Adrenal Glands

[Robinsnest72]

I have been on 7mg of prednisone for 3 weeks now . Would my adrenal glands be working?

[SheffieldJane]

Your Adrenal glands stop working after about two weeks of steroid treatment. They should begin to start producing cortisol when you get below 7 mgs. It is important not to stop treatment suddenly and to taper your dose slowly to give your Adrenal glands time to begin functioning again. In some cases your doctor may advise a Synacthen Test if they have any reason to suppose that your Adrenal glands are not kicking in as they should. This would be at around 4/3 mgs of Pred.

[Hidden]

Hi, we’re you on higher doses previously, as your message reads that you “have been on 7mg for 3 weeks”

That’s slightly different if you were on higher doses before?

Regards

MrsN

[Robinsnest72 in reply to Hidden]

Yes, I have come down from 15mg. I remained on 7mg for the last three weeks and I get blood work done next week. Then am going to go to six with the slow taper. Just wondered if my adrenal glands would be working now as I sure am tired at times and light headed. I also have this prickly feeling in my face and legs.

[NursePeggy in reply to Robinsnest72]

I have been on Pred since Sept 2014, for the last two years have been on 7mg trying to reduce. Have managed to get to 6mg a few times. Each time had to go back up to 7 mg because of flare ups or severe fatigue. I get lightheaded and dizzy frequently, with my eyesight not happy and also very fatigued. If I reduce even by a quarter mg I am lightheaded and dizzy (not vertigo), and also when I go up by a quarter mg. It makes trying to reduce an absolute nightmare.

I also get a prickly, pins/needles feeling in face and legs.

[PMRpro Ambassador]

They don't just wake up and jump out of bed raring to go - it is a gradual process and until you are off pred altogether it is a collaborative effort: the adrenals produce a top-up for the dose of pred you are on to give the body the amount it needs to function properly.

The dose at which is happens isn't the same for everyone - some don't absorb as much of the oral dose as others and they may notice a difference in how they feel as early as 10mg. Others may get to 2mg and feel fine but then a synacthen test shows they have no adrenal function to speak of.

Many people feel fatigued at this sort of dose - and it is very likely to be that the adjustment isn't as smooth as we might like it to be.

[Conundrum in reply to PMRpro]

...your opening paragraph made me smile (good start to the day) but explained it so well; thank you, as always

[Longtimer in reply to PMRpro]

That`s my dream one day...your first line in reply!....

[Daffodilia in reply to PMRpro]

I am taking a lot of naps at 7.5 mg - when I dropped to this from 10 mg my face swelled over night and went down in the day for three or four nights and days and now back to before. My own theory is that my adrenal glands shot some extra cortisol into my system when I reduced but that could be rubbish ofcourse.

[PMRpro Ambassador in reply to Daffodilia]

Did you drop directly from 10 to 7.5mg?

[Daffodilia in reply to PMRpro]

Yes as directed by GP - asking for 1 mg tabs now as he suggested for next drop

[PMRpro Ambassador in reply to Daffodilia]

Should always be 1mg once you get to 10mg. Never more than 10% of the current dose ...

[Daffodilia in reply to PMRpro]

Thanks - asking GP for 1 mg tabs

[SnazzyD]

I found 7mg to be a tricky time when it is still too high for the adrenals to get the message but not quite enough Pred to deal with ups and downs of the day. I didn’t feel like I was getting much action until about 5mg and below. Until about 3mg the function definitely felt sporadic even though my Synacthen test said they were capable of working.

[Daffodilia]

7 mg

[Daffodilia]

I have heard they start working at g

[Hidden in reply to Daffodilia]

See pmrpro's reply above. They are asked to start contributing but it can be a very slow process.

[PMRnewbie2017]

Remember also that although we speak of the Adrenal glands working they are only a part of the bigger picture. It is the whole HPA axis which has been affected by the corticosteroids we are taking. The Hypothalamus, Pituitary and Adrenals work together via complex feedback mechanisms so all need to begin working together harmoniously, and it can take up to a year after stopping pred for this to run smoothly. This is one of the reasons why we get slightly different physical manifestations as our dose of pred gets below 7mg.

[Robinsnest72]

If I only knew all this before . When one is so ill they sometimes do not think things out. My GP told me my blood counts would never come down on 15mg pred, well, they did, and I refused to take any more. My rhemy told me to take Tylenol for the morning pain so I am hoping IF I can get off pred, Tylenol would carry me through some days. For now, no choice as I am going slow.