treatment to treatment. I don't understand it all fully (or even much at all). All I know is if you feel so ill you need to make sure you are okay.

[Invention]

I do feel a little better. It's at night when it's the worst now. Which makes me think that I probably am getting some cortisol in the morning. From what I've researched, that is when it is highest, in early morning. Need to get testing, and keep anxiety under control, as that makes things worse. Thank you for your input.

[HeronNS in reply to Invention]

See your doctor, and do let us know how you get on. Hope you feel better soon - get lots of rest, and maybe some gentle walks in the open air.