Adrenal nodules?

[Gary1310]

Hi wonder if anyone else has Adrenal Nodules? How do they affect PMR and Prednisone? I have a nodule in each Adrenal. Apparently they do not produce hormone.....I am reducing my Prednisone by 1 mg every two weeks. I am down to 9mg from 20 mg. Feeling well.

[PMRpro Ambassador]

That really is a new one on me!! Have your doctors expressed any opinions?

[Gary1310 in reply to PMRpro]

I have not discussed it with my Rheumatologist but will on my next visit in late August. I will request an appt with an Endocrinologist at that visit. I understand many Adrenal Nodules are undiagnosed and are found at autopsy. Mine were found as “incidentals” at Mayo

[Suet3942 in reply to Gary1310]

I have one as well which was found when scanning my abdomen. Had a test and was told it’s not producing hormones.

[Gary1310 in reply to Suet3942]

Do you have PMR?

[Suet3942 in reply to Gary1310]

Yes Gary. Coming up for 6 years. You?.

[Gary1310 in reply to Gary1310]

Yes and reducing Prednisone 1mg per every 2 weeks. 9 mg now

[Hidden in reply to Gary1310]

Hi gary1310, if you can slow down the reduction a bit with your Dr it might be worth it in the long run. A lot of people get to single figures and relapse. A fast reduction along with too higher dose of pred at the start of PMR are the best indicators for relapse. If you go too fast you can't really identify what dose works as you whiz past. 🤞 Fingers crossed this doesn't happen. I got to 8mg on monthly reductions and flared. My markers went higher than at diagnosis. 32 up to 52. Back to 14-15 mg for months. 🌻

[Gary1310 in reply to Hidden]

Thank you. I seem to be doing well on 9g. I go to 8 mg on Tuesday. Will pay close attention to symptoms.

[SnazzyD]

I doubt anyone will be able to say for certain how it’ll affect you if anything, but I’m no expert. Endocrine ‘extras’ usually cause trouble if they prevent function or add too much into the mix. Nodule or no nodule I would probably reduce more slowly than 1mg per 2 weeks. From 9 to 5mg I did 0.5mg every two weeks if I felt well. Your adrenals will think you.

[piglette]

I hope they are benign? I think most are. In fact quite a high number of patients do have adrenal nodules around 8% I believe.

[Gary1310 in reply to piglette]

Yes, they are benign but I have not had them checked in about 10 yrs.

[SheffieldJane]

Sometimes you need to be the one to join up the dots Gary. Ensure that your Rheumatologist is fully aware of this previously diagnosed condition that will have an impact on your Prednisalone consumption and response, I’m sure.

[Gary1310 in reply to SheffieldJane]

..Thank You all. Yes, they are benign.....

[Christophene47]

I wonder if they are like thyroid nodules which do no harm, and are common; just need to be ultrasounded just to be sure they don't grow or change. I only know this because my primary thought the right side of my thyroid felt enlarged to him and ordered an ultrasound which showed small nodules; followed by a nuclear med scan to be sure they were not "cold" which are considered pre-cancerous. Hot is good.

But have no idea if that all carried over to adrenal nodules; sounds like some follow up may be indicated. I doubt they caused , or are related to PMR.

[Gary1310]

Thank you. I understand that Cortisol is produced in Adrenal Glands and I wondered if it could impact my Prednisone reduction success.

[PMRpro Ambassador in reply to Gary1310]

Yes - but did you not say the nodules are not producing hormones?

[Gary1310]

Yes, I said that. “They are not producing hormones”. Guess I should not wonder if they are going to be compromised. I just hope Adrenals kick in when I reduce Prednisone.

[fairy100]

I am on spironolactone as I also have Hyperalderstonism which means my adrenal glands are not producing the hormone(?) that regulates blood pressure. My blood pressure was uncontrolled by other drugs until I was diagnosed with that and I too am wondering how this is going to be affected by my reduction of Pred. So far down from 15mg to 7.5mg. Good luck.

[PMRpro Ambassador in reply to fairy100]

Aldosterone is secreted by a different bit of the adrenals, it is a mineralocorticoid. I think pred will only affect the production of cortisol in your case so it should be the same for you as anyone else. You will reduce the pred and wait to see of the adrenal function returns - but at a guess they will monitor you rather better.

[fairy100 in reply to PMRpro]

Thank you. I will take this up with my GP at my next meds review.

[Gary1310 in reply to fairy100]

Hope you will let us know how it affects your Adrenal Cortisol production when you are off Prednisone. Do we know at what point Adrenals start to produce Cortisol? Tuesday I reduce to 8 mg Prednisone for two weeks.

[PMRpro Ambassador in reply to Gary1310]

Any time from now - it depends on the patient and how much of the oral dose of pred they absorb. Officially its 70%, in fact it is anything from 50% to 90%.

[Gary1310 in reply to PMRpro]

Thank you!