Adrenal Insufficiency effects on lymphocytes

[hill-walker]

Hello dear Forum Folks. I posted a week or so ago about slowly tapering from 5mg pred t 4.5 and the fatigue and periodic aching neck I was experiencing. My concern then was GCA symptoms vs tapering response. I was also having unusual increased heart rate at times. Lab work yesterday revealed low lymphocytes, as low as in June 2024 when I was on mega pred dose for early GCA. This is distressing as it means I'm vey immune compromised, when I was finally starting to enjoy community life out in the world. (as much as one can now in the dark evils of USA politics!) In researching, I learned that adrenal insufficiency can cause all of these symptoms. I have an appointment with primary doc in about a week, and could email my rheum with my "self diagnosis", but I doubt he'd be as receptive as primary doc. My hope is to be tested for adrenal insufficiency and a useful treatment plan created. I'd appreciate any thoughts, opinions, experiences, info. Thank you being there. You are all a gift.

[piglette]

Remember your adrenal glands have been 'turned off' for quite a while and even now at 4.5mg they are not yet fully functioning as the pred is still allowing them to be lazy, so any readings are likely to be lower than they should be. Probably taking readings when you get down to around 3mg is more sensible. In fact the adrenals normally take up to a year after you have reached zero steroids to be totally up to speed.

[hill-walker in reply to piglette]

Thank you Piglette. I appreciate your info.

[piglette in reply to hill-walker]

I hope it makes sense.

[hill-walker in reply to piglette]

Yes. The need for patience, yet again!

[Groggrim in reply to piglette]

Piglette I've read this on the forum before about adrenals. It sounds a long road, but the longest road begins with one step. I look forward to the eventual end of this road whenever and wherever it comes. GG x

[piglette in reply to Groggrim]

As you say, you will ge there!

[posthinking01]

As someone who has adrenal insufficiency - I found the pain of trying to come down too much to bear to come off it completely and have found a 'sweet spot' but I had Sepsis back in 2018 and they sent me out of hospital on 200 mg of steroids - the dose I had received via IV but now in tablets. It took me 18 months to get down to a reasonable figure - which is now 4 mg or 5 if needed. See below you are on 4.5 and the level of HC is 18 mg so you are running 'lowish' where the adrenals do need to buck up and take over - hence why you are feeling pain etc. - I have just done some research on low lymphocytes and a high protein diet can help this.

An approximate corticosteroid dosing conversion:

Prednisone

4.5 mg

Hydrocortisone

18 mg

Normal cortisol levels for women can vary depending on the time of day and the clinical context. However, for most tests that measure cortisol levels in the blood:

6 a.m. to 8 a.m.: 10 to 20 micrograms per deciliter (mcg/dL).

Around 4 p.m.: 3 to 10 mcg/dL.

(it must not go below the above figures otherwise the results could be very dangerous)

Hope this helps.

[hill-walker in reply to posthinking01]

How kind of you to research this, posthinking01! I do eat a fair amount of protein, but will increase it. Your help is much appreciated.

[posthinking01 in reply to hill-walker]

Happy to help - two eggs a day for breakfast if you can tolerate them and lovely hearty fresh soups from supermarkets - expensive but worth it - Sainsbury's do some lovely fresh soups which are like a meal in themselves - protein is the repairer of the body as you probably already know. All the best !

[posthinking01 in reply to hill-walker]

Sorry didn't realise you were in the USA - hope they do the delicious fresh soups we can get here now. and I understand from the media that eggs are in short supply so hopefully you will be able to buy them. Take care wishing you all the best for your health.

[pmac22]

I have adrenal insufficiency from long term steroid use for GCA. I have suffered two adrenal crisis, in hospital for both of them. My endo told me I will be on steroids permanatly, and if having an emergency to tell medical workers I have steriod induced Addisons, then they will understand. Anyways was in hospital with the flu last month and adrenal issues and my lymphocytes, white blood cells and neutrophils were extremely low, they put me on neutropenic precautions in the hospital. It took several weeks for blood work to return to normal, but it has. One of the doctors told me that adrenal insuffiency or crisis can do this. Hope you are feeling better now.

Peggy

[hill-walker in reply to pmac22]

Thanks for your considerate reply Peggy.

[Kendrew]

Just to add that any infection itself, viral or bacterial may also cause a low lymphocyte reading. This obviously includes things like colds, flu, covid, stomach upset, etc.

I received a low lymphocyte reading following a series of emerging health issues. It was repeated 3mths later and was back to normal.

[hill-walker in reply to Kendrew]

Thanks Kendrew. good to know.