Hi everyone,
I wonder if anyone can help me as to why I keep waking up in the middle of the night feeling terrible nausea, I take cyclizine to calm it down but it’s really annoying. No definitely not pregnant, this has been going on for a while but seems to have got worse more recently.
Any views on this would be helpful pls.
Xx
Ps I do take anti acid omeprazole so it can’t be the cause of my nausea.
Is it always at a similar time?
HiYes it’s about 2.30-3 am, very annoying
When do you take your pred? Midnight is the time at which cortisol reaches its nadir - maybe it is your body protesting at lack of that?
I did wonder that, so what’s the answer, should I take my pred at night when I go to bed, or maybe take it later in the day so it last me through the night, or just live with it?
Could it be related to when you take Pred or other meds? They could be hitting the system at that time. I feel that I had a phase of this a few years back. Even a late evening meal could trigger it. Gaviscon was surprisingly effective.
HiThe meds I take now are pred and levothyroxine first thing in morning, when I remember I take vit d (calci chews), other than that I don’t take anything else, apart from the anti nausea tabs or piriton.
I couldn’t take Omeprazole it caused digestive problems. I have had no stomach issues since moving to gastric resistant Pred. I take them at bedtime and wake feeling good.
I only take omeprazole when I need to, not every day, I e no idea about gastric resistant pred, my rheumatologist pres a huge amount every time I go there, I never have to get any top upsXx
Sorry I don't have any medical expertise so I am just making a comparison. Like you, I take pred, levothyroxine and Adcal-D3 (calci chews). However, my doctor also prescribes Lansoprazole to protect my stomach. Are you protecting your stomach?
Hi I do sometimes, only when I have bad indigestion .
I found Omeprazole caused nausea and eventually didn’t work anyway. However, you can’t just stop it without tapering off. Gaviscon is good stuff and I used to take it before bed particularly. Is the nausea stomach based with stomach symptoms or a swimmy head nausea?
Might be low blood sugar - does a bit to eat help? Have you tried last evening snack too?
Might be low cortisol which in turn an cause low blood sugar. It is this low cortisol in the very early hours that is thought to trigger cortisol production for the morning. It would be interesting to see if a later Pred dose works as PMRPro says though it might delay the adrenal glands’ return to function if the nighttime low is prevented from happening. The Endocrinologist advised me to change from my historical pm dosing time to morning. An experiment would help with diagnosis though.
Are you eating enough salt? I found that my very low salt diet for higher doses of Pred became inappropriate on low doses because low adrenal function causes loss of sodium.
Ah you may have hit on a problem, I don’t take salt with anything, I do suffer from low sodium but this cleared up when I went on pred, apparently pred increases sodium levels, mine became a bit more in line with what it should be, but still low, that was when I was on higher dose of pred, not sure what it is now, also, you may have hit on the low blood sugar, I eat my last meal about 4.30-5pm and have nothing else till the morn, maybe I could try eating something small but then I’m trying to lose the weight pred put.
A handful of nuts perhaps such as almonds? I ate a lot of nuts when I was on high dose Pred along with a low carb diet and it was fine. What do you eat for your last meal?
Well I cook for myself and husband, it’s our main meal of the day, I’ve cut out potatoes most days so it’s usually meat and veg or fish and veg, sometimes vegetarian meal.Sometimes I eat very little during the day, other times I have porridge and some toast, other times I have soup at lunchtimes, but this does vary, I don’t eat breakfast or lunch everyday.
Ps. I do have a takeaway every Saturday and roast dinner every Sunday and I do have my moments of pigging out, chocolate sometimes crisps, but I seem to have gone off them just lately.
So actually, based on that, there is a fair bit of carb going in which will push up insulin levels and give you a corresponding low later. Also, you will put on more fat because that’s how insulin removes glucose from the blood. You might get on better eating more so that you don’t need to “pig out” as you put it when the body says, “nuts to this, I need a stuff” because it’s not getting what it needs at other times. A good amount of fats, ideally vegetable oils, really helps too. Having been through this Pred thing starting at 60mg it really has shown me that, to a point of course, what you eat is more important than how much.
Hi
Interestingly enough I had my son and daughter-in-law over for a meal last night, we ate a little later than I’d normally eat and lo and behold, no night time nausea, so maybe that’s the answer, I’m leaving too long a gap between my meals, or maybe it was such sheer exhaustion.
X
I hope that’s the answer as it is nice an simple! I do wonder if routinely skipping meals puts our already stressed bodies under even more strain, especially when the adrenal glands are not working properly. Also, bear in mind when you skip meals you are skipping the opportunity to put in nutrition, not just calories.
That’s food for thought! Having read the suggestion that fasting might help bump start the immune system ( Dr Michael Moseley ) I have been trying to leave a longer gap between evening meal and brunch next day. Hmm Also the other info on omeprezole was interesting too. I’d put my digestive issues down to pred. thinking that omeprezole was helping. Doubled dose of omeprezole and it got worse ! Now stopped everything. Better on the tummy front at least. So much to learn on this site .. wish my doctors ( rheumy and upper GI specialist) had guided me on this !
They are utterly convinced that PPIs can do no harm! Or at least that is the message they frequenly convey!I read a study somewhere that about a third of patients benefit from PPIs - a third can't cope with the adverse effects and for a third they just don;t work!
I’ve now read that PPI inhibit good gut flora. Bearing in mind that the gut biome is thought to be responsible for just about everything including feeling happy/ not being depressed, I’m also wondering if my uplift in mood was not just vitamin D but stopping omeprezole as well. There’s a history of idiopathic oesophageal cancer in my family. My mum took Omeprezole for years without an endoscopy check. I’m sure I’ll learn more in the years to come as more research is done. Meanwhile I’ll stick to gaviscon as and when.
Thanks for your knowledge and advice
~I really do enjoy Dr Michael Mosely but I think fasting is better left to those without the associated chronic challenges of PMR.We are not aiming to bump start the immune system whilst on steroids.
I know how my body feels when I've left it too long between meals - very shaky and feeling dreadful ~
Yes I can understand that. It was just that in his book on the fast 800 he specifically mentioned a couple of anecdotes where a woman with an autoimmune condition fasted for 2-3 days and her condition regressed. Like I say - an anecdote.
~Wouldn't that be just the ideal situation? I'm not so hardy - maybe 10 years ago but in my dreams now ~
Be wary of increasing gastric acid problems because you can get a rebound effect if you just stop Omeprazole suddenly. Normally the advice is to tail it off if you’ve had it a while. Also, be wary of changing too many things in one go, because it becomes too difficult to know what really did what, though often it is a little of everything that helps. When you say you want to “bump” the immune system, what do you mean and why do you want to do this when you are trying to suppress it with Pred? Might be worth treating this whole thing with deep self care and giving your body what it needs in terms of really good nutrition as best you can afford and perhaps avoid anything that feels like beating your distressed body with a stick. When the adrenal glands need to come on line, my personal experience is that you need to keep stress of all sorts down in order not to feel horrible.
I meant improving my PMR symptoms / healing myself/ improving my own immune response. It was at its worst when I was looking after my terminally ill mother. (Cancer is such a cruel disease- I was so sad at losing her but at the same time hoping she might die in her sleep as I hated watching her suffer) Now clearing the family home for sale. I am very lucky ( especially after what I read on here) as my symptoms have decreased, and I’m now taking a break from pred. I stopped omeprezole in Feb, stomach pain gone and recent endoscopy all clear. I really thought it was ‘my turn’. So stress lifted massively.
I am working on all things healthy ! From eating better and sleeping better. Accepting that I can’t do all I used to. I’m just frustrated that after paying privately to see various consultants, I’ve learnt more on this site than I ever have in a consulting room.
Always eager to read what you post. Thank you!
Reminds me of my mum who suffered horribly and I just wanted her to go so she didn’t have to bear it. It is a hard conflict to hold in one’s heart. Sorry the first part of my reply to you was meant for 2013Mayo as I got my replies in a twist.
Great dog btw ! Aren’t dogs great ?!
Hi. Since starting on the pred I’ve had about a dozen nights of severe nausea and vomiting. Usually after a meal that was a bit more or a bit richer than usual. The GP increased my omeprazol to twice daily and it stopped. But I’m also careful I don’t overeat or eat rich dinners.
Hi
Yes I agree with rich food causing nausea/indigestion, I’m also very aware of foods with cream, they play me up so I do try to avoid them.
X
Exactly! It’s the cream.
Have you tried using Greek yoghurt in recipes calling for cream?
foodrepublic.com/2012/09/18...
thekitchn.com/heres-how-to-...
I use an egg beaten in a small pot of Total Greek yogurt as a low carb topping for lasagne or cauliflower cheese or like a quiche. It has never separated when I've used it.
Whole milk Greek yog is 5% fat - much much lower than cream.
I’ll try that. Thanks
2mg and fatigue and nausea 
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