I’ve been on prednisone for three years and have gradually reduced amount so I’m now taking one mg every four days. I’ve had little or no input from gp or rheumatologist but have managed by following advice from amazing people here. I finally got to see a rheumatologist last month and she agreed I could have a cortisol test to check adrenal gland function. My gp surgery does not do the test so I will be going to another clinic. They open for tests at 8.30. I haven’t been told if this is a fasting test or if I should not take prednisone on that day. I would be grateful for any advice.
Many thanks
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Ana-16
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If you can’t get in touch with the people doing the test for advice. I would be inclined not to take Pred on the day of the test and not eat. This would be less likely to ruin the test. If I remember correctly, this is what I did for my Synacthen Test.
Contact the clinic!! That would be wishful thinking. I will just not take anything for the previous 24 hours. There won’t be any issue with missing a dose of the other meds I’m on. Thanks for the advice
Yes. It’s not been great though my gp is lovely. Just that I’ve been left alone to manage everything for almost a year. Without this forum I would have been lost.
No you don’t need to fast. My synacthen test was booked for 10am and I was still drinking the coffee I bought from the hospital cafe when I arrived at the unit. No problem. Just don’t take the pred fro 24 hours prior.
Oh dear that is confusing. Some seem to insist on fasting and some think it’s unnecessary. Checked with dr Google as the advice there is that fasting is not necessary
You should not take any pred in the 24 hours before the blood sample is taken. So you take pred in the morning the day before and none until after the blood sample is taken.
Is this just for a basal cortisol or will it be a proper synacthen test which takes an hour or so?
a simple blood test, usually pre 9 am, I had mine done at my GPs, though it might have been at the direction of the endocrinologist at the time I can't remember now, was many years ago
Hi Ana I've had the Synacthen test twice in the last few months and you don't have to fast but you mustn't take any steroids for 24 hours beforehand. As you only take 1mg every 4 days you can arrange your test for a day you don't take it. If you don't have adrenal insufficiency symptoms it's likely that you are ok. Good luck
I had the test in July and the department told me to not take Pred for two days before, I didn't need to fast though. I ended up getting a horrible flare afterwards, which thanks to Dorset Lady and other lovely experts on here, I managed and am back down to 4mg, just above what I was on (3/3.5mg). The test was successful, but now I am under pressure to keep on reducing to zero. I feel like they treat it as an addiction we need to be weaned off, but the pains I had with the flare made me realise that I still actively have PMR and I will now reduce at my own speed, or not at all, if it is controlling the PMR and reducing causes pain.
I hope your test is successful and with you at 1mg every 4 days, you stand much less chance of getting a flare - good luck!!
I just took the test last week. They told me to eat nothing after midnight before the test and I could take my morning meds as usual. I elected not to take them until after the test.
Think you already got the right answer that you should not take prednisone the morning of test and 24 hours before. I am curious as to why your rheumatologist wants you to have the test. Were you having symptoms again since you were at a low dose? I was down to 2 mg prednisone per day and had a significant flare and my rheumatologist refused a cortisol test I requested since she felt it would not show anything that we didn't already know since my flare showed that my adrenals weren't producing enough and the answer to that is more prednisone which I increased. I would have preferred the test to get a more definite answer.Good luck with the test.
I was only repeating why my rheumatologist said I didn't need that test, in her opinion- "that testing of the adrenal axis (cortisol) will likely show suppression and the treatment of adrenal insufficiency is steroids, which I am on already, so she suggested to save time/money to differ the cortisol testing with no further tapering for now and staying on 2 - 3 mg/day of prednisone."
I did appreciate the information you sent on adrenals and would have preferred to get the cortisol test to better understand where I stand.
Perhaps she didn’t explain her idea properly- but it’s an odd comment for her to make… and yes you do want to know where you stand. If you aren’t having any particular issues would say they are working- but unfortunately you don’t know how well… but a cortisol won’t tell you that either.. just if they are capable of working.
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