weight gain after stopping prednisone?

[mppk]

I’m a 68 yo man diagnosed with PMR late 2021. Started on 15 mg prednisone but had to come off quickly because the mood swings and rage were intolerable. Did 5 monthly Actemra infusions but they didn’t make any difference. Went back on prednisone September 2022, 15 mg for a couple of months. Worst symptoms of shoulder pain were mollified and my rheumy had me taper 1mg/week. Other than the agitation and mood swings I didn’t have other typical prednisone side effects. I actually lost a couple of pounds through the treatment. I’ve been off prednisone for two weeks. My pain level fluctuates but is generally tolerable, not nearly as bad as at the height of the disease a year ago. During the taper, and after, I’ve dipped into severe depression and crying jags. Also, weirdly, although my diet hasn’t changed I’m gaining weight. I’m keen to stay off prednisone as the emotional roller coaster makes day to day life difficult. How long will these symptoms last? Has anyone heard of weight gain after prednisone?

[DorsetLady PMRGCAuk volunteer]

I would say your adrenals stuttering is partly to blame for your depression now -even if the Pred was the culprit previously.

Have to say weight gain is unusual after finishing Pred - and the opposite usually occurs if your adrenals are floundering -so that does need following up.

This link gives information on what happens to your adrenals when you are on Pred -and comes from The FAQs section -

healthunlocked.com/pmrgcauk...

I think they need testing (as described in link) and you probably need to see an endocrinologist…

[mppk in reply to DorsetLady]

Thank you for the adrenals primer. I will ask my rheumy for the cortisol test.

[PMRpro Ambassador]

If Actemra didn't help at all I think it is fair to suspect that, whatever it is, is very probably NOT the PMR we talk about here since it is mostly mediated by the IL-6 cytokine and would at least improve with Actemra even if it didn't go entirely (it doesn't always and nor does GCA), PMR isn't really the disease, it is the name given to a set of symptoms and it has several potential underlying causes. Did your doctor consider that?

[Seacat30]

I lost weight with PMR and when first on prednisolone. I had very little real appetite while taking it and didn't get fat. Now I am off steroids I am back to my old foodaholic self and can gain weight again. Oh dear!