On/Off Nausea

[diana1998]

Has anyone else suffered from persistent queasiness? I emailed my rheumie, very nice, who I haven't had to see for 5 years. I asked if my nausea since 27th Aug could be caused by 1. Too little pred 2. Adrenal insufficiency. I was on 3mg over the summer and felt fine and found the half mg drops from 5mg quite easy, no pmr pain, bloods always normal. Now hovering between 3.5mg and 4 experimenting re sicknesss. He emailed back by return and said he'd never had a patient who'd suffered from nausea from insufficient pred or with adrenenal insufficiency. (I had a synacthen test done at 5mg and results were hopeful). He was pleased I was under 5mg. So I'm to go back to 3.5mg and have another synacthen test done in 2 weeks. In the meantime, quality of life gone as can't book to see friends in case the day is a nausea one, holiday cancelled . I can eat normally and queasiness passes after lunch. Any other sufferers as so miserable and want to be shot of it. Anti sickness pills make it worse. Eat very plainly, veg from garden, cook from scratch. 🤔🙄

[jinasc]

Stomach protection tablet?

[diana1998 in reply to jinasc]

Been taking emeprozole since 17th Sept as never needed it before. No difference alas.

[DorsetLady PMRGCAuk volunteer]

As you know the date it started, did that correspond with a reduction in Pred, or anything else that could be causing it?

Like you, I would be thinking reduction may be issue…..as it seems to wear off around lunch time…that’s assuming you take your Pred around breakfast time.

As we all know at such low doses, 0.5mg can really make a big difference.

You are also correct in thinking it could be adrenals, (it’s certainly a symptom of low adrenal function) but if so, I would have expected it to be all day maybe …..not just mornings as you imply.

See how you go at 3.5mg, and don’t be at any rush to lower….the final stages of tapering are very often the most difficult.

Please keep us informed.

[diana1998 in reply to DorsetLady]

No, I had a cystitis attack on 27/8, took 1 antiobiotic and was really ill retching and sweating, finally sick. Bad since then. Had emergency surgery appt with suspected ulcer on 16th Sept but all fine. Duty GP was horrified I took my pred at 7pm after food. Said to restart emeprozole and adjust pred slowly to take after breakfast which I did. No difference. Queasiness wise taking morning or evening pred made no difference. I take the gastro resistence ones as seemed to help drops under 5mg. Very surprised rheumie said he hadn't experienced a single case of nausea when reducing pred. I'm feeling like a hermit. At one stage, natural yog seemed to cause nausea a year ago but use oatmilk now. I have appt with gastro after synacthen test.

[DorsetLady PMRGCAuk volunteer in reply to diana1998]

I'm surprised at rheumy's comment as well! Wondering if the antibiotic started it all off.. they aren't the nicest things to take..

Let's hope you can get some answers and relief from Gastro appt.

[diana1998 in reply to DorsetLady]

Thank you

[Rache]

I had similar symptoms reducing. Mine occurred at a slightly higher dose, maybe because I take enteric coated pred which is absorbed more slowly. Like you, it improved after lunchtime. I’m reducing from 4mg to 3.5 at present and don’t often have nausea now so I think it improves as the body adjusts. I used to find that eating something helped, dare I say it, something with carbs such as oatmeal with plant milk.

[diana1998 in reply to Rache]

Yes, I'm on a low fibre diet so crackers do help. Have cornflakes and oatmilk for breakast. Tomorrow will have just toast to try. Nausea starts when I wake up. But some days I'm fine. Not dropping in a hurry though, after nearly 6 years I know the dangers of that! I'm Mrs Tortoise! So glad you're now feeling ok.

[jinasc]

nhs.uk/medicines/omeprazole...

Common side effects

These common side effects may happen in more than 1 in 100 people.

Headaches

Feeling sick

Being sick (vomiting) or diarrhoea

Stomach pain

Constipation

Farting (flatulence)

Stop taking it and see what happens. If it goes away, then ask for Ranitidinewithout 'prazole' in the name eg Oman, Lanza'.

BTW Your Pharmacist would have known that side effect, they know more about drugs than any other medic.

[PMRpro Ambassador in reply to jinasc]

No ranitidine - famotidine or cimetadine (Pepcid or Tagamet)

[Thelmarina]

This is off left field but I had several gastric attacks, was referred to a gastroenterologist, had a scan of the bowel and was discovered to have diverticular disease. At the very least your nausea may be due to another condition and not to do with PMR, Pred or the adrenals. Good luck anyway. Nausea is vile! 🌺

[diana1998 in reply to Thelmarina]

Yes starting with a synacthen test through the gastro. I don't have diverticulitis as that shows up in a colonoscopy. No nausea today. Yippee 👍

[Thelmarina in reply to diana1998]

Brilliant! so pleasedmxx