Parked at 4.5 mgm prednisone

[Karenjaninaz]

It seems, that even when I try 1/4 mgm decreases, I feel ill. My rheumatologist ordered a morning cortisol level after a 24 hour “fast” from prednisone. The endocrinologist consult ordered the test after 48 hours but I felt very ill and popped a 5mgm dose about an hour before the blood draw so the results were inaccurate. Another problem, aggravated by the low dose, are my years long LOW blood sugars— I have to test them when I feel ill. I get low readings before breakfast like 56, 68 and other low readings in that range. A low fat diet for cholesterol management doesn’t “hold” me till morning. An evening snack I will try.

I add the endocrinologist ruled out other causes for my years long low sugars; my sister has the same.

Can anyone else relate?

[SnazzyD]

Did you tell them that you had taken the 5mg? 48 hours seems a bit extreme. When I had my firstSynacthen test and morning cortisol tests I was taking my Pred at 5pm. I just had to withhold that dose until after the 9am test the next day, so I was 16 hours late. I used to have really low blood sugars for years and the only way to stop it was to avoid carbohydrate snacks or high carb meals. When on Pred I had to have extremely low carbohydrate diet to avoid weight gain and high blood sugars. When my adrenal function was low my blood sugar tended to be low again which is a symptom of poor adrenal function.

[Karenjaninaz in reply to SnazzyD]

Snazzy, Yes I understand about low adrenal function inducing low blood sugars. I don't even feel hungry when this happens; I just feel tired and unwell. This is often cured with a decent meal or snack. I realize high carbs don't help. When I am careful to eat properly between meals I'm usually OK. I need to consider an evening snack before bedtime. I'm eating a Mediterranean diet but its low fat is not enough to hold me- especially when I exercise more. my long term low blood sugar tendencies before PMR are enhanced with the low adrenal function.

I did tell the endocrinologist about the 5 mgm after a 48 hour hold of the pred. My next test will be a 24 withholding.

[SnazzyD in reply to Karenjaninaz]

Do you know that your low fat diet is affecting cholesterol positively? Is it affected when you eat higher fat but plant based oils?

[Karenjaninaz in reply to SnazzyD]

I use only plant based oils(olive, safflower and Benecol spread) and my lipid lab results are reasonable; my cardiologist is rather aggressive. Plant base oils do NOT hold me as well as animal - I mean meats with fat. The other night I had white meat chicken, wild rice mix and peas with gravy and plant spread. No added sugar apple sauce. My morning fingerstick glucose was 58{!}. I eat at 6pm and breakfast at 6am. If I eat something like beef chili the night before my sugar is ~ 70. I am normal weight age 78.

[PMRpro Ambassador in reply to Karenjaninaz]

A Mediterranean diet isn't meant to be LOW fat, it is meant to be healthy fat, olive oil and oily fish.

[Karenjaninaz in reply to PMRpro]

The cardio wanted "low fat". I am rather generous with the oils but its really not enough to stabilize my blood sugars. My sister is the same way but not adrenal insufficient so she has a better time managing. I don't like oily fish- too bad. I like shrimp and other fish like flounder and brook trout.

[PMRpro Ambassador in reply to Karenjaninaz]

Your cardio is a bit out of date - the evidence is that low fat doesn't manage cardiac problems.

[Karenjaninaz in reply to PMRpro]

He hasn’t identified any cardiac problems but, on CT scan, I have atherosclerosis of my aorta; I am 78 so not a rare finding. I am normal weight.

I think Ill go out and have a cheeseburger with tomato, onion and mayonnaise.

[PMRpro Ambassador in reply to Karenjaninaz]

Wonder what the figures are for 78 year olds and signs of atherosclerosis!

See - that doesn't appeal to me at all! The fat on meat now - different matter altogether ...

[SnazzyD in reply to Karenjaninaz]

Do they also distinguish between HDL and LDL as in needing high levels of HDL and low of LDL (from saturated fats) or are they saying low to both? Here’s a bit of a discussion bhf.org.uk/informationsuppo...

[Karenjaninaz in reply to SnazzyD]

In my case my LDL is only slightly elevated and my HDL is excellent. I was always told by ny gp my lipids were “balanced.” I think my cardio is a little over the top.

I am changing GP to a geriatrician who might be more reasonable for this soon to be 79 year old.

[Chihuahua1]

I have suffered low blood sugar issues throughout my late teens through to my 40s. There was no apparent reason for it and I had to carry glucose tablets around with me. I learnt the symptoms and gradually learnt how to control it with diet. I don't get it much these days.

[artfingers in reply to Chihuahua1]

I still have low blood sugar issues and have had them all my life as did my father and my all 5 siblings. I'm at 5 pred a day (3 in morning and 2 at night). If I don't take a bit of sugar (in one form or another) before jogging, I will suffer for it midway through my slow shuffle-jog as I call my slow jogging pace. Same for riding the stationary bike but that all depends on when I ate last and what I exactly ate. I also have to watch when and what I eat throughout the day. Hubby can go all day without eating - not me at all! Small meals work best for me and for sure at least 3 meals a day - more like 3 meals with two snacks in between and yogurt with my pred late at night. I see my rheumatologist Friday so we will see what she says as far as lowering my pred any lower which I haven't been able to do for a year without a flare! Dang. Most of my family suffer from low blood sugar. Good luck!

[Chihuahua1 in reply to artfingers]

My low sugar has become less of an issue because I have gained so much weight ; partly through high doses of pred and partly through sedentary ways since PMR and Fibro reared their ugly heads. If I exercise, even gently these days I will suffer for days afterwards. It took me 2 years before I could start reducing my pred and then the reduction ws every 6-8 weeks. There was no point in trying to rush it, although it took several attempts before I learnt that lesson

[PMRpro Ambassador in reply to Chihuahua1]

You may both be surprised to be told that eating lower carb consistently can REDUCE the hypoglycaemic episodes. Eating carbs triggers insulin and that sends the BS level crashing down - hypo attack and more carbs required. Rinse and repeat.

betterhumans.pub/how-the-ke...

diatribe.org/low-carb-vs-hi...

are 2 anecdotal reports, one non-diabetic, one diabetic, about smoothing BS levels using lower carb. NOT keto.

[Karenjaninaz in reply to PMRpro]

I know this and need to take some sugar when I test low. This morning I was 65- too low. It could be that, since a portion of my small bowel was removed, my situation is more complicated. IBS is triggered by fats and carbs are recommended in a flare. Complex carbs introduced slowly after an IBS flare abated.

[PMRpro Ambassador in reply to Karenjaninaz]

I imagine the short bowel might well add to the problem.

[artfingers in reply to PMRpro]

Yes, I do know this, good point about the carbs. I try to limit them as much as possible. Even with low to no carbs, I have to watch what I eat just before exercising so I don't hit the wall so to speak. I've learned to read my body (how I feel) and pace when I eat too. I could never, for example, go jogging if I hadn't eaten for hours that day. Works well for me to eat, wait an hour then exercise. My hubby who has no such issues can go many hours without eating with no issues at all. Not me.