Encouraging production of natural cortisol

[Maggiechris]

Hi there

I'm so glad I found this website. It's full of interesting and informative articles and lots of friendly people with similar problems who can empathise and pass on tips from their own experiences. I'd never even heard of PMR until I was diagnosed and I don't, personally, know anyone with it to whom I can speak. So this is a lifeline!

I posted a few days ago to say I'd increased my dose of Prednisolone from 3mg to 10mg because I was experiencing extreme fatigue, muscle weakness and generally feeling pretty poorly.

Now feel quite a bit better but I'm still limited by the amount of physical activity I can manage without bringing on the above symptoms. I know if I overdo things a period of rest will restore me.

What I'm wondering is ..............is there any harm in pushing oneself slightly (not totally overdoing it of course) and bringing on some fatigue? Would this encourage the adrenal glands to produce more cortisol naturally?

Any thoughts?

[Hidden]

Everybody is different with regard to this question. I've seen a lot of people say on here that they don't have the strength to do anything more than the lightest of tasks without becoming quickly exhausted , but then there are others like the chap I was speaking to this morning, who like me has tried to keep on going as near to normally pre PMR as possible, and mostly with no ill effects.

For myself, I flared up over the last couple of weeks from dropping down my pred dosage too fast and in steps which were increasingly large in terms of percentage, (constant 1mg drop which represents a bigger % stepdown every time you do it) but after moving back up to 10mg for four days I was ok and have now dropped back down to 6mg to start again and feel fine. I've been out on my bike for an hour the other day, and this morning did one of my favourite short 10 minute follow along abs workouts followed by a walk for about an hour. I was tired by lunchtime but I'm ok again now. No PMR pains at all and I'm hoping I'll feel the "right" kind of pain tomorrow in my abs from my little workout session.

So I guess the answer to your question and bearing in mind what I said in my first sentence is that if you feel ok and able to push a wee bit then try it and see how it goes, but needless to say if you feel overtaxed then just stop.

Taking note of your age I wouldn't advocate heavy exercise but maybe go for a walk in the sunshine if you feel able.

From your bio it looks like you're definitely having adrenal issues and I don't know if exercise will stimulate them to start working or not. Maybe some of the more experienced old hands can advise....

[piglette]

As you reduce the steroids will not reduce enough cortisol so the adrenal glands will have to come back from their hols. If you have no problems with the PMR, reduce as far as you can. I got to 5mg and I was zombie like I could hardly move from the fatigue so went up to 6mg. I then dropped back to 5mg and stayed there for several months. Ideally you should not increase if you get the deathly fatigue but tough it out, but I was a wimp.

[PMRpro Ambassador]

In a word - NO! The only thing that will encourage production of natural cortisol is a low dose of pred (artificial steroid). You have to put up with the fatigue due to lack of steroid to get the replacement steroid.

As pointed out - your age is a little bit against you, adrenal function wanes with age anyway and so recovery may also take longer. And if you stay at above 5mg, it won't happen anyway, as that is enough pred to suppress natural production.

Exercise, build up gently, but don't push yourself too far. You only developed PMR last year so it is very likely still active - and contributing to the fatigue. Overdoing it with active PMR is a risk for it getting worse.

[CamGina]

You could discuss tapering more gradually with your GP. I am now at 7.5 and am reducing by 0.5 mg instead of 1. I do try and exercise as much as possible. I walk my 10k steps and go to the gym.

[LCfan]

PMRPRO is far more knowledgeable about all this. It seems you are expecting life to return to normal sooner than is realistic. Take it easy and don't push yourself too hard with any activities. It takes as long as it takes. I am off pred now but at 74 have osteoarthritis and other conditions which are quite limiting, so don't have much energy anyway .