Denise,
Good Morning and I am sorry I am just getting to your question now.......
Secondary adrenal suppression following chronic use of inhaled steroids for asthma is a relatively infrequent, but potentially significant, clinical condition. Adrenal insufficiency when present can be readily diagnosed and easily treated. If missed, especially with high dose therapy, adrenal crisis can occur during times of significant physiologic stress. The symptoms of weakness, fatigue, weight loss and gastrointestinal complaints are common to many other disorders, so adrenal insufficiency should be considered in their differential diagnosis.
While rarely occurring from natural causes, secondary adrenal insufficiency is most commonly caused by suppression of the hypothalamic-pituitary-adrenal (HPA) axis by exogenous glucocorticoid administration. This leads to inadequate secretion of ACTH and CRH and consequently results in insufficient adrenal cortisol secretion.
The ACTH stimulation test remains the main diagnostic test for both primary and secondary adrenal insufficiency. The ACTH stimulation test is clinically relevant because it accurately reflects the adrenal reserve. Additional advantage includes its ease and broad experience with its use. More recent low-dose ACTH stimulation testing uses only 0.5 µg or 1 µg of ACTH instead of the traditional dose of 250 µg. The rationale of the low-dose ACTH test is that it may have higher sensitivity compared with the traditional tests.
From the info I have the cortisol lab values for a normal reading are AM: 4.3 - 22.4 μg/dL;
PM: 3.1-16.7 μg/dL.
I would suggest asking for futher testing as you are in a very low range. Remember to be your own best advocate.
I am sorry to read of this new problem for you and thank you as always for your support as I know you to be a warm and caring friend.
Gentle Hugs,
Kitt