Hydrocortisone Tablets

[cmToddy]

I posted in March about my position. I had painful hands and needed MTX for RA. My specialist advised me to come off Pred by the end of April. I was on 2mg after 4 1/2 years of PMR. I am not on the MTX as had osteoarthritis and CTS, At the end of April I had an appt with the Specialist who reviewed my bloods, I was feeling really dreadful and I knew it was that I was missing the Pred. My cortisol level was very low also body salts. I was then prescribed Hydrocortisone tablets -30 mg a day. After two weeks on them, I feel worse than ever and am so dizzy and tired that I am laying on my bed most of the time. In desperation I went to A& E and had emergency steroid treatment. They confirmed very low salts and that my cortisol was 30 much lower than 300 this time last year,

I feel like I am fading way. Since the drip treatment, I have spoken to my Dr, who spoke to an Eccrinologist and my Rhumatalogy. They are all certain I should improve on the Hydrocortisone but I am not. I have a synathacan test next week.

Any comments welcome and appreciated.

[SnazzyD]

Sounds grim. Did you feel quickly better after the steroid boost in A&E? Do you feel better after the daily Hydrocortisone that then wears off?

[cmToddy in reply to SnazzyD]

No I didn’t even feel any difference after the drip. Also, I feel worse after the 20mg I take in the morning. Does that mean anything to you. Thx

[SnazzyD in reply to cmToddy]

How long after the 20mg do you feel worse?

My experience of having a decent shot of hydrocortisone when in a crisis was that it helped a great deal within the hour.

Did you feel ok on Pred?

When you say you had low salts, what do you mean? Potassium?? How did they deal with whatever it was you were low on?

[cmToddy in reply to SnazzyD]

Thank you for response Snazzy. About 1/2 after taking it, I feel I have stepped backwards and can only rest. I pick up a little about 2pm, but not enough to give me a snowflake of energy. They gave my sodium in a saline drip. As you can imagine A&E was so busy, they didn’t spend long talking to me. After 17 hours in there I was so very tired but expected to pick up later. I am sure he mentioned glucose and potassium. They did not tell me what was in the drip, just to increase my salt intake. Grateful for your interest.

[cmToddy]

Snazzy and yes I did feel better on Pred at least when I was about 5 mg I did. Under that I was never right. So very tired with low mood.

[SnazzyD in reply to cmToddy]

Sounds like you need to be back on Pred because you can’t tolerate the Hydrocortisone. I would argue that the effects of being debilitated may now be worse than low dose Pred.

[Athas17]

Perhaps you could keep some electrolyte powder in the house. Be fussy when choosing as some have added sugar. In the meantime, you can try some lucozade.

[cmToddy]

Athas thank you. I have been told of this and

sounds like a good idea.

[PMRpro Ambassador]

I would be asking to return to pred - it can be used to manage adrenal insufficiency and it isn't uncommon for patients to feel better on the pred their body had got used to than on HC which some people just don't tolerate.

[cmToddy in reply to PMRpro]

Thank you Pro my thoughts exactly. I have Syn test next week and Rheumatologist will call and I shall mention it then, if no better.

[PMRpro Ambassador in reply to cmToddy]

You really aren't the first to find HC an unpleasant alternative to pred. and its effect isn't as longlasting so even if it works fairly well, you get dips. Especially if there is some component of the PMR - which HC is hopeless for managing.