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High cortisol levels on long term prednisone?
I had my cortisol levels checked recently and they said they were to high for someone on long term prednisone. What could cause this? They questioned my compliance, which I don't understand, since the levels are too high.
asked Feb 18, 2010 at 08:44AM in Asthma
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2Votes
answered Feb 18, 2010 at 01:15PMThe usual response in someone on long-term systemic steroids (either oral or frequent injections) is suppression of the body's ability to make its own corticosteroids. In your case, the cortisol level being high would be contrary to the expected response. Another thought, in the current treatment of asthma, because of the availability of inhaled corticosteroids, it is unusual to have a patient on long term prednisone. -
4Votes
answered Feb 18, 2010 at 03:14PMThere are several explanations for this...only one of which is failure to take the oral steroids. First, depending on the type of laboratory method used, the very prednisone that you take can interfere with the assay and appear like cortisol. When the test was done, when was your last dose of prednisone? Second, if you HELD your prednisone for 24 hrs and your adrenal glands are not completely suppressed by the prednisone, then you may have high levels of cortisol the next day as your adrenal glands compensate. Third, depending on the dose of prednisone you are on, there can be very little suppression of the adrenal glands. Five -10 mg of prednisone daily often causes very little suppression as the duration of effect of prednisone is very short. Finally, some people have a body that even more rapidly metabolizes the prednisone, even at higher doses, such that little suppression is seen. It is not accurate on your physician's part to state that high levels must be because you are non compliant with your steroids. There are many other explanations. -
2Votes
answered Mar 03, 2010 at 07:21AMI can think of assay problems leading to this result. I can not think of a situation when taking steroids and then stopping them briefly would lead to "rebound overproduction" of steroid by the adrenal glands (in fact, in diagnosing overactivity of the adrenal gland we actually give steroids and look for suppression of steroid levels the next day).
Certianly, if you had cushing's syndrome, in which your body was making too much steroids, this would lead to the measurement of high blood levels even in the presense of taking steroid pills (as per before, this is how we actually diagnose these things).
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The content on or accessible through Medpedia.com is for informational purposes only. Medpedia is not a substitute for professional advice or expert medical services from a qualified health professional.
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