sstrad wrote:My primary doctor ran a lot of blood tests, and ruled out the polymyocitis, but wants me to go see a rheumatologist. She put me on prednisone for a little bit, and I felt a lot better, but took me off
That you received multiple rounds of chemotherapy with added steroids + experienced "feeling a lot better" when placed on glucocorticosteroids at a later period of time leaves to question the possibility that your present symptoms are due to low serum cortisol (adrenal insufficiency).
Secondary adrenal insufficiency is a little know,
but serious, endocrine disorder that can arise from the use of exogenous glucocorticosteroids (ex. dexamethasone added to chemo for relief of nausea). Secondary adrenal insufficiency is not on the radar of most MDs/physicians - but it should be.
A simple blood panel would give a clue. Ask your MD for a "morning baseline cortisol level (fasting) and morning baseline ACTH level." The blood levels must be drawn between 7-8 am (your values will be compared to statistical/expected morning values, cortisol levels following a diurnal pattern/circadian rhythm that is time sensitive). A baseline cortisol level below 5 ug/dl and an ACTH level below 12 warrants follow-up with an endocrinologist.
Anyone who takes corticosteroids (prednisone, dexamethasone) for any extended period of time should be aware of secondary adrenal insufficiency and be on the look-out for signs/symptoms. The pituitary/adrenal glands can be suppressed with use of corticosteroids.
I live with Addison's disease (primary adrenal insufficiency, complete adrenal gland failure). It is no picnic.
- Karen -
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.