Hot Flushes increasing

[Godrevy1960]

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?

[PMRpro Ambassador]

"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 in reply to PMRpro]

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 Ambassador in reply to Godrevy1960]

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 in reply to PMRpro]

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 Ambassador in reply to Godrevy1960]

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 in reply to PMRpro]

Thank you very much I shall read it

[SuziCutie in reply to PMRpro]

That is very helpful thank you

[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]

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]

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]

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]

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 in reply to Andjo06]

Yes very helpful thanks

[Hidden in reply to Godrevy1960]

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 Ambassador in reply to Andjo06]

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]

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 in reply to Pinkpepper]

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 in reply to Andjo06]

Thanks for your advice, best wishes

[Andjo06 in reply to Pinkpepper]

You too

[Godrevy1960 in reply to Pinkpepper]

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

[Pinkpepper in reply to Godrevy1960]

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]

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

[Godrevy1960 in reply to Pinkpepper]

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

[PMRpro Ambassador in reply to Pinkpepper]

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

[Pinkpepper in reply to PMRpro]

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