Cortisal Results

[Southmead]

Hello fellow sufferers,

I took my 3 monthly blood test, they like to to see how my Adrenal gland is performing, the last test a few months ago my results were 8.8 in the range of 8.00 to 25. Which was encouraging.

This time they were 5.4. a few weeks ago I tried tapering down slowly below 5mm of Pred, but that as many of you know, seems to be the trigger point for flares.

Currently I'm on 5mm of Pred which seems to keep it under control, albeit with some stiffness. Is this latest result a sign that my Adrenal gland is not working as well as it was?

Thank you

[PMRpro Ambassador]

For cortisol levels, Mount Sinai quotes:

"Normal values for a blood sample taken at 8 in the morning are 5 to 25 mcg/dL or 140 to 690 nmol/L. Normal values depend on the time of day and the clinical context. Normal ranges may vary slightly among different laboratories."

I think it is probably just some fairly normal variation. At 5mg pred it is reasonable to see cortisol levels that are at the low end of the normal range. At this point I think it is of slightly academic interest what the cortisol level is - most endocrinologists like to wait until you are down to 3mg pred for a more reliable indication.

[Southmead in reply to PMRpro]

Thank you, I realized after I should have probably not taken my morning 5mm dose of pred before the test..

[PMRpro Ambassador in reply to Southmead]

No - you are supposed to delay taking that dose until the blood sample has been taken - with no pred in the previous 24 hours.

[Southmead in reply to PMRpro]

Force of habit morning Pred, I may take another blood test just be sure. Thank you again..

[PMRpro Ambassador in reply to Southmead]

I honestly wouldn't worry about it. You can take all the blood you like, it won't change what is going on, so once every 3 months is plenty. The only thing that will improve the values reliably is to be at a lower dose of pred - yours are functioning, they will only improve as you reduce the pred and eventually get off it and even then it will take up to a year for them to get back to normal.

[Pollyanna16 in reply to Southmead]

Was this a basal blood test? I have requested one which my gp has at last agreed to. I was diagnosed with Adrenal Insuffuciency in 2019 & am keen to see if I can reduce from 3.5mg. The gp said I should take my pred as normal before the test when I asked him. I know you mustn’t take it before the synacthen test. I will probably not take it until afterwards it seems logical.

[PMRpro Ambassador in reply to Pollyanna16]

Better to take none in the 24 hours before - it needs to be taken in the morning so you just take it a bit late.

[Pollyanna16 in reply to PMRpro]

Thought so, thanks for the confirmation!

[Southmead in reply to PMRpro]

Thank YOU!!

[piglette]

How nice to have a doctor that is interested in your adrenal glands. I am not sure my doctor even knows I have adrenal glands the amount of interest he takes.

[PMRpro Ambassador in reply to piglette]

Does yours actually know what you are supposed to have? i.e. PMR

[piglette in reply to PMRpro]

I should not think so for one minute.