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Took dexamethasone. Cortisol level low. On prednisone. Is the immune system pressed under prednisone medication?

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Endocrinologist
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Hallo doctor i have secondary XXXXXXX disease 3 months ago because i took dexamethasone not in the correct way. my cortisol level was so low with number 1.4 from the normal range start from 4 for 8am cortisol then my endo put me under prednisone with 5mg in the morning and 2.5 mg at night then 3 months later i test cortisol again at 8 in the morning while i take prednisone 5mg at 6 in the morning then the result was 4.8 above the minimum range of 4 . My question is:
1. my endo told me that cortisol blood level test not affected wether i take prednisone or not, is that true?
2. Do my disease is getting recover? My endo start to tapering my prednisone starting next month with only 5mg in the morning
3. Did my immune system was pressed under this prednisone medication although it just the replacement of low cortsisol level
Thanks doc
Posted Tue, 27 Aug 2013 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Shehzad Topiwala 44 minutes later
Addison's and adrenal insufficiency are conditions whose diagnosis is best made by a formally trained endocrinologist.

Prednisone is one way to treat it. However it suppresses the body's cortisol production (if any is being made by the adrenal glands). That is why most endocrinologists prefer to gradually convert prednisone to hydrocortisone, and then check blood cortisol levels 24 hours after the last hydrocortisone dose.
It is likely that your endocrinologist will also attempt the same.

Depending on the cause of damage to the adrenal glands, the condition may be reversible or not.
For example if it is caused by auto-immune destruction of both adrenal glands then it is mostly permanent.
If it is a result of long term high dose steroid therapy for another medical disease, then slowly it is possible for the adrenal glands to recover

For more information, you may wish to peruse this link:

WWW.WWWW.WW
Above answer was peer-reviewed by
 
Follow-up: Took dexamethasone. Cortisol level low. On prednisone. Is the immune system pressed under prednisone medication? 1 hour later
Supposed to be because of the dexamethasone i was took previously with no proper way, so my endo will tapper my prednisone from 5mg in the morning and 2.5mg in the evening to only 5mg in the morning because of my 2nd lab test after 3 months was slightly above normal ( although i was took prednisone at 6 in the morning 5mg and did the test 8 in the morning) , what i like to know that related to my question above, thanks doctor
 
 
Answered by Dr. Shehzad Topiwala 11 hours later
You have received correct guidance from your endo. The prednisone taper is a rational approach
Above answer was peer-reviewed by
 
Follow-up: Took dexamethasone. Cortisol level low. On prednisone. Is the immune system pressed under prednisone medication? 48 minutes later
Sorry doctor, please give me some infornation related to my first writing about the no 1,2,3 question in the beginning, thanks
 
 
Answered by Dr. Shehzad Topiwala 4 hours later
1. my endo told me that cortisol blood level test not affected wether i take prednisone or not, is that true?

prednisone will lower the blood cortisol levels when you take a test

2. Do my disease is getting recover? My endo start to tapering my prednisone starting next month with only 5mg in the morning

If it is truly secondary adrenal insufficiency from high dose dexamethasone (or any other cortico-steroid) , there is a possibility of recovery

3. Did my immune system was pressed under this prednisone medication although it just the replacement of low cortsisol level

Replacement doses of prednisone should not impact immunity much. However each type of steroid has differing properties when it comes to effects. For example, hydrocortisone has more natural steroid like effects because it is quite similar to the cortisol made by the human adrenal glands. Prednisone has greater immune system suppressing effects than hydrocortisone.
Finally, any cortico-steroid in high doses can suppress immunity
Above answer was peer-reviewed by
 
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