Our bodies make cortisol. Can they be "forced" to make enough for PMR?

[LIVEORDIEHEREIAM]

I would guess that this approach has been looked into but have not heard of it.

I am assuming that big Pharma would have absolutely no incentive to put in any effort in that direction.

But I wonder...

[PMRpro Ambassador]

Cortisol isn't really involved in PMR although some patients are found to have lower adrenal function but excess cortisol has exactly the same potential adverse effects as pred without being as effective as an antiinflammatory so you would need more. There are illnesses where the body produces more cortisol than it should - Cushings disease gives the same body changes as high doses of pred (when it is called Cushings syndrome). There are a few causes of excess cortisol - mostly tumours somewhere in the HPA axis (hypothalamus, pituitary or adrenals)

[SnazzyD]

You’d be no better off. The artificial steroid is given to stop the inflammation from PMR because we don't make enough of our own to do that. Pred is also a more potent version. If you were to get a pill that forced your adrenal glands to make all of their own cortisol in enough quantity to be effective against the PMR inflammation, you’d have the same side-effects. People who make too much cortisol through illness get the same Cushings problem that we do.

[LIVEORDIEHEREIAM in reply to SnazzyD]

Thanks for clearing that up for the rest of us! Somehow, I had the notion that pred was used to replace the cortisol and that the cortisol was in short supply for some reason, so...

The old saying about it taking a community to raise a child applies to PMR sufferers too! Thanks again!

[SnazzyD in reply to LIVEORDIEHEREIAM]

Well, it has replaced the natural cortisol in that it is so potent and good at its job that the body’s own production shuts down because the brain picks up the fact that there is a bucket load of the artificial variety so it doesn’t need to try. So Pred is replacing the natural cortisol temporarily. When the PMR doesn’t need such a high dose any more and the Pred gets below roughly 7mg the body is meant to notice and make up the difference with the natural cortisol. The trouble is that for many the system has been quiet for so long it doesn’t always work properly instantly and usually the only way for that to get back to normal making your own is by giving the body time to work it out for itself which can mean months of feeling tired and useless. For a few this doesn’t happen so they have to have a weaker steroid pill that replaces what should be made by the body but it has forgotten, so that is a type of replacement too. And you were hoping for the simple answer?

[PMRpro Ambassador in reply to LIVEORDIEHEREIAM]

I would say that it has been "cleared up" fairly often and most of the info is in the FAQs!