prednisone

is prednisone only for those that have low cortisteroid levels? I've been scanning the forum and quite a few people are on prednisone. I'm curious if they also have low cortisteroid and if not is there a chance that prednisone could raise cortisol to too high of a level?

Hi Alexb,

 

Actuall, the adrenal glands don't stop producing cortisol unless a person has been on prednisone for a long time.  It takes many years for the adrenals to "fatigue".  The main reason for prednisone is that autoimmune diseases of all types tend to make people insufficient in their cortisol levels.  We still produce cortisol, but not enough to battle inflammation. 

 

The body naturally makes about 7mg of cortisol when we have an "adrenalin rush" or a situation where cortisol is needed to battle inflammation.  Someone with an autoimmune disease makes less than that.  So prednisone is introduced to make up the difference and help the body fight.  AI diseases can also attack the adrenals causing adrenal fatigue or out right adrenal crisis, where taking prednisone is a life long medication need to keep a person alive. 

 

Yes, you can be on too much prednisone.  Symptoms are ususally a constant adrenalin rush, jitters, trouble sleeping, fast heart beat, just to name a few.  So it's important to be on as low a dose as possible that keeps your AI disease under control.  Being on too much prednisone can also cause the adrenals to shut down prematurely.   

 

Great questions you have!  Hope all our advice and info helps!

 

Ginny 

 

 

Alex

There are over a hundred different autoimmune diseases - lupus and its variants are autoimmune connective tissue diseases like rheumatoid arthritis.
As far as I know low cortisol levels have nothing to do with lupus either as a disease symptom or as part of diagnosis.
There is a disease called Addison's, which is sometimes autoimmune in origin, that features low cortisol levels. People who stop Prednisone too fast after being on it at high doses for any length of time can get an Addisonian crisis because they haven't started producing their own.There's also a disease called Cushings which features high cortisol levels. People who are on high levels of Prednisone for any length of time can develop Cushingoid syndrome.

Lupus is diagnosed by looking at a total picture of symptoms and test results. There are only four specifics for lupus and not everybody with lupus has these specifics. They are anti ds DNA and anti Sm antibodies and proven lupus skin or kidney problems.
The sorts of factors considered in making a lupus diagnosis are as follows from the LFA site. They do not have to be present all at the same time. just observed over a period of time.




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Malar Rash :


Rash over the cheeks

Discoid Rash :


Red raised patches

Photosensitivity :


Reaction to sunlight, resulting in the development of or increase in skin rash

Oral Ulcers :


Ulcers in the nose or mouth, usually painless

Arthritis:


Nonerosive arthritis involving two or more peripheral joints (arthritis in which the bones around the joints do not become destroyed)

Serositis:


Pleuritis or pericarditis (inflammation of the lining of the lung or heart)

Renal Disorder :


Excessive protein in the urine (greater than 0.5 gm/day or 3+ on test sticks) and/or cellular casts (abnormal elements the urine, derived from red and/or white cells and/or kidney tubule cells)

Neurologic
Disorder :


Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic disturbances which are known to cause such effects

Hematologic
Disorder :


Hemolytic anemia or leukopenia (white blood count below 4,000 cells per cubic millimeter) or lymphopenia (less than 1,500 lymphocytes per cubic millimeter) or thrombocytopenia (less than 100,000 platelets per cubic millimeter). The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it.

Antinuclear
Antibody :


Positive test for antinuclear antibodies (ANA) in the absence of drugs known to induce it.

Immunologic
Disorder :


Positive anti-double stranded anti-DNA test, positive anti-Sm test, positive antiphospholipid antibody such as anticardiolipin, or false positive syphilis test (VDRL).

Adapted from: Tan, E.M., et. al. The 1982 Revised Criteria for the Classification of SLE. Arth Rheum 25: 1271-1277.

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