Shaky and faint in the emorning.

[Slosh]

Hi All,

I am currently on 5.5 mg - for last 4 days. The last two mornings I have been rather shaky and faint.

I have had coffee both morning - but this morning it started as I was making my coffee.

Yesterday it was really frightening - I kept wanting to pass out. I had a shock because a friend was involved in a car accident - she was ok. I sort of thought that it could have been due to the histamine intolerance - because the other symptoms of numb head, eyesight off etc were similar to my normal histamine related reactions. Stress increases histamine. I would not normally react like this to a stress incident - but I suppose it could be that the increase in histamine from stress was not being degraded.

I was just wondering if it could be an adrenal thing. I think that my adrenals have been shot for years anyway - even prior to PMR and Pred.

I take my Pred at about 12 midday - because that is when I eat my 1st and fairly substantial meal. Shall I change this. I just dont want to be eating something late at night - I am trying to heal a damge gut.

Thanks as always.

[MrsNails]

Hi Slosh

Really you should be taking it before 9am

You are probably on just too a low dose, maybe go back to 6mg; take it when you wake up with a simple biscuit & stay in bed a while, do a bit of reading etc before you get up & see how you go. Also try Decaf incase the Caffine is making you twitchy....

You are now below the Physiological Dose that we all need & if your adrenals are sluggish anyway you need to take steps to improve how you feel in a morning.

Kind regards

MrsN

[Slosh in reply to MrsNails]

Thank you - what kind of steps?

[MrsNails in reply to Slosh]

Taking your Prednisolone earlier ie before you get up.

If you are on plain Pred it takes up to an hour to kick in, if on coated it can take up to 4hours.

[Slosh in reply to MrsNails]

Oh of course - thank you for reminding me

[SnazzyD]

Could well be not enough cortisol. I found the effects of this could happen either after a sudden event like tripping or bad news or any emotional peak, or after a sustained bit of stress. Morning is when you should have a peak of cortisol. It may be that you need to start taking your Pred in the morning as endocrinologists suggest when trying to get cortisol production back on line. Make sure you are getting enough salt as poor adrenal function leads to lack of sodium so b/p can drop.

[Slosh in reply to SnazzyD]

Thanks you - that makes sense.

[SheffieldJane]

Just a thought. Are your blood sugars ok. I went through a phase of steroid induced diabetes. To my delight, lowering Pred, cutting out sugars and carbs has lowered it completely. I did need to eat often and little - sensible stuff. The others are probably right though, your Adrenals just cannot raise to the stress of occasions. Horrible feeling, it just has no where to go. Report this symptom.

[Slosh in reply to SheffieldJane]

Thank you - yes - I also thought that perhaps it could also be a sugar problem.

I will speak to my doctor.

[Arflane97G]

I used to feel a bit faint and groggy in the first few days after a taper. I have always taken my prep in the morning so just retired back to bed with a glass of water and a book and generally felt fine after an hour or so, best wishes

[PMRpro Ambassador]

"I would not normally react like this to a stress incident "

Mmm - but your adrenal function hasn't had a chance to get back to normal (takes a ong time even once you stop pred altogether) and the spike of cortisol to help you cope wasn't there.

Early morning would be better but if it doesn't work for you it doesn't work for you ... But you don't really need a full meal unless you have gastric problems. A small amount of yoghurt or a glass of milk is enough for many.

[Slosh in reply to PMRpro]

Thanks PMRPro - I do have gastric problems. But think I may have to take it earlier.

I stopped taking the gastric resistant Pred as I thought that I was reacting to the dye - may have to go back to that and wash it off.

Thanks.

[PMRpro Ambassador in reply to Slosh]

We have often suggested washing the outside of the e/c pred - you wouldn't be the first to have such problems!!

[Slosh in reply to PMRpro]

Yes - I willorder the gastric resitant for next lot and just wash them

[Nightingales in reply to PMRpro]

This is the first time I have heard of this. What is the point of GR pills if you are going to wash off the coating?

[Slosh in reply to Nightingales]

Not the coating - just the outside dye. There is another hard coating still.

I react to all sorts of things / additives in supplements etc. Have massive reactions to anti-histamines!!😳

[Nightingales in reply to Slosh]

Thank you.

[PMRpro Ambassador in reply to Nightingales]

Only the colouring - the outside, Smartie/M&M-like, coating is pretty tough, it survives stomach acid!

[SheffieldJane in reply to Slosh]

Can I ask what problem you experienced with the dye on gastric resistant Pred pills?

[Slosh in reply to SheffieldJane]

I have histamine intolerance - could not always tell what I was reacting to. Sometimes I would react to exactly the same foods that I had eaten prviously and the only thing that had changed was that I had started the gastric resistant pred. May not have been it at all.

[SheffieldJane in reply to Slosh]

Or you were waiting longer for Pred to reach your system perhaps. This is all pretty hard to monitor. I sometimes feel ok and at other times experience waves of flu-like feelings for no discernible reason. Painkillers do help. I experience nothing identifiably PMR or GCA. Stumped! Tocilizumab? Adrenaline?

[Slosh in reply to SheffieldJane]

So weird. My house mate and I have this little joke as we often get weird symptoms at the same time (she is very healthy) and takes no meds at all - we say mmmmm wonder if they are switching in 5G ....

[SheffieldJane in reply to Slosh]

😂 I know, I think my poor OH is experiencing psychosomatic symptoms or he’s actually got it.

[tangocharlie]

I can't drink tea or coffee with my histamine issues. The odd 'proper' ground coffee is OK but never the instant stuff. BTW I've found a probiotic I can tolerate, Optibac Everyday immunity, I think it's the one PMRPro found. what with that and giving up milk and pork I'm expecting a miraculous end to all my problems any day now. LOL

[Slosh in reply to tangocharlie]

We can live in hope 😂.

I take GutPro - now called Smidge. It’s a low histamine and histamine lowering formulation.

[tangocharlie in reply to Slosh]

Others have mentioned that in Facebook groups, thanks I'll add it to the mix

[piglette]

I have always been a fainter, but I had similar symptoms when I got down to around 5mg of pred. In fact I did faint a couple of times, luckily in crowded places like the grocers and the swimming pool. I blamed it on the adrenal glands. I mentioned it to my GP, but I think he was too busy looking at his computer screen and he just grunted.

[Slosh in reply to piglette]

Oh wow - that’s scary.

[tangocharlie in reply to piglette]

Same happened to me below 5 Pred. Dr told me I was suffering from anxiety - which was bollo**s - it was adrenals

[Slosh in reply to tangocharlie]

Can feel like anxiety - but I agree bollo**s!

How did you address it?

[tangocharlie in reply to Slosh]

Googled symptoms of adrenal insufficiency and contacted my rheumatologist but then events overtook and I ended up in A&E anyway, which was lucky because I managed to see an endocrinologist while I was there which saved a long wait for an appointment.

[Slosh in reply to tangocharlie]

Oh wow!

[Thelmarina in reply to piglette]

Could be solidarity. You are Piglette after all....😉

[Dambusters]

I had these symptoms later in the day - I take Preds with evening meal.

Doctor did blood test. My symptoms were a form of diabetes to be controlled by diet until next blood test on 2-3 months and then see how things go.

[Slosh in reply to Dambusters]

Thanks - yes I need to be more careful with my diet.

[Noosat]

When I was on a higher dose of prednisone, I have tapered recently to 2.5, uncoated, I played around with different times and splitting dose. Now for a long time I take it by 7a.m. This works best for me. In early morning I am sometimes a little achy and shaky, but this wears off as time goes by. I do think our bodies take a while to get used to new dosage. As of now, I am planning to have an aortic valve replacement in December, so am working on being calm and not stressing.

[Slosh in reply to Noosat]

Thanks for this.

I hope that your operation goes smoothly and that you recover completely and speedily. Xxx

[SandyBoots]

Did you check your blood pressure? Happens to me sometimes in the morning when my blood pressure is low.

[Slosh in reply to SandyBoots]

I do usually have low blood pressure actually. But don’t think that it was responsible for this

[artfingers]

It COULD be blood sugar issues also. My sister and I both suffer occasional bouts of exactly those symptoms early upon rising (feeling dizzy, faint, feel as if ready to pass out, shaky). One way we learned it was low blood sugar was by drinking a glass of orange juice and it immediately got better (well, that plus we already know we have hypoglycemia). You might want to check that too at some point with your gp.

[Slosh in reply to artfingers]

Ok - thank you - I am monitoring my sugar as well because I do think it could be a factor.