Which test result would you expect in a patient who has stopped long-term steroid therapy?

In a patient who has stopped long-term steroid therapy, the most expected test result is low levels of cortisol. This phenomenon occurs due to the suppression of the hypothalamic-pituitary-adrenal (HPA) axis that occurs with prolonged glucocorticoid therapy. When exogenous steroids are taken, the body reduces its own production of cortisol; over time, the adrenal glands become less responsive to ACTH stimulation, leading to atrophy of the adrenal cortex and diminished cortisol production.

Once the steroid therapy is discontinued, it takes time for the HPA axis to recover and for normal adrenal function to resume. During this recovery period, cortisol levels are typically low as the adrenal glands have not yet started producing sufficient amounts of cortisol again. This makes it critical to monitor cortisol levels in patients who are tapering off long-term steroid therapy, as they may be at risk for adrenal insufficiency during this transition.

In normal physiological conditions, levels of ACTH would usually increase in response to low cortisol levels, and thus the anticipated high ACTH seen in answer choice B would not be the focus when considering immediate cortisol levels. Additionally, aldosterone levels and CRH levels may not accurately reflect the immediate consequences of stopping steroid therapy, especially during the early