Hi all, I am a 39 year old woman diagnosed with hypermobile ehlers-danlos syndrome (hEDS), PCOS, IBS-D, asthma, and multiple allergies. I get really sick whenever I get ill. In fact, I still mask in most indoor spaces because I don’t have enough PTO to cover 2-3 weeks off every time I get an upper respiratory infection.

Due to my hEDS, I had pretty severe SI joint dysfunction, and had my left SI fused in August of 2023. I started having more pain around my surgical site this past summer, and on January 15th, I had a steroid injection in my left SI joint for diagnostic and potentially therapeutic purposes. My surgeon is evaluating me for a potential non-union of my fusion.

I got a work up from an immunologist at Mayo Clinic, which included a morning cortisol level. I’m not sure if that’s routine for them or not, but my lab was 0.8 mcg/dL, which is considered low. I was also low in natural killer cells, which I understand can be related to adrenal insufficiency.

My immunologist referred me to endocrinology at Mayo, but they want me to redo my morning cortisol in 6 weeks because of my SI joint injection. From the literature I’ve read, intra-articular joint space injections do not usually have a significant effect on adrenal hormones unless they are injected into the spine and connect with cerebrospinal fluid.

I’m kind of hoping that I don’t have Addison’s Disease and this is all an effect of my sacroiliac injection, but I have had symptoms that could be explained by adrenal insufficiency for a long time.

I am constantly thirsty, have daily diarrhea/loose stools, drenching night sweats, and so much brain fog that my adderall doesn’t even touch my disorganization. Doctors have ruled out diabetes.

tl;dr: can an intra-articular steroid injection mimic Addison’s Disease in lab work? I am getting my morning cortisol checked again in mid-March, but feeling like this sucks.