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Dr. Gupta
Dr. Gupta, Doctor
Category: Medical
Satisfied Customers: 9420
Experience:  Vastly experienced MD Physician with 19 years of experience.
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Do you have endocrinologist available, steroids, eye

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do you have endocrinologist available
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: steroids
JA: Anything else in your medical history you think the Doctor should know?
Customer: eye problem. AZOOR. hypothyroidism
JA: When was the last time you had your eyes checked? In general, how has your vision been lately?
Customer: 2 months.ok
Customer: replied 14 days ago.
this is about my daughter aged 34. has had long term prednisone due to eye condition which has now settled.she is on 4.5 steroid a day but had SST test which came back saying the adrenals did respond ok. however she feels that they are not. can you say whether the SST result could be inaccurate.
Customer: replied 14 days ago.
last time she tapered off steroids 2 years ago she felt terrible and her eye condition AZOOR flared up.

Hi,
Thank you for trusting Just Answer. Good day to you, I am Dr, Gupta. I'm board-certified with over 20 years experience. I have been reviewing your concern and I very much would like to help. The computer system will generate a phone call request if that is something you would like to consider as well. Otherwise, I am happy to chat with you here too.
Kind regards,

I can understand your concern about your daughter's health.

The short Synacthen test (SST) is used to evaluate adrenal glucocorticoid secretion in response to synthetic ACTH (also known as tetracosactide or Synacthen). Traditionally, after a baseline cortisol and ACTH, two plasma cortisol samples have been taken after i.v. or i.m. administration of Synacthen 250 μg, one at 30 min and one at 60 min. However practice varies and some physicians only take one cortisol measurement at 30 min.

95% passed if the 30 min cortisol value alone was assessed, giving a false negative (i.e. failed test) rate of 5%.

This means that there is a very low chance of less than 5 % of this test being wrongly negative.

I would recommend that if she is very much sure about her symptoms, a repeat test with two samples being taken at 30 & 60 minutes both would be able to help her out in a better way to diagnose if she has adrenal failure,

Thank you again for visiting JustAnswer. I hope I have given you a satisfactory answer. If you have any follow up questions, please reply here and I'll be happy to assist you.
Warm Regards,
Dr. Gupta, MD

Customer: replied 14 days ago.
Thanks .can steroid use affect other parts of the endocrine system like the pituitary gland? would that make you feel worse as you reduce the daily dose?

Yes, to both the questions, steroids can affect a lot of systems in our body, and they can certainly make you feel much worse when you try to come down, which is why a slow tapering is recommended under medical supervision,

Let me know if you need more inputs,

Warm regards

Dr. Gupta and 3 other Medical Specialists are ready to help you
Customer: replied 14 days ago.
thanks