
Suggest Treatment For Steroid Induced Cushings Syndrome

Question: Hi there around October last year after a bout of allergy my go gave me two shots of steroid in muscle then he put me on a week of oral steroid 25 mg for seven days... Upon discontinuation I got very sick ... He then put me on further two weeks 25 mg each day ... I have been real sick with very poor skin ... Thin skin lots if stretch marks have developed... I went for surgery on 7th if January which they gave me a shot of dezamethazone intravenously .. I crashed after 3rd day of surgery ... My morning cortisol came back as 390 and they ordered an ACTH test .as I can't get out of bed with severe nausea and muscle pain ... I passed the test ...even 5 mg of steroid improves my condition and thin skin and all the pains disappear ... They can't find any other medical problem with me ... Endorse dismisses me and I am sure steroids are to blame ... Endo keeps saying I have stomach problem ... And have no answer for think skin and muscle pain and weight loss ... I am just at my wits ends ... Please help me thanks ... I know that ACTH stimulation test is not always accurate and I fear they r missing it ...
Brief Answer:
Steroid induced Cushings
Detailed Answer:
Good day,
Noted your concern.
From the history, yoou seems to have developed steroid induced Cushings Syndrome. In that case, the cortisol should have been much lower ( provided they did the cortisol test after stopping prednisone for a day).
When someone gets steroid from outside for a long time, they develop thin skin and striae etc. Here the ACTH is supressed due to taking steroids for long time. However, adrenals would be still functional ( but the adrenals will eventually atrophy due to lack of ACTH).
You may need re evaluation with an 8 AM serum cortisol and ACTH levels. ( you should be off Prednisone or any other steroids for 24 hours) before the test.
Regards
Binu
Steroid induced Cushings
Detailed Answer:
Good day,
Noted your concern.
From the history, yoou seems to have developed steroid induced Cushings Syndrome. In that case, the cortisol should have been much lower ( provided they did the cortisol test after stopping prednisone for a day).
When someone gets steroid from outside for a long time, they develop thin skin and striae etc. Here the ACTH is supressed due to taking steroids for long time. However, adrenals would be still functional ( but the adrenals will eventually atrophy due to lack of ACTH).
You may need re evaluation with an 8 AM serum cortisol and ACTH levels. ( you should be off Prednisone or any other steroids for 24 hours) before the test.
Regards
Binu
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar

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