cortisol test

     Is that the same as checking to see if your adrenal glands are working sufficiently?  If so, I was told by my GI doctor that I had to be off prednisone completely before being tested.

Yes - For the past two years I've been trying to recover my adrenal function after having suppressed my own production of cortisol with having taken 40mg prednisone for 4months. The official diagnosis is adrenal insufficiency. The endocrinologist tapered my pred super-slow then switched over to hydrocortisone and tapered further and began testing. Every two months the fasting blood draws included the following; baseline cortisol & ACTH; an injection of synthetic cortrysin followed by blood draws at 30 & 60 min of cortisol & ACTH. Results in 2-3 days came with instructions on further taper and when to retest. Finally, I'm off cortisol for 6 weeks - after having documented adequate levels of baseline cortisol and post-stimulation injection levels of ACTH & cortisol.

However - these two years of debilitation in bed with bone pain, fatigue, migraines - symptoms of adrenal insufficiency - have left me terribly deconditioned, limp like a wet noodle.

I'd really like to share more and engage in dialogue on this issue - but have a rare evening out at a friend's place.

-Damini

I'm very interested in this thread, as I find it next to impossible to get below 5 mg or so myself. There is a small silver lining to all this: those people who have no adrenals because they had to be removed surgically- and thus by inference those whose adrenals have (hopefully temporarily) stopped all natural production of cortisol- do not get toxic effects when using steroids to replace their natural production. In a normal healthy person, natural production of cortisol is about 20 mg of cortisol- the equivalent of that metabolized by about 5 mg of prednisone (which metabolizes to cortisol). The body sees cortisol in the blood, period, and everyone has cortisol in their system- it is cortisol significantly higher than natural levels that can cause toxicity. Agfain, patients on lifelong steroids, having no adrenal glands, do not get any of the prednisone side effects we consider normal. So my theory is that many IBD patients who are considered steroid dependent are actually just incapable of producing their own cortisol- again, hopefully temporarily- and this may not necessarily be as much of a reason to panic as some of our GI's make it out to be if we can get down to 5 mg- just a thought. I do want to get off though, and am keen to get tested as well if the results can be meaningful even before getting to zero.