Hot Flushes increasing: I reduced my prednisolone... - PMRGCAuk

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Hot Flushes increasing

Godrevy1960 profile image
25 Replies

I reduced my prednisolone from 10mg to 9mg at the beginning of February and just about coping with the soreness but have noticed an increase in facial hot flushes and night sweats. Has anyone else felt these side effects have got worse as you reduce?

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Godrevy1960 profile image
Godrevy1960
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25 Replies
PMRpro profile image
PMRproAmbassador

"just about coping with the soreness"

Does that mean it has increased since you reduced? That, together with a return of sweats, would be a sure sign I had reduced too far. You should NEVER feel worse at the end of a taper than you did at the beginning. And your baseline is the level of symptoms relief you achieved with the starting dose. You are looking for the lowest dose that gets the same result as that.

Godrevy1960 profile image
Godrevy1960 in reply toPMRpro

No, I noticed a difference in soreness when I reduced at the beginning of February.. it is better and certainly no worse , just the flushes have increased. I am presuming I will be on this dose for at least 2-3 months and then is it usual to go to 8mg or 8.5?

PMRpro profile image
PMRproAmbassador in reply toGodrevy1960

Never mind thinking about the next step - just wait and be sure this one wasn't one too far! ;)

Below 10mg 1mg is more than enough, as you get closer to 5mg 1/2mg may be a better idea. Do you go from every day the old dose to every day the new dose in one step? Or do you use a slowed down approach?

Godrevy1960 profile image
Godrevy1960 in reply toPMRpro

I just went straight down to the new dose daily as advised by my GP. However I recently attended a local branch meeting where they did discuss using a slower alternative day approach

PMRpro profile image
PMRproAmbassador in reply toGodrevy1960

Even alternative days may not be slow enough and you will find a lot of discussion about such approaches here. This is one

healthunlocked.com/pmrgcauk...

which is being used in a clinical study in the north of England. At the level you are at it also helps encourage your adrenal glands to wake up without too much of a fight. Other slow plans are available.

Godrevy1960 profile image
Godrevy1960 in reply toPMRpro

Thank you very much I shall read it

SuziCutie profile image
SuziCutie in reply toPMRpro

That is very helpful thank you

Suetum profile image
Suetum

Yes and it was strange as they only started at 4 mugs. The advice here was it was a slightly too low dose so I increased and they went away again.

Pollyanna16 profile image
Pollyanna16

I am afraid my night time sweats have been persistent since starting on Pred in 2011 its been very hard to get a good nights sleep. However daytime has improved now I am down to 2.5mg. Hope your soreness stays away & take it slowly Godrevy!

Hellyowl profile image
Hellyowl

I am at 4.75mg and have hot sweats especially head sweating. I find any slight anxiety. Even normal stuff like realising I am running late and need to get a move on will soak me in sweat. I think it is adrenals.

Telian profile image
Telian

Hi,

PMRpro explains it well. It seems you’ve come down too fast and yes my sweats came back as I reduced. Try the .5mg reduction next but only when you’re symptoms have completely settled. We are all different but you sound similar to me in that taking it really slow is perhaps the only way.

Andjo06 profile image
Andjo06

Hi, just to share my experience: hot flushes/sweats came back when I (very slowly) reduced to 10mg, but I stayed on 10mg for a month or so and the flushes gradually reduced. There was also a little more shoulder/neck soreness for a week due to steroid withdrawal, but that subsided too. I held steady at 10mg, then started the reduction towards 9 and a half, very slowly again. The same thing happened, hot etc., doctor said it was due to my adrenals waking up a bit. Don't panic and increase your pred again, he said. I took the advice and although fatigue is a problem (no surprise) I coped with this by pacing & meditation. Cut out refined sugar and too many carbs, it's hard but it helps alot. I'm now nearly at 9 and a quarter. Doubtless the same will happen again with the flushes as I reduce further but in my case it's not a sign of reducing too far, my doctor said it's more a case of "the delicate hypothalamic–pituitary–adrenal axis" adjusting as natural cortisol levels increase (due to the reduction of the Pred). Hope this helps :)

Godrevy1960 profile image
Godrevy1960 in reply toAndjo06

Yes very helpful thanks

in reply toGodrevy1960

I struggled most of last year, March to September/October, we were in the Caribbean in March & every day was horrendous, couldn’t wait to get back on the Ship 🚢 I’m starting to struggle again, getting very warm, l hardly ever wear a coat & if l do its off as soon as l get in a shop! 🥵

Plus my wig is starting to annoy me as l get hot, my hair still hasn’t grown back properly after Chemo 🙆🏻‍♀️

PMRpro profile image
PMRproAmbassador in reply toAndjo06

Interesting you have a doctor who accepts adrenal changes can manifest at 10mg - I've always said they can but there are doctors who poo-poo the idea.

Pinkpepper profile image
Pinkpepper

I’ve just gone back up to 10mg as reduced too fast and also had a flu virus. Have been on this dose for 4 days but still getting flushes. How long did you take the 10mg dose before your flushes stopped please?

Andjo06 profile image
Andjo06 in reply toPinkpepper

Hi, the flushes gradually reduced/became less severe over 2 - 3 weeks. Also, I noticed they reduced further in frequency if I ate well and avoided sugary rubbish choc and cake etc.

Pinkpepper profile image
Pinkpepper in reply toAndjo06

Thanks for your advice, best wishes

Andjo06 profile image
Andjo06 in reply toPinkpepper

You too :)

Godrevy1960 profile image
Godrevy1960 in reply toPinkpepper

I was on 10mg for 3 months and they never disappeared altogether but have increased since on 9mg

Pinkpepper profile image
Pinkpepper in reply toGodrevy1960

I got down to 4mg, developed a heavy cough and cold and didn’t realise I should double my dose. Continued to drop to 3mg and then stupidly dropped to 2.5 after four weeks and the hot flushes and sweats started the next day. GP has told me to increase to 10 for a month but wonder if that is enough if the hot flushes are continuing and I should increase by a couple more.

Pinkpepper profile image
Pinkpepper

I also find I’m so tired wonder whether it is the hot flushes or adrenals not up to speed

Godrevy1960 profile image
Godrevy1960 in reply toPinkpepper

Yes, I find I get tired too. I put it down to trying to do a bit more

PMRpro profile image
PMRproAmbassador in reply toPinkpepper

And anyway, autoimmune disorders cause fatigue - it is one of the most common symptoms.

Pinkpepper profile image
Pinkpepper in reply toPMRpro

Gosh I didn’t realise this was such a complicated condition!

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