I began daily prednisolone (20mg) nearly 2 years ago, when I was first diagnosed. It probably helped eliminate the severe lung inflammation that was my major symptom. Hurrah! But I was keen to reduce then, and began tapering as soon as was allowed. After 6 months, I was down to 12mg, but was starting to experience severe episodes of shaking, sweating and nausea. And severe, persistent fatigue. Could it be related to the steroids? Could I have an adrenal problem? "Absolutely not, " said my rheumy.
I continued to reduce, until I reached 4mg. The sweat/shake/nausea episodes had finally subsided, but I was more fatigued than ever. My rheumy told me I had developed Fibromyalgia, and so still didn't need a endocrinology opinion. I sent off for home test kits for thyroid and cortisol levels anyway. They showed elevated TSH and thyroid antibodies and depressed cortisol. Finally, I got my referral.
This week, I got the results of a synacthen test; it showed adrenal insufficiency, "which is not surprising given that you have been on steroids for nearly 2 years", says the endocrinologist letter, "Do not reduce your prednisolone further". He also suggests increasing the dose by 1mg to see if it improves the fatigue.
I tried that yesterday. Three hours later, I had to see the GP, after a violent return of the sweats, nausea and shaking. "Gosh, you're not good at all are you? And after a one milligram increase!" she said.
So there you have it. Prednisolone - hero or villain? Or hero AND villain. You decide....
Hero when you need an immediate result. Im on 30 mg doze nowadays because first time in 10 years, the lungs were attacked. However I know its a villain in the long run. But i dont see a way out. It keeps coming back. I have now accepted the reality and going with the flow.