ACTH Stim Test Results

[kp60]

Hello. I've had PMR for 1 1/2 years and started at 40 mg Pred now down to 2 mg. It's been a struggle to get down and am still much fatigued , so based on blood test results below my doc ordered the cortisol/ACTH stim blood test.

Results: 6 mos ago am on 5 mg Pred adrenocorticopnophic (sp?)result was 6.6, and Cortisol was

5 ug. Last week the results of the 2 hour stim test were: 6 ug cortisol before injections and 25 after the injection.

Based on this my endo said I could stop Prednisone. Now I dont think I should as stopping without dropping daily dose slowly is not the right thing to do for PMR.

Am I right? Thanks much!

[piglette]

I am not sure some endos really understand PMR. I think they feel if your cortisol is OK you can just stop the steroids not taking into acount that you are actually taking the steroids for the PMR.

[kp60 in reply to piglette]

Thanks!

[PMRpro Ambassador]

Absolutely - your adrenal function may have sorted itself out although all the ACTH stimulation tells you is that your adrenals CAN produce cortisol. What it doesn't tell you - or him - is whether the rest of the set up (and there is a lot to it) is functioning properly and reliably too and that is often said to take up to a year to settle down after you stop pred altogether.

But in terms of PMR/GCA, even 1mg can be plenty to keep symptoms at bay if the underlying autoimmune condition is still active albeit at a low level. Unless you are also on Actemra, I wouldn't be dropping from 2mg to zero so quickly. You can accept that the fatigue isn't necessarily an adrenal insufficiency problem - but the PMR could well still be lurking.

[kp60 in reply to PMRpro]

Thank you!

[kp60]

Thank you!