@lluth412
"I had a functional medicine person test cortisol this month - very high in the AM near non existent in the late afternoon."
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That is "somewhat normal" for a cortisol level in the morning ---not completely normal in the afternoon.

When did you take your Prednisone dose? For a valid a.m. cortisol level test you can't take any Prednisone for at least 24 hours. Ideally, for a more accurate a.m. cortisol level when on a low dose of Prednisone --- you would need to hold your Prednisone dose for 48 hours.

It is debatable what the low dose of prednisone is. My endocrinologist said I needed to be able to maintain a 3 mg dose for an extended period of time before a morning cortisol level was warranted. I also needed to be "symptomatic" of adrenal insufficiency to warrant a cortisol level to be checked.

I must have been symptomatic enough to get my cortisol level checked and it was "quite low." However, my endocrinologist was somewhat surprised that I had a cortisol level so soon after being on moderately high doses of prednisone for 12 years. Since I had a cortisol level even though it was low ... my endocrinologist was "optimistic" that my adrenal function would continue to improve if I could stay on a lower dose of prednisone. She didn't want me to increase my dose any higher than 3 mg unless it was absolutely necessary.

The main point my endocrinologist was making was that my cortisol level wasn't ever going to improve unless I could stay on a very low dose of prednisone. I was reading that I shouldn't have any pain when treating PMR. My endocrinologist said I needed to expect "some pain" when trying to taper off prednisone. She said I shouldn't automatically increase my prednisone dose for "prednisone withdrawal pain" unless it was absolutely necessary. All the while, I needed to avoid things that could cause an adrenal crisis.

All of this is easier said than done!