Cortisol levels

[musclesinflamed]

I was diagnosed with PMR 16 months ago. I was put on 20mg of Prednisone and not told to taper for several weeks. Since then I've been cautiously tapering by the DL method. I exercise a lot, eat well, etc. Unfortunately some months into the Prednisone I was diagnosed with steroid induced diabetes. I cut back on carbs and kept it under control although it wasn't easy as I'm a vegetarian. (I lost about 20% of my weight and a lot of strength.)

When I got down to 3mg of Prednisone I had a flare. (But the diabetes disappeared!) I went back to 4.5mg and felt better but the diabetes popped up again. Now I'm between 3 and 3.5mg of prednisone again and a bit nervous. So I asked my endocrinologist to test my adrenals for cortisol production to see if they were waking up.

After fasting and an early morning test, I got the results today but don't understand them: "Baseline was normal at 9.81 but they didn't stimulate well. 30 minutes after "stimulation" I was producing 13.85 and another 30 minutes later it was 14.84".

Can anyone explain what that means &/or give input as to what I should do?

Thanks in advance!

[Grammy80]

I can't help you at all....since you and I are in the States, the heavy hitters will be here when they wake up and I'm sure can help. I'm a 5-year GCAer and down to 1mg plus Actemra. This forum is a life-saver!! My best💞

[PMRpro Ambassador]

Baseline was normal at 9.81 - normal range for baseline cortisol is usually about 10-20mcg/dL

but they didn't stimulate well. - the injection should stimulate production of cortisol and the levels in response to the injection of synthetic ACTH were not as good as they would like.

30 minutes after "stimulation" I was producing 13.85 and another 30 minutes later it was 14.84

seem OK to me, Cleveland suggests over 12.6 is acceptable but then point out that every lab has its own range so without the range for YOUR lab it is difficult to say much.

my.clevelandclinic.org/heal...

These are results while you are still on a reasonable dose of pred which will still be suppressing cortisol production. But they are working and are likely to improve as you reduce the pred dose further. I wouldn't worry too much at present and be patient.

[musclesinflamed in reply to PMRpro]

Thank you!! that make me feel better and understand a little more.