Adrenal Insufficiency: New Data

[Sandmason]

medpagetoday.com/endocrinol...

[Angelsmummy]

Interesting.,xx💐😜

[Kaaswinkel72 in reply to Angelsmummy]

Thanks for this article.

Although lengthy (?) it is in my opinion a must read for “ us”. Go,go, go!

After 7.5 years of prednisolone consumption for PMR my (new) rheumatologist has started me on hydrocortison because she diagnosed it was nt PMR (any more.?)

( WHAT!) She diagnosed this indeed from my clinical presentation, and she is (I agree] correct.

I want to stress to you to try to detect a good rheumatologist, (succes!) who is able to make the correct diagnoses. So that you don t, like me, eat various amounts of prednisolone for a long time ( probably) for a not PMR. Ending up with the various side effects like osteo porosis etc.

Yes correct diagnoses is paramount. And yes, speaking up is another one!

All the best and aroha ( for the new zealanders among us) for all.

[powerwalk in reply to Kaaswinkel72]

Kaaswinkel, How do you find the HC? Are you feeling any better on it?

[Kaaswinkel72]

because I apparently now don t have PMR the hydrocortison does the job well, so far. I feel less stressy.

Interestingly my diastolic bloodpressure has come down considerable! But I am even more hungry than before so eat like a builder! Does nt matter, I was to thin!

[powerwalk in reply to Kaaswinkel72]

Good its helping you.

[Wizards]

I stopped reading when it said everyone in the group was on prednisone for 12 weeks. Most people in our group are years, big difference in how the adrenals come back

[readingbooks in reply to Wizards]

Read on a bit further and it says 'median duration on pred was 13 months' .

[DorsetLady PMRGCAuk volunteer in reply to readingbooks]

Quite!

[Wizards in reply to readingbooks]

Still an extremely short time and study group is small.

[proactive]

The cumulative dose of prednisone is stated in the article as 348 mg... How is that possible when PMR patients are started at 50 or 60 mg per day and PMR patients at 15 mg to 25 mg......Am I misreading or not understanding something?

[AmbientB in reply to proactive]

It was puzzling, but I followed the links and buried deep in a data table with a footnote it's defined as the cumulative dose during the 6 months prior to the study. That would exclude the higher doses at the commencement of treatment but it still seems quite a low figure. Altogether I didn't find it terribly good news, as I read it as 34% still reported (subjectively) symptoms of adrenal insufficiency even though the test showed the figure was much lower. Interestingly, those who reported AI symptoms did actually have on average lower cortisol levels than those who did not.

[PMRpro Ambassador]

"Another study limitation was that it didn't capture patients who weren't able to sustain prednisolone cessation of at least 2 weeks, which could have impacted the prevalence of adrenal insufficiency."

And that means it was probably a self-selecting group who were already recovering adrenal function - some do.

A study done at Leeds found the opposite - that it took far longer than they had expected for adrenal function to return reliably. Half of these patients were off pred in 13 months - I would expect a reasonably speedy recovery of adrenal function if that was all.