Stopping prednisolone before blood test

[Pr0jection]

Every two months I have blood tests to check, amongst other things, my inflammation levels. Should I stop taking the prednisolone before I have my tests, and resume afterwards? I haven't been advised to do this by my rheumatologist but have read elsewhere that some people do this. Thanks

[SheffieldJane]

I think that doing this bi- monthly or so would probably end up in causing a flare. Stopping Pred cold turkey is never a good idea. There is your dependence on it for Cortisol for one thing, it could cause an Adrenal crisis, I believe. I do see where you are coming from. The blood tests will never be an accurate reflection of where you are with the disease, whilst it is being suppressed by steroids. Obviously do express your concerns to your Rheumatologist.

[Pr0jection in reply to SheffieldJane]

Thank you. I have to say that it never occurred to me to stop taking them until I read some other comments. However, I will mention it to my rheumy at my next appointment.

[Telian in reply to Pr0jection]

I never stop my pred before blood tests. As SJ says think about your adrenals.

[PMRpro Ambassador in reply to SheffieldJane]

The idea of the tests is to see if the dose of pred you are on is managing the inflammation - if it isn't you would need more and that would be shown for many people by the ESR/CRP starting to creep up and you at least need to stop the reduction for the time being and get it checked again in a few weeks. As long as the markers remain steady it is a sign it is possible to try another step down.

[ignatz in reply to SheffieldJane]

No nausea or vomiting, otherwise a typical day on reduced dose Pred...... :("Acute adrenal crisis is a medical emergency caused by a lack of cortisol. Patients may experience lightheadedness or dizziness, weakness, sweating, abdominal pain, nausea and vomiting, or even loss of consciousness."uclahealth.org/endocrine-ce....

[SnazzyD]

Stopping your Pred could result in an adrenal crisis. Also, given that it can take a while for inflammation to build back up to measurable levels, you have no idea how long would give you a meaningful result. It could be days, it could be weeks.

[Pr0jection in reply to SnazzyD]

Thanks Snazzy D. From what I've read it only means stopping taking it for maybe 4/5 hours. However, I doubt that this would show a meaningful result anyway. I don't think it's worth taking the chance, though, particularly when everything seems to be going well, apart from just a couple of niggly aches, which could just be old age!

[MrsNails]

I think you may be thinking about people having a Cortisol Test - Synacthen Test - where you don’t take your Prednisolone that morning until you’ve had the Test, they do it at 9am or as early as possible & you take your Pred after the last blood draw. It’s done to see if your Adrenal Glands are capable of working again, so not considered before you reach 5mg & is not necessary for most people.

Regular Blood Tests just carry on as normal unless you are given specific instructions.

[PMRpro Ambassador]

No - you must NOT stop taking pred suddenly, missing an odd day when you forget is one thing but even then it can cause trouble if you were to be under stress. It is also a different thing leaving taking the dose in the morning until after a synacthen test at 9am - that is important that there is 24 hours before the basal cortisol is measured.

The idea of the tests is to see if the dose of pred you are on is managing the inflammation - if it isn't you would need more and that would be shown for many people by the ESR/CRP starting to creep up and you at least need to stop the reduction for the time being and get it checked again in a few weeks. As long as the markers remain steady it is a sign it is possible to try another step down.

[ParsnipSoup]

No.

[HeronNS]

Not prednisone, but it was recently brought to my attention that one shouldn't take an iron supplement, for example, the day you are getting a blood test, if iron is part of what's monitored. I wonder if the same is true for other supplements (not medications)?