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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
It is probably okay for 18 hours but longer is better.
Specific Steroid Holding Times
Hydrocortisone: Hold for at least 24 hours before testing
Prednisone/prednisolone: Hold for at least 48-72 hours
Dexamethasone: Hold for at least 48-72 hours (preferred if testing must be done while on steroids as it has minimal cross-reactivity with cortisol assays)
https://www.droracle.ai/articles/267087/should-a-patient-take-oral-steroids-before-an-acth
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There might be other sources that say something different. Health care professionals are notorious for never agreeing on anything.
This is another reason why cortisol levels aren't done routinely. It might be difficult for PMR/GCA patients to hold their dose that long. I was able to hold my dose for 48 hours because Actemra prevented a PMR flare
Replies to "@caroljeand It is probably okay for 18 hours but longer is better. Specific Steroid Holding Times..."
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@dadcue
I’m guessing I would have held off prednisone for 20 to 22 hours between my last dose and the blood test. So it probably told him what he needed to know. He determined my cortisol level was normal and felt I was producing cortisol. I tapered to 3 mg yesterday and feel ok so far. Maybe having had 4 kevzara injections has also helped.