How Can Get Control Of Severe Asthma Be Treated?

Posted on 5 days ago

Question: I have had 4x Triamcinolone injections. I had 2x40mg, 2x80mg every 4 weeks. These stopped 4 weeks ago. I had them to get control of severe asthma.
My problem is my cortisol level is 133 which is low. What is the reference range please?
I am worried sick something serious is going on.
Will this affect my fertility? I am already 45 and trying to conceive even though the odds are against me.
How can this be treated I am really really worried.
A short synacthen test is being arranged.
I don't feel poorly or anything just so scared and this is causing panic and anxiety.
Thank you for your help in advance

Answered by Dr. Olgeta Xhufka (1 hour later)

Brief Answer:
Increased cortisol levels after using triamcinolone.

Detailed Answer:
Hello dear,
Cortisol normal range varies 10-20 mcg/dl in morning (8-10 am) to 3-10 mcg /dl in evening.
You are having increased cortisol levels which is normal after using triamcinolone.
The cortisol levels will gradually get back to normal. Having high cortisol levels will lower sex hormones and reduce chances of pregnancy but they will get back to normal soon.
Stress will also not help you with fertility.
Try to reduce stress having more physical activity, go out for a walk,eat healthy foods, eat black chocolate.

Hope I have answered the question.
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Olgeta Xhufka (49 minutes later)

The hospital have said my levels are low not high? Maybe I misunderstood as I panicked. So you really don't think there is anything serious going on.
They are arranging a short synacthen test. What is that please?

Thank you very much

Answered by Dr. Olgeta Xhufka (1 hour later)

Brief Answer:
Possibly you misunderstood the value.

Detailed Answer:
Hello dear and thank you for asking again.
I think you misunderstood the value of cortisol levels.
They are doing a short synacthen test to test the ACTH ( adenocorticotrophyc hormone produced by pituitary gland) which stimulates cortisol production.
The test is needed to check your adrenal gland function .
You need to remain calm and do the test as recommended.
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Olgeta Xhufka (11 hours later)

I am still having periods is this a good sign its not affecting fertility

Answered by Dr. Olgeta Xhufka (1 hour later)

Brief Answer:
If you are having cycles means you can still conceive.

Detailed Answer:
Hello dear and thank you for asking again.
If you are still having regular periods it means that you are having fertile cycles and you are having ovulation.
Continue trying to conceive.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Olgeta Xhufka (58 minutes later)

Thank you so much

Answered by Dr. Olgeta Xhufka (3 hours later)

Brief Answer:
You are welcome.

Detailed Answer:
You are welcome.
Best regards.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Olgeta Xhufka (36 minutes later)

My GP has just sent this what is it converted to mcg/dl please
13/11/2020 Serum 9am cortisol concentration = 133 nmol

Answered by Dr. Olgeta Xhufka (3 hours later)

Brief Answer:
It is a bit low level of cortisol for 9am.

Detailed Answer:
Hello dear and thank you for asking again.

133nmol/l is equal to 4.82 mcg /dl.
It is a low concentration of cortisol for 9 am.
Do the synacthen test to check the adrenal gland function.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Olgeta Xhufka (3 hours later)

Can it be down to the steroids if not what can be done? I am worried about a tumour or something

Follow up: Dr. Olgeta Xhufka (5 minutes later)

These levels are looking very alarming to me. It won't affect my fertility will it if I am having periods? Can it correct itself now I am off all steroid injections

Answered by Dr. Olgeta Xhufka (43 minutes later)

Brief Answer:
I don't think this will affect fertility.

Detailed Answer:
I believe this levels are only related to corticosteroids usage recently.
I don't think this is serious and it can get back to normal by itself.
I don't think this will affect fertility.

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Above answer was peer-reviewed by : Dr. Arnab Banerjee