PMR - ? R/A ? Adrenal Gland

[Sonofjimmy]

Hi All,

I have previously posted with historic developments from my farthers time line through PMR/R/A diagnosis to recent developments and treatments for shingles, salmonella bacteria and over the last couple of days pneumonia and finally Adrenal gland fatigue. The latter of which they are now doubling his pred from 30-60ml to kick start his Adrenal gland which they say has gone to sleep?

Ironically even though he has been off the metex and humera for over five weeks he has had no pain R/A PMR pain symptoms since.

The concerns now are the infections he seems to be picking up and the Adrenal gland fatigue. Like all of us we continue to look for the golden answer to his condition over the last 12 months since his initial complaint and diagnosis of frozen shoulder. With the recent developments we now find ourselves looking at the link between the Adrenal gland fatigue, pneumonia and the PMR-R/A symptoms which have consistent indicators such as:

Mussel / joint pain

Heavy sweating situations

Fatigue

stress

Disillusioned & uninterested at times

Abnormal sleeping patterns

Weeks immune system (always put down to treatment)

Again this is a very complicated case, even the rhumy specialist is amazed that he currently has no pain. We are seeking a joint consultation with his rhumy & bio specialists hoping that a open discussion may provide some factual data that could be analysed for further diagnosis and treatment

We are wondering if anyone has had a similar situation / experience that may provide a link from the infection condition that may mirror over the R/A PMR

Thanks again for your wonderful support

[PMRpro Ambassador]

"they are now doubling his pred from 30-60ml to kick start his Adrenal gland which they say has gone to sleep?"

Are you sure about those figures? Whatever that would do, it WON'T "kickstart" adrenal function. It is because of high doses of pred that the adrenal glands go into hibernation and the only thing that persuades the adrenal glands to produce cortisol again is there being only a low level of corticosteroid in the blood which triggers the feedback system governing the HPA axis (hypothalamus, pituitary, adrenal axis). Not that it really matters if the adrenal glands aren't functioning well - you send the patient to an endocrinologist who will use a suitable dose of corticosteroid as a supplement.

[Sonofjimmy in reply to PMRpro]

Many thanks, I will clarify with my mum, she is at the hospital with him. He also has a scan planned as they think he may have a clot by his lung.

More complications!

Thanks again

[piglette]

Hi SonofJimmy, whatever your father's problems are they will certainly not be adrenal gland problems if he is on over 7-8mg of pred. Over that dose our adrenal glands go to sleep anyway as the pred takes over the production of cortisol so our adrenal glands can take a holiday. As you slowly reduce and get to around 7mg your adrenal glands will have to wake up. The body needs about 7.5mg of cortisol a day, so it will have to start producing its own if the pred is no longer giving it at low doses. It does sound as if whoever is increasing pred to such a high amount seems to me to know very little about adrenal problems. Fatigue is also a symptom of PMR and the pred does not help that.

[DorsetLady PMRGCAuk volunteer]

Hi sonofjimmy,

The more I read your posts about your father's situation the more confusing it seems to be.

The symptoms you describe are all PMR/GCA standards. And yes they could also be attributed to Adrenal Gland Fatigue, but as PMRpro has already said if he's on anything above 10mg then they aren't going to be working anyway. The Pred at that level releases cortisol way above what your body does naturally (7.5mg equivalent approx). Don't understand what the doctors are trying to prove.

You do actually mean 30mg to 60mg and not 3mg to 6mg ?

If he's at 30mg then he shouldn't be getting pain anyway - so that's another strange thing for the Rheumy to say.

Think you do need to sit down and discuss with relevant specialists, and the sooner the better.

[Sonofjimmy]

HI, Yes 30-60

We do have a appointment with the rhumy planned for the 28th, and he is likely to remain in hospital over the next couple of days while the pneumonia and clot is investigated.

Your right this is very complicated, he was previously on 25mg of pred and still had pain during the last year. The complication was the upped him to 50mg at the same time as starting met again with humeria treatment so we did not know what was working. At the same time he started a course of anti biotic for a stomach infection which he had had on record for a few months without ever treating. Since this date he has had no pain and we don't know which one worked.

Since then he has had no met or humeria for five weeks, he has reduced from 50 - 40 - 30 every three weeks without any pain.

Now the infections have taken over - shingles, salmonella, pneumonia? Hopefully they will come up with something in the hospital, they have stated that they want to have all the specialist disciplines together to discuss between them - I think they are now confused

Our big hope is that he will generally recover from bad times and be 60% himself recently with no signs of permanent R/A PMR Pain. He also has no visible signs of the condition and has full use of all parts (this is making us think its never been R/A PMR and maybe something that is infection based) which after attacking his joints and mussels has eventually attached his system

Apologise for rambling on! We honestly get more information from here than we do with the consultants and there may be possibility that someone has or is in the same situation

I am waiting for them to come out of the scan so I can confirm then Adrenal Fatigue summary

Kind Regards

Ryan

[HeronNS]

Can he get seen by an endocrinologist, as PMRpro suggests. Prednisone is not going help his immune system fight off infections, so the lowest effective dose would be best, rather than doubling an already reasonably high dose. I do hope you get some good answers soon.

[jinasc]

One question, was he on anti-biotics for quite a while?

If so, they knock out the good guys as well as the bad.

After an op, I was in trouble and finally a different Consultant came along and advised me, that if I could afford to buy VSL#3 and take at least a 10 day course, the good guys would be replaced quickly. It is not available on prescription. I did and it worked.

Now if I am prescribed an anti-biotic, I buy Yeo Valley, organic, pro biotic with L.Acidopolous plus 1 teaspoonful of Manuke Honey (highest UMF I can) and they help to kick start the good guys and the honey boosts the immune system.

Long shot, but....................

[Sonofjimmy]

HI,

Yes, he has been on and off antibiotics now for over one month, my mother has questioned the double dose with the nurse and they have agreed to leave this until tomorrow when we talk to the doctor who will have the results of his scan they performed earlier.

They have reconfirmed that the purpose is to assist with fighting the pneumonia infection and to assist the Adrenal Gland which is not working. We will digest all of the appreciated information and request some feed back tomorrow when the doctors arrive on their rounds

With the recent drop from 50-40-30 over a six week period with no R/A PMR pain arriving, we believe that he should be continuing with the pred reduction with the hope that the pain element of his condition may have passed now, going back to 60 does not make any sense at all

Again many thanks for your valued support

Ryan

[PMRpro Ambassador in reply to Sonofjimmy]

That it is being used for his breathing I can accept. But a dose like that is far too high to be justified by "assisting the adrenal glands" - that is rubbish.