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Secondary adrenal insufficiency question
Polymyalgia Rheumatica (PMR) | Last Active: 1 hour ago | Replies (14)Comment receiving replies
I will keep this information in mind. My endocrinologist is very responsive and is in the best position of anyone on my care team to have the big picture. I'm holding off any further discussion with him until I get the cortisol level test results and then he and I will look at a course of action. I am very sure that my original diagnosis of PMR is correct, but I do think that a lot of my additional seemingly unrelated conditions have a common unidentified etiology and have suspected for a while that the answer belongs somewhere in the endocrine system.
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@potterywoman
You can have both PMR and also have secondary adrenal insufficiency from taking Prednisone for a long time. That was what I struggled with because there were overlapping symptoms.
The beauty of PMR being treated with something else rather than prednisone was that Actemra didn't suppress my adrenal function. PMR was treated while I recovered from secondary adrenal insufficiency.
My endocrinologist said that I had to stay on a low dose of Prednisone for my cortisol level to improve. I only had to be able to stay on 3 mg of prednisone without increasing my dose. After my cortisol level improved, I was able to discontinue Prednisone. Now PMR is treated with Actemra instead of Prednisone. I still have PMR according to my rheumatologist but Actemra doesn't suppress my adrenal function while it keeps PMR in remission instead of prednisone.
I had both PMR and secondary adrenal insufficiency from prednisone at the same time. The difficulty was that PMR flares were treated with more prednisone. The treatment for secondary adrenal insufficiency was less prednisone or ideally --- NO prednisone.
It was impossible to take more prednisone for PMR flares and less prednisone for secondary adrenal insufficiency at the same time! The main reason for tapering slowly off Prednisone is because of adrenal suppression.
Doctors understand the need to taper off Prednisone slowly but also "as soon as possible." Waiting for PMR to "burn itself out" doesn't always happen and is ridiculous because my case of PMR is refractory.
As we all know ... PMR can last for a long time. When PMR is treated with "long term" prednisone ... it is a setup for secondary adrenal insufficiency in my opinion.