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Taking Steroids. Had Transdermal From Flector Patches. Having Weakness, Unable To Urinate And Suffer Diarrhea. Suggestions?

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Posted on Sat, 19 Oct 2013
Question: I am having a lot of problems with this program since upgrading to XXXXXXX ios7 last week. Sorry about the confusion i did not get any of your responses at first. Just got it and answered all and it erased my response as i was sendiing.
in reponse to your question i have not been taking any p.o. Steroids. I had an injection in my shoulder in may. I had transdermal from flector patches prescibed post op in april. No more since.
As for my thyroid function. Repeat thyroid panel was drawn and wnl with antibodies negative after my synthroid was increased from 25 mcg to 50 mcg.
In 2011 when i was first having serios symptoms of weakness, lethergy, unable, urinating constantly, diarrhea......unable to swallow without pain and choking... Etc... I told my primary i had been feeling weak since my steroid injectons in spine ( last injection one month prior). Labs came back critical low as follows: cortisol 0.9. (2.3-19.4) acth 3.7 (7.2-.63.3)ebv igm 1.6. He just ordered a repeat cortisol and acth with 24 hr urine c:cr but wants me to see him in 3 months ( dec) and do these closer to that time.
doctor
Answered by Dr. Manoranjan Chowhan (4 hours later)
Brief Answer:
natural sequel to the the treatment

Detailed Answer:
AS you mentioned that you had been prescribed P.O .Steriod, also the inj. Steroid to your shoulder besides transdermal patches. In every likelihood there is suppression of the cortisol level as reflected by your lab tests and moreover you have symptoms of weakness.

This is natural sequel to the the treatment you received and you need to undertake a repeat test of cortisol and ACTH with 24 hrs Urine Creatine as suggested.

You also can report to your treating Doctor as advised

Hope this answers your question.

with best wishes
Dr Chowhan
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Manoranjan Chowhan (24 hours later)
I have NEVER taken po steroids. I was given a prescription for a taper once in my life last year for unmanaged migraines but i got relpax instead never took steroid taper. had back surgery 8 years ago and received steroids and my head became swollen and round and i got sick. This back injury i have been extremely cautious and tried to refuse cortisone injections altogether for fear these serious side effects would occur again. I was told that i would have to receive the injections give up my workmans comp. I stopped applying flector patches and regardless of what was prescibed to me i took nothing with steroid in it while receiving back injections . This lab result in 2011 was one month after my last injection..... So i had no steroids by any route in my system for a month prior.
This is why i am trying to understand why my acth went down aling with my cortisol. Does this point to pituatory? If short of sugery what treatments are most effective?
doctor
Answered by Dr. Manoranjan Chowhan (19 minutes later)
Brief Answer:
Brief reply

Detailed Answer:
OK granted you did not take P O steroid but the Injectable form of steroid also is equally responsible to bring down the level of cortisol
Moreover the injectable form of steroid are usually of long acting nature so the effect does last for more than expected duration.
As regards the pituitary the same is less likely,If there is problem it will not be confined to only Cortisol other hormonal problems will also be there.

However your treating physician will look in to this also but first thing first please get your repeat test done as suggested by your treating physician and later other possibilities can be excluded one by one
with best wishes from
Dr Chowhan
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
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Dr. Manoranjan Chowhan

Radiologist, Nuclear Medicine

Practicing since :1991

Answered : 103 Questions

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Taking Steroids. Had Transdermal From Flector Patches. Having Weakness, Unable To Urinate And Suffer Diarrhea. Suggestions?

Brief Answer:
natural sequel to the the treatment

Detailed Answer:
AS you mentioned that you had been prescribed P.O .Steriod, also the inj. Steroid to your shoulder besides transdermal patches. In every likelihood there is suppression of the cortisol level as reflected by your lab tests and moreover you have symptoms of weakness.

This is natural sequel to the the treatment you received and you need to undertake a repeat test of cortisol and ACTH with 24 hrs Urine Creatine as suggested.

You also can report to your treating Doctor as advised

Hope this answers your question.

with best wishes
Dr Chowhan