As many readers are aware, I began a weekly regimen of depo-medrol injections for PMR in late August of 2016. See my 3 month old post: “Depo-Medrol Injections for the Treatment of PMR”.
My initial maintenance dose was 80 mg per week which resulted in a steroid pulse that began at 20 mg on the day of the injection and gradually tapered to 4.7 mg by the end of the week. This resulted in a “median” daily dose of 10.3 mg and exposed my HPA axis to serum levels that were below the 7.5 mg threshold on the final 2 ½ days of each week.
When I began to taper, my weekly dose was reduced to 70 mg (for one month) which generated a pulse that ranged from 17.5 mg down to 4.1 mg; with a median daily dose of 9.0 mg. When this period ended. I was further reduced to a 60 mg weekly dose which resulted in a pulse from 15.0 mg to 3.5 mg; with a median of 7.7 mg each day.
On the final three days at 60 mg, my daily serum levels (based on a chart I extrapolated from Pfizer release profile data) were approximately 4.8, 4.4, and 3.5 mg respectively and on these days I began to experience small “rushes” that went on for most of the day. Though impossible to describe, each rush was mildly pleasant and felt as though a stimulating drug was briefly coursing through my chest. Several hours after the next injection, the rushes stopped.
Although uncertain, I believe a limited amount of adrenal function may have been preserved by the steroid pulse therapy and when the serum levels of medrol fell below five, the adrenal glands began releasing very small amounts of adrenaline and cortisol together (an event that takes place when the body is under stress) and it is the adrenaline I am sensing.
If this is true, my concern is that the constant rushes may be a sign that relentless signals from the brain are over-stimulating, (and therefore exhausting) what little function my adrenals have left.
Has anyone experienced what can be described as rushes when tapering, or might I be sensing some other withdrawal symptom that I am mistaking for adrenal activity?