Sweating, shakiness alongside PMR problems - steroids or other cause.

[missrat]

I'm 67 and have a long history of dysthymia / chronic depression with exacerbations, and also moderate essential tremor affecting my hands and head. I've had two very successful hip replacements and have arthritis in my spine. Four years ago I had PMR which settled on steroids. This year the pain came back more severely - mainly pelvic girdle, but also shoulders. My ESR and CRP were normal, but my symptoms responded promptly to steroids. I saw a Rheumatologist on Tuesday and am continuing on steroids, awaiting my test results.

At present I am having a lot of problems with sweating and with feeling shaky, and wonder

- how much of this could be attributed to the PMR itself

- does prednisolone itself cause hyperhidrosis?

- does reduction in steroids cause these symptoms?

- could some be related to my low dose of long-acting oxycontin?

- I have changed from venlafaxine to nortriptyline - both can cause this as an effect when in use and on withdrawal - how much is due to this?

- I am undergoing a lot of stress at present - how much is this contributing?

I wonder if anyone has ideas for handling this? I'm having more sweating now than in the whole of the menopause!

-

[polkadotcom]

Hi missrat, you don't say what dose of Pred you are on, if you've mentioned it before, sorry, I'm having a day of brainfog.

From the swift reaction you had to steroids it would seem that you are having a PMR relapse and I think - at least for myself - PMR caused me to sweat in the first place but nowhere near as much as once on steroids, they seemed to exacerbate it and I've been soaked at times ever since.

Again for me, the reductions did cause some shakiness but this disappeared after a week or so. I don't associate it with excessive sweating.

Don't know about the Oxycontin as I've never used it - it is a powerful drug, but if you are on a low dose I wouldn't have thought so. You could check the side effects on the Interweb to see if it is a rare one which isn't listed in the leaflet?

Nortriptyline - I'm on amitriptyline which hasn't caused me any problems, it's closely related to nortriptyline, but you may well be on a higher dose than I am.

Stress? I think you may have hit the jackpot there. Under pressure I turn into a waterfall, which wasn't good when I was at work. Having retired I still find that if I am stressed I drip and for that reason I try to avoid it, but of course it isn't always possible by a long chalk.

My head sweats the most and when the problem was at it's height I slept on a thick towel with another wrapped round my pillow - it was easier than trying to change sheets in the middle of the night. I really never found an answer for myself, but others have reported both sage extract and red clover worked, and one found an answer in taking a low dose of HRT. There are many more herbal/homeopathic supplements out there, so you could browse through them.

The other thing which causes me problems is humidity. It's high here today and I am already getting hot and bothered, so will go out into the garden too cool off in a minute. My neighbour will think I am even more eccentric than ever, it's pouring with rain!

[Celtic PMRGCAuk volunteer]

Hello missrat

I'm afraid I don't have any knowledge of most of the pills that you are taking but have you checked for interactions between them all?

When on the higher dose steroids, I suffered many episodes of overheating and sweating, strangely during mealtimes and always following a dose reduction, and, like Polkadot, my head sweats were the most intolerable. Even now when off steroids, as soon as the temperature goes over the 20's the back of my head starts dripping....and itching!

Have you tried avoiding coffee, alcohol and spicy foods as they can all trigger the sweats?

With regard to "tremor of hands and head", I certainly suffered the hand tremors and used to feel at times that my body was sort of trembling inside if that makes sense but this all disappeared on the lower doses.

Hopefully your recent blood test results will show an improvement so that you will be able to reduce the steroid dose which with any luck will improve your symptoms/side effects.