I'm seeing my rheumatologist in a couple of weeks so I will discuss this with him, but in the meantime I wonder if anyone else has experienced this. I'm currently on 7.5mg since August 2020, 79 years old, and have no real aches and pains. In fact I feel pretty good most of the time. However, every morning from around 4.00 a.m. until I get up I have discomfort in my chest. Once I'm up I don't have a problem for the rest of the day. It feels more like muscle pain but it's enough to stop me from sleeping. Perhaps I'm being over sensitive but I wonder if my adrenals are starting to kick in. From what I've read I'm on too high a dose for this to happen, but thought I'd ask the question. Thanks for all the helpful advice from this support group. Much appreciated.....
Early morning discomfort in chest : I'm seeing my... - PMRGCAuk
Early morning discomfort in chest
Hi there.Morning chest pain/discomfort could be caused by a number of things, e.g. eating late at night/close to bedtime: sleeping position.....Perhaps you can relate to this?? However, I wouldn't wait to get this checked out and I, personally, would be ringing my GP today explaining my symptoms.
Hello, chest pain is quite a general term so it’s difficult to say. It’s worth seeing the GP and the Rheumy might say that anyway if they decide it isn’t anything to do with your condition. In the meantime it’s worth noting where the pain is exactly and if it is very localised. Does it travel anywhere? Is it sharp, dull, spasmodic? Does it hurt more when you breathe in? Does it pulse? Can you find the spot and make it hurt when you press or is it deep inside? Is there anything you can do to make it worse or better? What happens if you don’t get up and just lie there? Does it happen every night? Any other symptoms occurring with it no matter how mild? Does the pain allow full movement of limbs and body? It could be stomach/oesophagus, cardiovascular, musculoskeletal or other so detail really helps.7.5mg is certainly low enough for adrenal insufficiency to start making itself known. It was this level to 5mg when I felt the worst. However, it shouldn’t be causing pain like this. Some docs think it doesn’t happen until 5mg and below, some don’t think it happens at all and that it restarts seamlessly. Hopefully yours will be more realistic though there is no quick fix they can apply but to stay in cortisol deficit so the body realised it needs to make its own cortisol. Testing for adrenal function doesn’t happen until below 5mg if the result is to be useful.
Thank you SnazzyD for a very helpful post. I'll take notes tomorrow morning when I'm sure it will happen again. I'm seeing my GP also at the beginning of July and she's very responsive so I expect she will check me over and send me to a cardiologist if she thinks there might be a problem. Enjoy your day......
It’s worth a try from a diagnostic point of view to take some Gaviscon at bedtime for a week to see if it makes any difference. A yay or nay will help the doc with their diagnosis.
Thanks. Good idea.
Hi,
As said any chest pain/discomfort should be checked as a matter of priority.
Couple of points, around 7.5mg is when your adrenals should be attempting to start working again - have a look at link, but chest pains is not normally a symptom of them struggling -
healthunlocked.com/pmrgcauk...
The fact that it happens around 4am which is when the substances (cytokines) that cause inflammation shed may indicate it is PMR/GCA related, but again it’s not a common occurrence. But the fact that it seems to disappear for rest of day…… perhaps a phone call to Rheumy prior to appointment would be wise, he may want blood tests done. At least touch base with GP.
“I'm currently on 7.5mg since August 2020”….do you actually mean that you’ve been on 7.5mg for almost 2 years, or is that a typo? If it is correct, then why at same dose for so long?
Have you had covid or done anything prior to discomfort that could have caused it if you think it’s muscular?
I am doing gentle stretching exercises, but have been doing them for over two years now, since diagnosis. I started swimming again a little while ago but apart from that, nothing has really changed. Not had covid either. My rheumatologist wants me to stay on 7.5 mg for at least 2 years and I've decided to follow his advice. He's dealt with auto immune disorders all his working life (now in his late 60's) and seems to know what he's doing.....fingers crossed!
Could be the swimming maybe…but would have thought you would get it all the time if it was. Bit of a conundrum …
2years at 7.5mg -that’s a new one on me, but if it works then good….hope it does.
And please let us know what happens with chest….
Will do, and thanks for taking the time to reply.
I think he's taking a cautious approach as there's a history of GCA in my family. He's also said that at 7.5mg side effects are negligible. Hope he's right......
Yes he’s correct about side effects being negligible-but it’s the length of time I was interested in -very often hear 1 year but not so much 2 years. But it will be interesting to know how it goes.
Prof Mackie said in a research meeting a couple of weeks ago that they are now feeling that the "safe" dose is much lower, I think since it has been accepted that the physiological dose is not IRO 7-8mg but possibly as low as 2-3mg. On the other hand, it probably depends a great deal on the patient - and how well they adopt changes to mitigate the effects, such as diet for weight gain and risk of steroid-induced diabetes.
I'm having my once a year fasting bloods tests soon which should tell me how well I'm doing (or not). I decided to stick with my rheumy's advice as there are so many differing theories around about how to treat PMR. I know that a sensible eating plan is key, as well as keeping reasonably active. I may well try to taper very slowly to 5mg over the next year but the most important thing to me is to be as pain free as possible so I can enjoy the remaining years of my life. I don't really want to spend it, as my mother did, yo yo'ing with steroid doses. She didn't have a very good life at all from her mid-70's until she died at 91. A fair age to reach but most of it spent in bed. Thanks for taking the time to respond, always welcomed...
I'd think it is unlikely to be due to adrenal function - not so much because of the dose because that varies and some get there at higher pred doses than others but because adrenal discomfort tends to be back and flank pain. But any form of chest pain should be checked out.Snazzy and DL have already said everything else I would have said.
Thanks PMRpro. The only occasional discomfort I get is in my buttocks and between my shoulder blades.
Both of which are not uncommon in PMR - due to the associated myofascial pain syndrome making back muscles tight, Buttock pain is a sign of piriformis syndrome - there are stretches that help.
Thanks again, I'll take everything that's been said on board and will report back when I've seen my GP. I forgot to mention in my first post that my blood pressure is completely normal.
I seemed to be really hit by my adrenals coming to life, but I have never had chest discomfort.
Thanks for replying piglette. I'll talk to my GP about it. It's probably nothing to worry about, maybe something muscular. I'll stop exercising for a couple of days, to see if it makes any difference.
It could possibly be stomach acids causing it.
Thanks Piglette, I'm going to take some Maloxx tonight to see if it helps....
That will be interesting, let us now if it works.
Not what you're looking for?
You may also like...
Continued discomfort
Severe pain in right hip in the morning
Actemra and chest discomfort
Early Morning Aching
Taper Discomfort
Related Posts
discomfort or??
Discomfort in leg
Butterfly feelings in my chest
How early should I take pred in the morning?Moderation team
