Adrenals at and below physiological levels of pre... - PMRGCAuk

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Adrenals at and below physiological levels of prednisone.

Hindags profile image
16 Replies

I’m curious about how to tell if my adrenals have started coming on board at 6mg. Pred.

I’ve posted about the weak Wobblies I was getting in the afternoons starting @8.5 mgs. Then the Wobblies morphed into smoother waves of weakness at around the same time @7mg. Now I’m mostly @6mg for the last several weeks and those waves have disappeared. I’m still more tired than I used to be with more assorted aches and pains. I’m having difficulty finding exercise that my body will tolerate without rebound pain. But that weird end of afternoon, early evening stuff that I attributed to adrenal wonkiness is hardly noticeable.

Why am I asking? I have anew symptom. Back at 8.5 I had some episodes of low blood pressure with the weak Wobblies and my GP took me off of the low dose blood pressure med. I was taking with breakfast. (2.5mg amlodipine). On my last visit to the clinic a few days ago, my blood pressure was higher than ever. 172/72 , pulse 65. I’m thinking that if low blood pressure is a sign of adrenal insufficiency, then maybe this rise in blood pressure is a sign that the adrenals are functioning.

I’m monitoring my BP at home now, per my GP’s recommendation. The values run 145/72 Pulse 60s. It has been pretty consistent the last three days. It is as though I’m back to my old blood pressure except with a lower heart rate. My heart rate used to be high 60s to mid 70s. My pressure almost always goes up when my heart rate is low.

Any advice as to what might cause this spike in BP at this point? Where else would you look for an explanation. (In addition to Pred I’m taking 2.5 mg rosuvastatin and fosamax 70mg weekly as well as calcium, D3, magnesium 250, coq10, biotin, to get me through this.)

Thanks.

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Hindags
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16 Replies

Hi hindags. Not sure I can help with bp but got to say that amlodipine really knocked me off my feet. I felt the life being sucked out of me. It was pre dx with PMR. It took a few weeks for everything to settle. Hopefully others will have more ideas than I have.

Hindags profile image
Hindags in reply to

Thanks for your reply.

I was taking half the lowest dose and didn't notice any did effects. I wouldn't mind going back on it. Wonder what the changes in BP and pulse might mean and what tests might illuminate the situation.

in reply to Hindags

Taking your own bp is always better for me. As soon as they put cuff on at the drs I feel my no rise I am sure lol. To be honest if I was hitting 145/72 on a regular basis I would be happy. They can do a 24hrs bp machine test for you...perhaps have ECG or something just to see if anything is happening- but it s just a snapshot.

I would definitely check on drug interactions with vitamins you take.

Hindags profile image
Hindags in reply to

Yes, thank you. But the only new one is the Hair Skin and Nails that has had brought my nails back from 10 years ago. I have already determined to stop that one. The others have already been vetted through a program that Kaiser has. Maybe it's time for another check.

Soraya_PMR profile image
Soraya_PMR

Compare and contrast what you are doing in the 15-30 minutes prior to the B.P. being taken.

More activity at the clinic? Resting at home?

Hindags profile image
Hindags in reply to Soraya_PMR

I thought I was pretty chill when they took it at the clinic. I was not worried about the blood pressure per se, but was concerned about the sudden pain between shoulder blades that had taken my breath away the night before and was still impacting turning my head somewhat that morning.

Still never anything that high except when I experienced rebound from atenolol withdrawal a few years ago.

Thanks for the reply. Perhaps it was that worry that spiked things...even without my sensing it. Everything with my body works a bit differently these days

It seems to be taking time for me to accept this new reality. Understanding why would help me, but I don't understand why. So it is all about accepting these changing scenarios as the new normal I suppose.

Lol. I think I have had to tell myself just this many times in this lifetime. One of those truths that I seem to have to rediscover.

This forum is a lifesaver. Thank you again.

Soraya_PMR profile image
Soraya_PMR in reply to Hindags

There’s no doubt that acute pain can raise your B.P. (chronic pain less so). NSAIDs can raise it. Stress as you point out can raise it, even ‘white coat phobia’ (fear of doctors/hospitals) and fear of your B.P. being too high!!!

I was aiming more at the fact that you may have walked to the clinic, maybe a bit of a rush? Didn’t get a ten minute sit down before it was taken? Whereas your self monitoring is likely a more leisurely affair.

Couple of weeks ago I went to the practise nurse for something entirely unconnected with PMR. She was delayed, and I wasn’t perturbed in the slightest, I remember saying to her ‘I was about to drop off’ after I’d sat and waited for half an hour or so. Nurse decided to weigh me and take B.P., completely unexpected on my part, and the best reading I’ve had since PMR....120/70, I’ll take that thanks!!!

Here are some other simple ideas as to how minor things may affect B.P. suntechmed.com/blog/entry/4...

Hindags profile image
Hindags in reply to Soraya_PMR

Thanks for the link. Quite interesting.

PMRpro profile image
PMRproAmbassador

Like Poopadoop, if I was getting 145/75 regularly I wouldn't be worrying! The 145 is marginally high - but really not worth getting your underwear in a knot about!!!!!

Hindags profile image
Hindags in reply to PMRpro

Thanks for the reassurance. The rise in BP seems to correlate with a drop in heart rate of about ten points on average. It just seems strange all of a sudden as I'm tapering into these lower levels of Pred. .

I haven't been able to find much useful info about the adrenal return. The CSS posting remains one of the most useful. Is there just so little known?

PMRpro profile image
PMRproAmbassador in reply to Hindags

I think you should ask your GP to order a Holter ECG trace - that's 24 hours. If both BP and pulse change there may be something causing it.

Hindags profile image
Hindags in reply to PMRpro

I'm heading into the clinic later today to have my monitor checked against theirs. I will ask about the 24 hour monitoring.

Thanks so much.

Klah profile image
Klah

I have treated my “borderline” blood pressure (145/75) for years because my doctor does not like “spiking” blood pressure at all. That means my blood pressure can be low...120/60...but can suddenly spike up, which she considers worse than consistently high blood pressure. Heart disease = #1 killer of women. You really have to take your BP at random times over the course of at least a week to get an “average”....but, like I said, I think you have to watch out for the spiking.

Hindags profile image
Hindags in reply to Klah

Thank you so much.

I went to the clinic today with both of my BP monitors that I have at home. I wanted to see which, if either, was closest to the office readings. I figured that that would rule out the office effect. I followed everyone's advice, got there early and took time to settle and relax. I do wonder, however, just how realistic this resting BP is when I am rarely resting like that as I live in the real world.

In the office, the reading on my "better" home machine with a cuff, was quite a bit highest 148/73 pulse 68. My wrist machine was a bit lower, 133/77 pulse 71. She tested my blood pressure on the office machine three times. She tested my right arm at 135/68, Pulse 68. The left arm was 131/64 pulse 68,. A bit later she tested the left arm again 121/62 pulse 69. What a different picture from last Thursday with a spike of 172/73 (or so) that didn't go down on a second testing. I wasn't given the heart rate last week.

So weird. I'll be interested to see what my GP says when I send him the results at the end of the week.

Klah profile image
Klah

Just as a side-light...In the past when I have monitored my blood pressure on a regular basis, it became stressful and I would obsess when I could feel like it was elevated. I would take a reading too often! Your 143 reading is a little high, and you are smart check it out with your doctor. Let us know how it goes😊

Hindags profile image
Hindags

Replying to myself. I've done a bit of googling.

I found these articles quite hard reading but probably pertinent.

medind.nic.in/icb/t08/i10/i...

ncbi.nlm.nih.gov/books/NBK2...

The first has some interesting things to say about the difference between Prednisone and natural cortisol, and recommendations about what constitutes stressors that might require increasing Pred. at least temporarily.

The second has some interesting Pred drug interactions listed.

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