Mid Morning loss of energy

[Lauterbach]

I was diagnosed with PMR in August was was initially on 20mg Pred, but now on 15mg. With the Doc's agreement I take the Pred after my evening meal and not in the morning. If I took them in the morning I would wake up quite achy and it would take a few hours for the Pred to work its magic. Taking them in the evening I do get a bit aching later in the day, but then I am nor doing as much as in the morning. However, recently after some moderate exercise, e.g. working in the garden, I run out of energy about mid to late morning. It really is noticeable and I have to resort to energy boosters, i.e. Snickers bars. Although the funny thing is when I go on walking trips, and these are all day 12+miles walks, I don't get the same energy drop. Does anyone elseget the same sort of energy drop?

[SnazzyD]

Hello there. Your energy drops are not surprising; you have a systemic illness and Pred is not a cure, just a safety net to stop the inflammation doing damage, which makes it invaluable and sometimes a lifesaver. The trouble is with Pred, it masks the feelings you would otherwise have to remind you that all is not well yet, such as pain and fatigue, which is a downside. With this in mind, the body needs to be cared for while your body decides to stop attacking itself which continues on until it burns out in a few years. My personal observation is that exercise that involves a repetitive rhythm of consistent physical loading is much easier to sustain than one involving erratic movements, strain and stretching. Gardening is actually very demanding and because one is focused on the task, it is easy to over do it. You really need to care for your muscles, ligaments and tendons with both Pred and PMR. So, sadly Pred isn’t like a can of go juice that gives you wings until it wears off and this is one of the biggest learning points and frustrations with this disease and treatment.

I would also, very much avoid giving yourself a boost with high sugar edibles because you are very likely to become overweight and diabetic, because of the metabolic effects of Pred. Some of your energy drops could also be due to the over stimulation of insulin as the body desperately tries to clear the blood of so much high sugar on top of that caused by the Pred. It also, forces your body that is needing every resource available to cope with the demands of an immune system that has gone rogue. Energy drops are one of the few a warning signals left to say that you need to recharge by rest, not giving it a kick up the rear.

[Lauterbach in reply to SnazzyD]

Many thanks for your response. It's given me food for thought - if not energy

[PMRpro Ambassador]

Fatigue is a major problem with autoimmune disease and it isn't affected much by the pred - it is a different management problem that means pacing. And you are doing a steady but gentler activity on your long walks than you will be in the garden. Different activities have different effects and I have always found anything that involves using my arms finishes me off very speedily! Cleaning windows is hopeless!

healthunlocked.com/pmrgcauk......

Plus - everything Snazzy said! And another plus comment: that Snickers bar will repeat the surge of glucose and insulin, something less carby before and during the activity will help.

[Lauterbach in reply to PMRpro]

Many thanks for your response. Certainly different muscles seem to have been affected differently. Walking and cycling seem OK to the legs are good, but my arms seem to have lost much of their strength. and in the garden I was digging up plants with a trowel so using the arms. So, as I said to SnazzyD, you've given me food for thought.

[PMRpro Ambassador in reply to Lauterbach]

Right from the start my arms seemed more involved than legs at relatively low intensity activity - they seemed to lack power in the sense of not wanting to do what I wanted them too. Pillowcases and duvet covers were a nightmare! I had a lot of bicep pain - whether holding a phone to my ear or carrying shopping, cleaning windows or other household tasks.

[Louisa1840]

Yes I can totally relate to "the wall of Fatigue " hitting around mid to late morning. It happens to me every day. The answer is not high sugar Snickers bars but rest and more rest. Your body will thank you and will respond to the lack of stress. PMR is all about cutting out stress from your life and listening to your body. Be patient. The median length of PMR is five point nine years and you just have to go with the flow if you can. You are in very early days.......

[DorsetLady PMRGCAuk volunteer]

Hi,

This might give a bit more of an insight into your illness and how to live with it - healthunlocked.com/pmrgcauk...