Low Cortisol Level

[headgirl]

Hello, I'm looking for advice again please. A couple of weeks ago I saw a Rheumatologist for the first time at my local NHS hospital who I have to say was very thorough & helpful. I have to have several x-rays taken and an ultrasound of my shoulders & in addition to this I have had blood tests taken. These included one to check Coritsol level which was taken at 9am with my last dose of 7.5mg Prednisolone taken at 7.30am the previous day. I have heard via my GP that the Cortisol level was 57 (normal range 140 -620) but she doesn't feel that any action is required. I thought that at 7.5mg, this was too high a dose for levels to be checked? At the moment I don't have any PMR or GCA symptoms but feel short of energy and light headed. Any thoughts would be very welcome.

[PMRpro Ambassador]

It was probably a bit pointless - but it matters more when doing a synacthen test. Some doctors just don't think, just automatically write the request! You are at the stage where your body is just having to think about some adrenal function - it depends on how much of your oral dose you are absorbing and since some people only get as little as half, some people notice the difference from 10mg down. If you can put up with it and you are lucky it should improve - but some people have to put up with it for a while. Snazzy says 5 down to 3mg was awful for her.

[SheffieldJane]

You could ask for a referral to an Endocrinologist. I did and he took it very seriously indeed. My Cortisol levels did recover their potential when my Pred dose had decreased after my second Synacthen Test. In view of your symptoms I might insist. Be prepared for a different set of priorities from another specialist though. I felt quite conflicted.

[headgirl in reply to SheffieldJane]

Thank you, that sounds like a good idea.