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Very low end of normal lab values for cortisol and ACTH after stopping
Polymyalgia Rheumatica (PMR) | Last Active: Mar 8 3:34pm | Replies (14)Comment receiving replies
I think a low cortisol is expected after months on prednisone. It potentially is a serious problem but probably not something that’s worth worrying about. Other than staying off prednisone to give your adrenals a chance to recover, there isn’t much else you can do. A medical alert bracelet should be worn by anyone that is on prednisone. An adrenal crisis can happen to people while they are still on prednisone.
I had a low cortisol level after being on prednisone for many years. Overwhelming fatigue was my main symptom. I needed to stay on 3 mg of prednisone until my cortisol level improved. It took months until my cortisol level was at an adequate level to allow me to taper off prednisone. I avoided having a flare because Actemra controlled my PMR symptoms.
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My fatigue is now extreme the last 2 days. My last dose of prednisone was one week ago today. My endocrinologist said as long as my blood pressure doesn’t get too low , I don’t have nausea and vomiting, or develop an acute illness, it’s okay to stay off of prednisone. She also said it’s highly unlikely that a cortisol level of 10 will lead to adrenal insufficiency however no test is 100 % accurate. I’m paraphrasing what she said. Right now my fatigue and the body aches are the worst I’ve ever had but I’m also having sinus problems so I’m wondering if I’ve caught a virus. Even so, I’ve never experienced fatigue this sever; I feel like I don’t have enough energy to take the next breath. Oh and she also said it will just take time for symptoms to get better. I have to say I’m still not too reassured that I’m not experiencing adrenal insufficiency however.