tired

[kingharold11]

Hi everyone now I have found my way back to the site what have they done to it? I have just gone through what might be described as an MOT blood tests water samples etc which eventually has resulted in the doctor saying basically that I was fine. My blood pressure is normal (130/63)cholesterol 5.9 no signs of diabetes a water infection which drew me to the GP in the first place has cleared up courtesy of some antibiotics. Trouble is I don.t feel fine I am totally knackered I sleep like a log at night but don't feel very lively when I get up. I am all right till about 2pm then I have to lie down. I am planning to reduce the steroids later on this year (i am on 6mg) but not yet

[piglette]

At around 7.5 mg your own adrenal glands are having to start to do some work again rather than relying on the pred to do it for them and this can make you feel pretty tired as you reduce.

[DorsetLady PMRGCAuk volunteer]

Hi,

Would agree with piglette - probably your adrenals.

I felt really shattered for about a year whilst mine were getting their act together. Started when I was around 6mg and stayed the same until I got down to about 3 or 2.5mg.

Like me, I guess you've been on Pred for quite a long time, and I think that can make adrenals a bit slow in starting to work again. But they do get there eventually, and you've had the other obviously things tested for, so I think it's something you just have to live with. Might be an idea getting Vit D levels checked, mine were a bit low, but they're ok now. Also, if it goes on you might suggest to the doctor that he checks that your adrenal are actually working.

Good luck.e

[PMRpro Ambassador]

Totally agree with piglette and DL - patience first and possibly request a synacthen test if the fatigue doesn't improve.

[paddyfields in reply to PMRpro]

Re synacthen test. Is this expensive? My rheumy responded to my request for a Dexa scan do she would probably agree to this. My problem is that there are so many things that could be making me tired. I have always been inclined to fall asleep easily - in boring lectures for example - leaving aside the insomnia/sleepiness related to Parkinsons and the fact that - according to the patients leaflets - almost any medication you might chance to take for anything (!) may cause drowsiness.

[PMRpro Ambassador in reply to paddyfields]

Shouldn't be - all it involves is taking a sample of blood at 9am (after not taking pred for the previous 24 hours) then an injection is given to stimulate the adrenal glands and another blood sample taken about half an hour later.

[paddyfields in reply to PMRpro]

Thanks for that PMRpro

[Wells77 in reply to PMRpro]

Quite worried by this. Last year when down to 1.5 I asked gp for adrenal function test after learning from this forum it is advisable. I seem to be tactfully making suggestions to docs bases on information found here.Hey ho- given form to take to local unit for test any time of day. One sample taken-result-normal. None of procedure as described here. I did continue to reduce extremely slowly and have been off pred for 8 weeks.Finding it an anxious time.especially when I experience morning stiffness. Is it slowly returning ,is it just normal age related,etc etc..Was particularly upset when I had difficulty reaching toenails to cut them! I suppose we all have the possibility of return hanging over us.Should we wait until symptoms become bad or play safe and try a low dose?

[PMRpro Ambassador in reply to Wells77]

To be honest if you get to 1.5mg without excessive fatigue or other problems I think it is fair to assume your adrenal function is pretty much OK - it is people who struggle or are experiencing severe fatigue who need the test.

As for returning stiffness - you must remember that your muscles will take a fair bit of time to return to anything like normal, they have been compromised for some considerable tome. And you are older than when the PMR started as well as being rather less fit - there is bound to be a difference. It is felt that it takes up to a year before you can say things are "normal" - and that applies to adrenal function too.