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Testing for Cortisol levels during taper of prednisone
Polymyalgia Rheumatica (PMR) | Last Active: 2 days ago | Replies (28)Comment receiving replies
I asked this question at my last appointment. Rheumatologist said he wouldn’t order the test until I was off prednisone.
Replies to "I asked this question at my last appointment. Rheumatologist said he wouldn’t order the test until..."
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@vjm0223
That is a common position for a rheumatologist to take. They worry about the rheumatology problem more than the endocrine problem with adrenal insufficiency.
Another problem is there isn't that much that can be done for prednisone induced adrenal insufficiency. The treatment is the same because you have to continue taking prednisone or some other corticosteroid. You must also continue doing a slow taper and hope that someday you can taper off prednisone.
I will say it was a whole lot easier for me to taper off Prednisone after Actemra was started. It still wasn't that easy because I was on Prednisone for 12 years.
Actemra controlled my inflammation while I tapered off prednisone and didn't suppress my adrenal function. I have to assume my IL-6 level was too high but that was never tested either.
Until the mentality that Prednisone is the "only option" for PMR/GCA, I guess we have to accept adrenal insufficiency as a potential problem. Adrenal suppression is temporary in many cases but can be permanent for some.