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Testing for adrenal insufficiency while on prednisone
Corticosteroid induced Secondary Adrenal Insufficiency patients may be put on a tapering program with the objective of restarting adrenal cortisol production and discontinuing steroid therapy; however, this approach should be considered in the consideration of secondary adrenal insufficiency with a history of past steroid abuse. The long-term side-effects of corticosteroids include osteoporosis (which results in decreased bone mineral density and decreased bone strength) and increases in the incidence of diabetes mellitus, insulin resistance, and hyperlipidaemia, anabolic steroids for sale in the us. Although corticosteroids are safe in most people, their long-term side effects must be carefully assessed in order to determine if therapy should be terminated or discontinued. The potential long-term complications of corticosteroids include decreased immune function, increased liver function, and osteoporosis, on adrenal while insufficiency for prednisone testing. Corticosteroids can reduce the risk of prostate cancer, but these findings are not consistent. In a recent population-based case-control study, the association of a history of steroid abuse with a decreased risk of localized prostate cancer recurrence was observed (OR = 0.84, 95% CI 0.81-0.92) in men who had been on and off of oral or transdermal testosterone therapy for >2 years, and a borderline association was observed when the study included controls who were no longer taking these medications [6]. In one prospective cohort study, women taking oral and transdermal testosterone for >2 years had significantly poorer overall survival than women who had never used such medications, indicating that patients taking such medications may be at increased risk of prostate cancer [10], testing for adrenal insufficiency while on prednisone. However, in response to a recent analysis of five high-quality randomized controlled trials on the use of transdermal testosterone in men to treat prostate cancer, Cox et al. found no strong evidence to support the use of transdermal testosterone to treat prostate cancer [4]. Corticosteroids may be associated with an increased incidence of the diseases of aging. Older women are at significant risk of developing osteoporosis and fractures due to the osteoporosis-associated reduction in bone mineral density and greater incidence of vascular diseases, particularly in the spine [11]. In a study of nearly 4,000 elderly women, we evaluated the association of steroid use with osteoporosis and mortality. The use of oral contraceptives was not associated with any significant increase in the incidence of osteoporosis [12]. There are a number of potential confounders that must be considered for evaluating patients who undergo endocrinologic procedures requiring oral and transdermal testosterone therapy.
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