Adrenal function/Covid risk

[Bubble56]

I have been reading your posts this morning and adrenal function has been mentioned a few times. I am currently on 5 days 7mg/2 days 8mg on the slow taper programme. I thought that because I was on fewer than 10 mg I was not at such a high risk where Covid is concerned but what I am wondering is I am more vulnerable now I am at the stage my adrenal glands need all the help they can get to "kick in"?

[TheMoaningViolet]

Hi Bubble, my understanding is that indeed you are less vulnerable under 10mg per day. The issue with adrenal glands is the same when it comes to any nasty infection/illness (so not just Covid), your adrenal glands will need some assistance. And, this will potentially remain the case for up to a year after you stop taking steroids. There is a pinned post called Sick Day Rules which you should have a look at. Good luck with tapering. Vx

[SnazzyD]

It isn’t as easy to say that if you don’t have x,y or z, or 9mg Pred rather than 12mg that you are ok or not. There are enough people now who defy the general stereotype of a Covid risk person. Yes 20mg is regarded as immunocompromised, the effect can carry on for a while. If you have adrenal insufficiency any illness can be too much or even just tripping up a step can make one feel ill. If you do become ill in any way, they would give you extra cortisol to compensate for the increase in demand so it’s an easy fix should it come to that. There is no way to pep them up and reducing too fast in order to put a bomb up them as you risk adrenal crisis which could put you in hospital anyway. Slowly slowly withdrawing Pred is the only way but how slow is slow enough? That depends on the person, not useful really. From 10mg I dropped 0.5mg every 6-8 weeks down to 3mg and then 0.5mg every 10-14 ish. In those periods I introduced the new dose as you are.

[Bubble56 in reply to SnazzyD]

Thank you all for your replies. I am following your DSNS taper plan meticulously and so far so good 🤞🤞, it is to be highly recommended and whenever I think “I ‘m fine” and I’m tempted to jump to the next stage in reducing the steroids I remember your sound advice. I am so grateful for this forum and your help.

[PMRpro Ambassador]

No-one really knows - but if you were to catch it then the first thing they are likely to do is increase your pred dose to provide adrenal function support. Don't do it yourself - discuss it with a doctor in the event!

But we are all at the same risk of catching it - no-one who hasn't had it has any hope of immunity and it's looking as if having had is not a long term solution. The only way to go is social distancing (first and foremost) and good quality masks when out of the house and hand washing. It's boring - but keeping away from anyone who might have it (that means everyone ) is the safest thing to do.

[Greensleeves]

My daughter tested positive on Saturday, so I’ve had the dreaded NHS app isolation alert . It’s scary , but I’m obviously more worried about her . Her symptoms are so weird . It will be a relief once she has fully recovered. I’ve sent her an oxymeter and humidifier. I think we all feel helpless with it being the unknown.

[Marilyn1959 in reply to Greensleeves]

Hope she is ok. My son had test today. He is at uni, but lives with two other students who have also been poorly. Unfortunately he goes down like a sack of potatoes with a common cold. I think this is because he was treated with strong antibiotics at 7 weeks old for suspected meningitis. Anxious times. Thinking of you.

[Greensleeves in reply to Marilyn1959]

Oh thank you, they are anxious times . It’s such a worry . She’s lost her sense of taste and smell , has the cough and bad aches . I hope your sons test is negative, you just want them back home to look after them. You obviously went through a traumatic time when your son was a tiny baby , those memories don’t leave us , the worry returns with any threat . If I’ve caught it , I’ll be worrying about my other daughter too . Take care thinking of you too x

[composition]

I haven't heard of the slow taper approach of 5 days low, 2 days up one. Sure would be easier than trying to split these small prednisone pills. Could someone send me the slow taper approach? thank you.

[PMRpro Ambassador in reply to composition]

Some people need to do both

healthunlocked.com/pmrgcauk...

If anything is not clear - just ask.

[composition in reply to PMRpro]

so is there a slow taper chart I can review?

[PMRpro Ambassador in reply to composition]

Not from me no. There is an app that was developed by someone as a project. All the various approaches are linked from here

healthunlocked.com/pmrgcauk...

Personally, for the DSNS approach I use a monthly calendar and highlighter pens. If you want to start with 1 day new, 5 days old:

On Day 1, mark it in one colour as the New Dose day. Count 5 days (2nd, 3rd, 4th, 5th, 6th) as old dose days, use the other colour if you want. The 7th is then the next new dose day, the 8th, 9th, 10th 11th are old dose days, 12th new dose day, 13th, 14th, 15th old dose days. And so on, always reducing the number of days between by 1. Once you get to alternate days old/new, you then reverse the process, adding a day of new dose each time.