Adrenals and PMR: Hi Everyone I am starting a... - PMRGCAuk

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Adrenals and PMR

Linny3
Linny3

Hi Everyone

I am starting a program to try and strengthen my adrenals. It almost seem counterintuitive to do so. The prednisone is tapping down our over working adrenals because of the pmr and here I am trying to build them up. Any thoughts on the subject sure would be appreciated. I have read and studied so much I am making myself dizzy and confused. Not hard to do while on prednisone.

Make it a Wonderful Day

LIn

12 Replies
PMRpro
PMRproAmbassador

I think you have misunderstood the biology. Your adrenals are not overworking - they have nothing to do with PMR (as far as its know, never say never!).

The reason your adrenals aren't working is because you are taking pred. Your body needs a corticosteroid called cortisol which is essential for it to function and it is made by the adrenal glands. Your body doesn't distinguish between artificial and natural corticosteroid - which is just as well in fact - and because there is already plenty in the body it doesn't make any more.

It is a bit like your central heating boiler when you have a wood burning stove in the room where the thermostat is. You put on the boiler and when it is cooler than the thermostat is set at it produces heat. Then you decide to light the wood burner - it produces heat in the room and the temperature rises so the thermostat clicks off. The boiler no longer produces heat - but the woodburner isn't affected by the thermostat and carries on warming the room. When the fire burns out, the room cools down again and the thermostat reacts - bringing the boiler back into business. Your adrenals are the boiler - your pill box is the wood burner. As long as you are taking enough pred from the pill box, the adrenals stay switched off. As long as you are above about 8mg that is the way things will stay.

As the dose of pred falls the body realises it need to top up the oral dose - and it will do so in almost all people. My personal opinion is that there are better ways to spend your money than on adrenal support programmes! There is no really scientific evidence that there is such a thing as "adrenal fatigue" - and if the adrenal glands are unable to start up again all the supplements you can find won't poke the adrenal glands awake until they are ready.

morrison
morrison in reply to PMRpro

Great explanation 😊

bunnymom
bunnymom in reply to PMRpro

I had two very fatiguing weeks between 7 and 6. Now at 6 for 6 weeks and deathly fatigue hasn't been back. Can I assume my adrenals have kicked in? Will they kick in when I am stressed so that I can handle things better? Or do we have to be at zero?

PMRpro
PMRproAmbassador in reply to bunnymom

It isn't really possible to say - it does sound as if they have woken up and are beginning to work relatively normally but it is felt that it can take as much as a year even after stopping pred altogether before they work reliably. You just have to wait and see - see how you react when stressed for example. And remember to carry a card of some sort saying you have been on long term corticosteroids just in case you were in an ccident or taken ill and unable to tell medical professionals.

What dose of pred are you on? If you are over around 7.5mg ‘boosting’ your adrenals will not make a blind bit of difference as they have gone to sleep and are letting the pred do all the work. PMRPro explains it very well.

Linny3
Linny3 in reply to piglette

Isn't the point to try and awaken them even while on the prednisone? Mine just aren't waking up under 10mg. It has been a long time with trying many different combinations of ways to reduce the prednisone.

PMRpro
PMRproAmbassador in reply to Linny3

You can't - they respond to a deficit of corticosteroid in the body. As long as you are on higher doses of pred there is no deficit.

This got me curious. I wondered if all the hormones produced by the adrenals are suppressed, not just cortisol, and it looks like it's pretty general, plus of course the pituitary also gets involved. It looks like it may be worth supplementing DHEA as this is one substance which pred itself doesn't compensate for.

ncbi.nlm.nih.gov/pubmed/165...

TooSore
TooSore in reply to HeronNS

Ok, I read it - could they make some of those words any longer? Makes it hard to remember and understand. If the DHEA is suppressed while taking prednisone, does it come back up to speed as we reduce below 7.5 mg? Lag behind a bit? I ask because I've always found tapering my dose reduces me to tears. Even if stiffness and aches are ok, fatigue a factor but manageable, the tears are always just below the surface. I don't know if it matters but I was just starting menopause when PMR hit, so maybe those hormones get into the act as well? When asked my Rheumatologist (who is quite good compared to many) just murmured about checking my thyroid levels. They were reading ok last they were checked but it's been awhile. I feel like I could be more successful at tapering if I could manage the easy tears - it gets embarrassing.

Sorry PMR brain was working when I wrote the previous. I meant the immune system not the adrenal system. Though they must be interwoven. As an autoimmune disease isn't the immune system working overtime? Going to have to rethink what I am thinking. Not today, brain not working.

PMRpro
PMRproAmbassador in reply to Linny3

Yes - the pred is suppressing the immune system a bit, depends on the person. But the last thing you really need is to make the immune system work MORE. Though there does seem to be some benefit in using probiotics to make your gut flora better. Especially after being on antibiotics.

I posted about my near death experience on a late night drive which certainly got the adrenals working, kept me awake all night and not something I can recommend. I definitely felt the rush!

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