Adrenals Waking Up

[Robinsnest72]

I know this has been on here before but cannot find. I am on 7mg of pred. My Rhemy claims it takes about three months for them to start working but I forgot to ask at what dose?

[piglette]

It starts at around 7mg, I found I started to get very tired around 5mg so hung on that dose for a while.

[SheffieldJane]

I began to struggle a bit between 8 mgs and 7 mgs and actually ended up on 7 for a year. The body needs to begin making its own Adrenaline to make up the shortfall after 7 mgs which I have learned is the physiological dose. I had my first Synacthen Test at around 5 mgs , to see if my own glands were capable of producing Cortisol. ( a bit too soon, ideally). I was found to have Adrenal Insufficiency and was referred to an Endocrinologist. Fortunately, my second test showed that it had normalised. It can still take a year after zero to have a good natural Adrenal function.

My main symptoms now on 4 mgs are fatigue and a kind of malaise. It is not clear whether these symptoms stem from my Adrenal function. I am due for anther Synacthen when I get to 3 mgs.

[Constance13 in reply to SheffieldJane]

Wow - 3 Synacthen tests! For some reason my doctor won't agree to 1, but he has said I will be on 4mg Pred for life. Just can't get that!

[PMRpro Ambassador]

I suppose it depends how you define working. But it depends a lot on how long you have been on pred and at what dose. Three months is a very conservative estimate - since it is considered that it takes up to a year even after stopping pred altogether before adrenal function is reliable.

Even on the way down, the amount of pred you personally absorb from the gut also plays a role - if you say the body requires the equivalent of 5mg pred to function well, the fact that one patient absorbs only half of their dose while someone else absorbs more like 90% of the dose also as an effect.

You will know how long it takes when you have managed to get to a lower dose successfully - and there are plenty of people for whom it has been more like a year, and occasionally even longer, before they are able to say they reliably feel well and not fatigued.

[DorsetLady PMRGCAuk volunteer]

I think it depends on individuals and maybe the amount/time on Pred.

Me - started on 80mg - when down to 6mg -fatigue sent in (sure sign of adrenal not on form) - it took another 8-9 months during a very slow taper to reach 3mg and adrenals functioning,

However it can take up to an year once off the steroids for adrenals to be fully up to speed.