Bloating, nausea and tingling

[Casia]

I’ve recently tapered to 1 mg having delayed my taper due to hip surgery 12 weeks ago. I seemed to have no classic PMR symptoms but over the past few weeks have been very windy, tingling hands and feet and lately feelings of nausea. I spoke to my gp and didn’t mention the tingling as I first thought it was related to the hip op where I was given a large dose of dexamethasone. My gp prescribed omeprazole as I’m having reflux and loss of appetite. I was thinking of seeing a gastroenterologist but on reading posts here I wondered if anyone has had any similar experience and advice ?

[PMRpro Ambassador]

As I said on your other query - I doubt the pred is to blame, except maybe being not enough. GI symptoms in general are typical of adrenal problems. Some patients have tingling in hands and feet

mayoclinic.org/diseases-con...

[Casia in reply to PMRpro]

That’s really interesting. I’ll mention that to the gp. Thank you.

[SheffieldJane]

Did these symptoms only arise with your latest taper? It may be that you have tapered too low, too fast. At one time or other I have experienced all those symptoms with PMR without the added stress of an operation.

Your doctors could also explore your Adrenal function, if they haven’t already. My gastric symptoms were greatly helped by a move to gastric resistant Prednisalone but we are currently experiencing a shortage of 1 mg gastric resistant Pred. Omeprazole and similar caused more problems for me such as diarrhoea and sickness. Prior to changing to Entric Coated Pred I was considering an Endoscopy. At that time they had stopped that operation in my area. I am currently trying to source the 1 mg gastric resistant tablets and hoping that it is a temporary supply problem.

[Casia in reply to SheffieldJane]

Strangely I don’t seem to have any PMR symptoms. That’s why I’ve been tapering and tapering very slowly. But it’s so helpful to know this. Thank you.

[SheffieldJane in reply to Casia]

The next part of my story was a further diagnosis of Large Cell Vasculitis/ GCA diagnosed by ultrasound not specific symptoms. ☹️

I think that 4 years of Pred has definitely left me with digestive sensitivities and I have had to exclude some foods. I have Psoriasis on my feet, burning and tingling. My hands tingle and itch, nothing to see though.

[Casia in reply to SheffieldJane]

If there is little inflammation and no PMR symptoms wouldn’t it be better to get off the pred completely? I really don’t want to increase the dose.

[SheffieldJane in reply to Casia]

Inflammation will usually appear under control in blood tests, whilst on Pred. In my case Tocilizumab has been prescribed and the aim is zero Pred.

[Casia in reply to SheffieldJane]

Good luck! And thank you. X

[PMRpro Ambassador in reply to Casia]

Well yes - but unfortunately at this level the adrenal function is just as significant as the PMR. You can live with PMR symptoms, you can't live long term without functioning adrenals supplying cortisol for day to day body processes.

While you are on above about 5-7mg pred that replaces the cortisol and the body doesn't produce any more - like your central heating boiler doesn't switch on as long as the room where the thermostat is is being heated by (for example) a wood burner. As the pred dose gets lower, the adrenal glands need to produce a top up of cortisol but it takes time to get going and isn't too reliable for some time, even after stopping pred altogether. In the meantime, you may need a bit more pred to keep you well.

[Casia in reply to PMRpro]

Thank you again. X