ADRENAL GLANDS WORKING ?

[Polylinc]

Could you please help with the name of the test needed roascertain whether adrenal glands will take over if steroid medication ends ?

Thank you x

[Hidden]

It's synacthen Test ...

[jinasc]

Synacthen Test. You need to be below 7.5mg and some Endo's prefer 5mg and below.

[Polylinc in reply to jinasc]

Thank you so much x

[PMRpro Ambassador]

... but it doesn't tell you the adrenals WILL work, it tells you that they are capable of producing cortisol when poked hard. The actual production of cortisol is dependent on a whole range of factors in the HPA axis (hypothalamus, pituitarym adrenal) so if one of those is off, it may still be a problem.

[SheffieldJane in reply to PMRpro]

I have been signed off by Dr Debono, my Endocrinologist, on the basis of an improving Synacthen result, alone.

[Pollyanna16 in reply to SheffieldJane]

Good news Jane. I am awaiting further blood tests today just to check my pituitary gland is in good health, plus test for diabetes which I am not expecting to be a problem 🤞 as PMRpro says there can be other factors at play.

[SheffieldJane in reply to Pollyanna16]

My results are academic really, I slept 3 hours yesterday afternoon. Sometimes I feel positive and raring to go in the early hours. I am just going to have to move to Australia. 😊

[Jackoh in reply to SheffieldJane]

That’s really good news x

[Polylinc in reply to PMRpro]

Thank yo so much PMRpro x

[Hellyowl]

I had to get down to 3.5 for my Endo before he would do the test. It showed my adrenals are waking up. He is seeing me 6 monthly. Which is good because Rhuemy hasn't seen me for 15 month.

[camerashy]

Hi

Just awaiting the synacthen test and my blood tests also show thyroid glands not producing enough

Have noticed my PMR is more prominent since I was changed from prednisone to hydrocortisone early days yet so still struggling

[PMRpro Ambassador in reply to camerashy]

Did they get the equivalent doses right? They (endos) often don't appreciate the antiinflammatory role for the PMR.

[camerashy in reply to PMRpro]

They did up it from 10mg to 15mg

I am just waiting until I have had the adrenal insufficiency test and then take it from there

It crossed my mind today. Should I just go cold turkey and see what happens. So many tablets with contra indications it just goes on and on. Can’t see a light yet!

Thanks again PMRprofor listening

[Hidden in reply to camerashy]

Please just don't stop. I don't know re HC but most likely same as pred..happy to be corrected but as I understand it if your adrenals are still napping it can make you very ill to stop support of them.

[camerashy in reply to Hidden]

Thanks Poopadoop x

[Hidden in reply to camerashy]

I know it's frustrating when multiple drugs interact. Fingers crossed you get it sorted soon. Have you felt any benefit from the increase to 15mg?

[camerashy in reply to Hidden]

Slightly on the GCA side but more aches with the PMR🥴

[Hidden in reply to camerashy]

Swings and roundabouts 🤯

[PMRpro Ambassador in reply to camerashy]

Do you mean you were on 10mg pred and they gave you 15mg HC?

The equivalent dose for 10mg pred is 40mg HC - no wonder it isn't managing your pain. It is pointless testing function until you are down to 5mg pred or less for the PMR. It comes first.

[camerashy in reply to PMRpro]

No sorry

I was tapering and was at 3mg preds

That was stopped and I was put on 15 mg of HC

[PMRpro Ambassador in reply to camerashy]

OK - I didn't really think you had been at such a high dose. In that case, how is the dose split through the day? The duration of effect of HC is much shorter.

[camerashy in reply to PMRpro]

I take 10mg in the morning and 5mg about 16-00hrs

[PMRpro Ambassador in reply to camerashy]

I think it is probably that the 15mg HC isn't doing as good a job as the pred did even though they are theoretically the same dose. Will he let you go back to pred after the synacthen test?

[camerashy in reply to PMRpro]

Won’t know until I see her again in October Looks like my thyroid output is low now😜

[PMRpro Ambassador in reply to camerashy]

Which can also cause similar symptoms. And pred suppresses TSH so it must be pretty high normally if they are noticing it.

[camerashy in reply to PMRpro]

Thankyou for your interest

I will tune in again when I have had my test results x