Glucocorticoid induced adrenal insufficiency

[piglette]

This article was in the latest BMJ and mentions PMR. I wonder how many doctors actually do what is suggested? Scroll down to page 328.

bmj.com/bmj/section-pdf/107...

[HeronNS]

Interesting. They even used the term "sick day rules"! However what struck me first was the patient had completed a three month course of prednisolone for PMR. Lucky woman if that's all it took to send PMR packing. Unlucky, of course, that she had to experience adrenal insufficiency. Btw, had I been able to follow my doctor's tapering plan without recurrence of symptoms I'd have been done and dusted in three months, which is indeed what I expected. I didn't know pred wasn't a cure.

[Raewynne in reply to HeronNS]

Yes I was amused at the 3 month course too.

[PMRpro Ambassador]

Heron beat me to it - they jest surely? Adrenal insufficiency after a THREE MONTH "course" for PMR? That is very unlikely to induce it - not longterm anyway - and it sure as hell wouldn't deal with PMR for long ...

[PMRpro Ambassador in reply to PMRpro]

PS - OTOH, definitely a reference to be kept to hand!

[piglette in reply to PMRpro]

I thought that when I read it and looked through to see if they were just looking at a particular period of her PMR, perhaps at a lower dose. On the other hand it could prove they know nothing about PMR!

[PMRpro Ambassador in reply to piglette]

Inclined to plump for the latter ...

[herdysheep]

completing a 3 mth course was what hit me most

[Raewynne]

Interesting.I had a fall last week.Rather unpleasant Didn't break any bones thank goodness.I joked about it at the time but when I was gotten up...walker and all I suffered really bad shock for a while.I wonder if adrenal insufficiency had anything to do with that.I am struggling reducing below 5.Very tired ,headaches.Aches and pains. And very blurry vision.I have collapsed in the past which I believe was adrenal insufficiency.Its awful.

It took me a couple of days to get over the fall.I didn't think about increasing my pred.

[PMRpro Ambassador in reply to Raewynne]

Probably - but a fall has been documented as casing a flare.

[Raewynne in reply to PMRpro]

Yes well about 2 days later I thought I was having a relapse of my Temporal arteritis.I in creased my pred .Rested and extra pain killers. I wasn't going to go to the Dr because he would have increased the pred far too much and then I would be months behind again.I am feeling better now.

[Flivoless]

3 month course of Pred? IMHO, that throws a question mark over the whole study.

[artfingers]

What I found interesting is that at lower doses of pred during a taper it was pointed out joint pain and all could be a result of adrenal insufficiency and not necessarily a "flare". Hard to tell I suspect.

[piglette]

I have written to the main person who wrote the article to tell her our comments on the three months for PMR!

[PMRpro Ambassador in reply to piglette]

Good for you - wonder if you will hear back!

[piglette in reply to PMRpro]

I am not holding my breath!

[j-e-a-n]

I have had PMR for 7 years and because of a couple of increases in the steroids when needed, am now down to 3 mgs per day, but 3 months ?????????

[PMRpro Ambassador in reply to j-e-a-n]

Actually - I suspect somewhere there is an article that provides criteria for PMR that stipulates a minimum prescence of symptoms. And it is rather more than 3 months ...