Well, darn! I don’t use Flonase much but decided to do a little more research on the nasal spray antihistamine I use, Azalastine. Turns out nasal sprays with corticosteroids, like Flonase, can also encourage the development of oral thrush. It disrupts the PH balance in the throat giving thrush a chance to grow. Azalastine is sometimes sold as a combo drug with a corticosteroid, the combo causes the same thing, but not with just the antihistamine.

I expect I’ll be right there with you for a ACTH plasma level test. I haven’t been taking cortisone/shots but my serum cortisol level is out of whack, and next step is ACTH to try to figure out a cause.