Hi
My husband has been reducing his predisolone tablets, he is doing this under doctors advice, he is now down to 1mg every other day, he is getting very very tired and I was wondering if this is a side effect.
Can someone advise please
Many thanks
Junie
Not knowing what he is taking them for, it would seem to me that his adrenal system is struggling and that he needs a bit more just now. The adrenals can become positively lazy and don't want to wake up - the best way is to wake them up slowly/gently to diminish the tiredness. We are in the winter months too, and some find that they just don't help.
Junie, as Polkadot has said it could be that his adrenal glands are not quite up to the mark to cope with your hubby's present low Pred dose, it could be the weather not helping, or it could even be that he has simply reduced too fast to his present dose, allowing the inflammation to get going again at some point and some symptoms to creep back in, of which fatigue can be one of the most common. He might be wise to increase the dose back up to where he last felt comfortable without the tiredness. If the fatigue resolves then remain at that dose for a much longer period before trying to reduce again by which time the adrenal glands should, hopefully, have kicked back in with a sufficient supply of natural steroid (cortisol) after having been suppressed by the longer term treatment.
How long has the fatigue been going on? Or perhaps a better question: since what dose and how fast has the reduction been?
Below about 7 or 8mg/day the body has to start making its own corticosteroid again. The complex hormonal feedback system that governs this takes a while to settle down and until that happens production can be erratic. The slower you reduce from 8mg the better chance there is the adrenal glands will wake up and start production - but in some people they are reluctant and in a small proportion of people they just don't regain their former efficiency. There is even some thought that poor adrenal function may have something to do with PMR though there is no real proof.
If the reduction has been too fast (and while it may have been under medical supervision, that doesn't mean it was slow enough) or if your husband's adrenal glands aren't functioning well that can lead to increasing fatigue as well as some other symptoms. One way of finding out is to do something called a synacthen or ACTH stimulation test - it tells you if the adrenals are capable of doing their job.
But a bit more information would be helpful.
I also have had problems with tiredness as I have dropped my pred dose down to lower levels. Sometimes it resolves within a day or two and sometimes it takes longer for my body to adjust. I was told before the PMR first hit me that my adrenals were very low and should take an adrenal support supplement, so I take it now when the tiredenss hits and I also take B12 which is good for energy. I recently read that DHEA levels are low in some people with PMR. Mine were extremely low when tested , and supplementing with DHEA has helped my energy a lot also. If you have access to a good physician of natural medicine close by, I would suggest talking to them might help. Hope your husband feels better soon - this low energy thing is really miserable!
Thanks so much for your reply,
We are going to see the Doctor tomorrow, I will ask about the symptoms you mention.
Thanks again
Junie
All the best, hope things go well with the doc tomorrow!
This post exactly explains how I am feeling. I have been down to 1mg pred for one month and was fine, but now I am so tired I am almost at a standstill. Thanks for all the advice above. I will go back up to 2mg for a month and if no improvement I will ask the GP for a test to see if my adrenals are OK. Once again, so great to have had this forum to help over the past 6 years.
tired
So Tired all the time
Tired and weak
Why am I so tired?
