Adrenal System re-starting

[Golf-1]

I am wondering if there will be any obvious physical indications that my adrenal system has started working again?

I am now down to 6mg of Prednisolone each day, tomorrow I have blood tests after which I suspect the GP will suggest I drop to 5mg. I have swollen feet, ankles, calves and hands that are not particularly painful but make it difficult to get shoes on and to clench my fists.

I have read posts that suggest the adrenal system kicks back in at around 5mg, should I be reducing to 5mg to encourage this, and if so is it likely to reduce the swellings? or should I stay at 6mg until the swellings have gone?

This is my dilemma, have still not talked with Rheumatologist as appointment has now been cancelled twice, so any advice would be very much appreciated.

[PMRpro Ambassador]

It doesn't "kick back in" suddenly at a given dose - as the pred dose falls, the adrenal glands should be prodded to start producing a top-up of cortisol so there is enough for the body to continue to function well and when that level is present, no more is produced. When that happens varies from person to person - the fatigue of poor adrenal function may set in around 10mg, or it may not happen until a lower dose, or it may never happen. It is less what happens but more what doesn't happen - the fatigue improves or you don't notice any fatigue.

The swollen ankles could be due to poor adrenal function - but it won't improve until you get to a lower dose of pred. It's a catch-22, You could try drinking more water and using salt if you tried cutting it while on pred - strangely, low salt and dehydration can both lead to swollen ankles.

[DorsetLady PMRGCAuk volunteer]

General info on adrenals - and as PMRpro say they don’t just kick back in, they need nudging …..

healthunlocked.com/pmrgcauk...