Cortisol levels

[marionofnorwich]

Well, I had the short synathacen test two weeks ago and a call from the rheumatologist on Monday. Apparently it was 368 after 30 minutes and 438 after 1 hour. The rheumatologist was bit downbeat about that result saying he was hoping for 450 plus, and also saying that it 'might come back' but also seemed to be preparing me to remain on steroids long-term. I am currently on 4mg and for a week before the test I dropped to 3.5mg (which I felt was a bit low for me). Back to 4mg now on his advice (and my inclination) but he said keep under 5mg. At least he is not rushing me, and I am aware that 4/3.5mg is enough to suppress the adrenals and give a false reading but does anyone know what would be an ideal 'normal' level? I can't find out on Mr Google. Any ideas?

[piglette]

A cortisol of >420nmol/L at 30 minutes post Synacthen indicates an adequate adrenal response, that is normally if you are not on steroids.

[marionofnorwich in reply to piglette]

So not so far off at 368? Under but not dramatically considering I am on steroids?

[piglette in reply to marionofnorwich]

I agree. Also they normally suggest you are down to 3mg before the test,

[marionofnorwich in reply to piglette]

Yes i must admit i didnt ask for the test yet but guess it is all info to compare at different stages

[PMRpro Ambassador]

gloshospitals.nhs.uk/our-se...

says

"A cortisol of >420nmol/L at 30 minutes post Synacthen indicates an adequate adrenal response."

I would have said that 368 when you are still at 4mg pred was pretty good going

Sometimes I wonder about their knowledge of physiology but hey-ho!

[marionofnorwich]

That's good. Whilst I do get quite dramatic dips sometimes, generally I wouldn't say I am suffering from extreme fatigue but I do ache all over a lot, especially legs and neck/shoulders so I am thinking that the PMR is still active. Thanks people, I wasn't unhappy with the result either but I thought maybe 'normal' was much higher

[Longtimer]

Well done! Is your Rheumie M, Yates?, if so, surprises me that he wasn't happy with that, I would be!....mine is 187.....I had a low reading when seeing him, and he was concerned. Keep us posted.

[marionofnorwich]

Yes it is Max Yates. Maybe just being cautious and not raising my expectations. I will see how it goes over the next few months