Question: I am taking replacement Cortisone following bilateral adrenalectomy. For years now I have had elevated white blood cell count, which my doctors say are steroid related. Why is this and does this mean that I am immunosuppressed?

Answer: Steroid replacement above physiologic can be associated with a high white blood cell count, Cortisol and Glucocorticoids will inhibit white cells from leaving the blood stream and therefore, may remain in the blood stream, making the count elevated. This occurs mostly when steroid therapy is too high, not when it is in the normal range. This may be related, therefore, to too much therapy. These patients may also be partially immunosuppressed.