Hypothalamic-Pituitary-Adrenal Suppression and Iatrogenic Cushing's Syndrome as a Complication of Epidural Steroid Injections

Table 1

Laboratory evaluation pertinent to our initial evaluation (normal values for our clinical lab in parentheses).

Time following 3rd epidural injection; (time of day for lab draw)	3 wks; 1505	7 wks; 1005	11 wks; 0838	15 wks; 0830
AM serum cortisol; 118.6–618 nmol/L; (4.3–22.4 mcg/dL)		63.5 nmol/L; (2.3 mcg/dL)	80.0 nmol/L; (2.9 mcg/dL)	63.5 nmol/L; (2.3 mcg/dL)
PM serum cortisol; 8.53–460.8 nmol/L; (3.1–16.7 mcg/dL)	16.6 nmol/L; (0.6 mcg/dL)
DHEA-S; 90.2–6940 nmol/L; (2.6–200 mcg/dL)		Undetectable
Prolactin; 121.7–1269.6 pmol/L; (2.8–29.2 ng/mL)		208.7 pmol/L; (4.8 ng/mL)
Bioavailable testosterone; 0.052–0.326 nmol/L; (1.5–9.4 ng/dL)		0.045 nmol/L; (1.3 ng/dL)
Free testosterone; 0.0021–0.0132 nmol/L; (0.6–3.8 pg/mL)		0.0017 nmol/L; (0.5 pg/mL)
Total testosterone; 0.21–0.87 nmol/L; (6–25 ng/dL)		0.07 nmol/L; (2 ng/dL)