My GP didn't really appreciate my need for an endocrine referral until my cortisol level was checked. A cortisol level can't be accurately checked until you are able to maintain a low dose of Prednisone for an extended period of time. You also need to be able to hold your Prednisone dose for at least 24 hours but 48 hours was better. An a.m. cortisol level was all I needed for my GP to immediately refer me to an endocrinologist.

There isn't that much an endocrinologist can do except for correctly interpreting cortisol levels. There isn't any treatment to "stimulate" the adrenals except for a very low dose of Prednisone. Hydrocortisone is the preferred treatment for adrenal insufficiency but not absolutely necessary. I stayed on low dose Prednisone.

My endocrinologist said I needed to stay on a 3 mg or less of prednisone for as long as it takes for my cortisol level to improve. It was rather nice to be told NOT to taper Prednisone any lower than 3 mg until my cortisol level improved.

The collaboration with my rheumatologist was to make sure I didn't need Prednisone any longer to treat PMR. Actemra (tocilizumab) is currently treating PMR instead of Prednisone.

@redboat was fortunate to be started on Actemra relatively soon after being diagnosed. I'm not sure if he experienced any Prednisone withdrawal symptoms or adrenal insufficiency.