Don't get your hopes up too much because there isn't that much that can be done for a low cortisol level. Except that a low cortisol level seemed to explain why I couldn't taper off Prednisone for 12 years. Otherwise, there isn't that much that can be done.
Artificial intelligence says this:
"Yes, when treating low cortisol levels, a corticosteroid like Prednisone can be used, but hydrocortisone is generally preferred because it most closely mimics the body's natural cortisol hormone, allowing for more precise dosage adjustments and potentially fewer side effects."
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A person who experienced an adrenal crisis explained it to me this way:
"I can appreciate why you have taken prednisone as you have over the years. Prednisone is truly a miracle medication in easing life debilitating inflammation and the ensuing joint and muscle pain. Sometimes it is the only medication that is effective. The benefits derived outweigh the immediate risks. Most likely, you will need to remain on a replacement level of corticosteroid (hydrocortisone is preferred) for life. You will need to take daily medication to provide for the cortisol normally produced by the adrenal glands."
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My endocrinologist didn't have any preference about which corticosteroid I used. She just said, I was lucky when my cortisol level rebounded after I was able to maintain a low dose of prednisone for a long time.
When you study some of the functions that cortisol has in the body, it was "regulating inflammation" that stood out the most to me. My thought was that it was no wonder I had flares whenever my prednisone dose got too low. My body always seemed like it lost its ability to regulate inflammation right around the 7 mg dose of prednisone.
I have no idea if it was a PMR flare or a low cortisol level that caused the out of control inflammation and an inability to taper off Prednisone.
I think PMR inflammation necessitated Prednisone in the beginning.. As time wore on, I think a low cortisol level contributed more to my abnormally high inflammation levels. Maybe a combination of PMR and a low cortisol level ... who knows???
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Does prednisone perpetuate a proinflammatory state??? As ironic as it seems ... perhaps it does.
I didn’t realize that there is cortisone and hydrocortisone? What’s the difference? Will have to mention that to my rheumatologist.