Adrenal advice

[HeronNS]

I've been at 1.5 mg pred for a while, and recently have had the occasional day at 1 mg. Today I had a bit of stress with a dental appointment and have felt shaky ever since. Appointment was about seven hours ago. Do you think that could be the stress requiring more cortisol to deal with than my adrenal glands are able to make? Should I take some extra pred, and if so how much? I'm even having trouble writing with a pen.

I need to edit - there were no procedures done, unless you count photographs and x-rays. Nothing injected into me!

[Sandradsn]

Did you have an injection for your dental treatment?

[Purpleazalia]

It sounds similar to an experience I had, so I would say it is likely to be adrenal glands not producing enough cortisol. Deciding on an appropriate extra dose 7 hours later is a difficult one though.

I was on 3.5mg, but had taken 5mg that morning, and took an extra 5mg at the end of the appointment.

I also took an extra 0.5mg for the next 4 days as a precaution against flaring after the stress.

I think I would try taking an extra 2mg today, and an extra 0.5mg for at least a couple of days after.

I hope you feel better really soon.

[HeronNS in reply to Purpleazalia]

Thank you. It never crossed my mind that I would find a consultation so stressful. Anyway I think I'll follow your suggestion, (barring any others ) and take a couple of mg with my supper. Then see how tomorrow goes.

[Sandradsn]

It maybe the adrenaline in the anaesthetic if you had an injection, it can make some people quite shaky and sometimes unwell.

[HeronNS in reply to Sandradsn]

No procedures done.

[SnazzyD]

That sort of thing happened to me and I would have to lie down for the rest of the day. This why I reduced by cutting 1mg up into bits to avoid a whole 0.5mg jump! No idea if it helped but it made me feel better.

Could also have been adrenaline in the injection or both.

[HeronNS in reply to SnazzyD]

No procedures done. I'll edit the post because people are making that assumption. I had to mail a birthday card and thought maybe once I'd got outdoors I'd perk up and want to walk further, but I felt wobbly the entire time and just wanted to come home and sit down again!

[SnazzyD in reply to HeronNS]

Still sounds familiar!

[Blackcat1M in reply to HeronNS]

sorry to hear That HeronNS, I felt like that last week in the garden fell and pulled my OH with me it shook me up more.

Take care hope you fell better soon

[HeronNS in reply to Blackcat1M]

Hope you're okay now?

[Blackcat1M in reply to HeronNS]

thank you very badly bruised on arm and really ach,hope I will be ok for my vaccine, take care

[HeronNS in reply to Blackcat1M]

Ouch!

[HeronNS in reply to Blackcat1M]

Are things improving today? Hopefully no serious or lasting damage. One thing about bruises is the ability to evilly gross out your loved ones by showing them as they become colourful! 😆

[Blackcat1M in reply to HeronNS]

thank you HeronNS you made me laugh.

Apart from a badly bruised arm I think I got of very lightly.

I had thought of buying some Arnica cream as I know it’s good for bruises.

How are you feeling in yourself?

🌼🙏

[HeronNS in reply to Blackcat1M]

Thanks for asking. Apart from ongoing grumpiness about suffering from the degenerative disease (aka aging), as I think Doris Lessing calls it in her science fiction books, I'm not doing too badly. I think the smoke plume from Alberta wildfires is affecting a lot of us in Atlantic Canada though, as anyone who tends to get headaches 🙋‍♀️seems to be having them all the time right now, and this is both tiresome and tiring. But PMR really behaving itself and I begin to think that maybe I now just have to wait out the slow adrenal return. We'll see!

[Blackcat1M in reply to HeronNS]

good luck and take care of yourself

[Hunter134]

Been a rough day so could very well be adrenaline shortish.Hope you feel better real soon.!!!!

[HeronNS in reply to Hunter134]

Thanks. Thought I'd feel better when I got home and had a cup of tea and the rest of my breakfast, appointment was early, but I didn't. Did a couple of short errands while in that part of the city to get full benefit of the fossil fuel burned to get there and back.

[Hunter134 in reply to HeronNS]

I overreact to everything so it's been hard to taper.

[HeronNS in reply to Hunter134]

I see from your profile that today is the fourth anniversary of your joining HU!

[Hunter134 in reply to HeronNS]

Wow I didn't know that.Yes I guess I've had it that long.I had it before at 59.Came back with alot of stress I was under My daughter had two transplants and my husband a spinal stroke.A but much!!!I suppose we all have our stories!!!

[PMRCanada]

Was wondering how you made out. Perhaps a call to the dental office or your GP may provide some insight/treatment for your symptoms. If extra pred, as suggested on here, works, then I’d be leaning towards adrenal insufficiency.

Despite not having any work done, it can still be stressful to go to the dentist, I went to my first appt with our new dentist recently, and I was so worked up they took my bp as part of their routine with new patients and it was very high. They wouldn’t work on cleaning my teeth till I provided note from GP confirming it was situational high bp. Did you happen to discuss a plan moving forward?

I can’t contribute much more practically but wanted you to know I’m thinking of you and hoping the new symptoms subside soon.

[HeronNS in reply to PMRCanada]

Moving forward is actually moving back, back to my dentist as the orthodontist said if he attempted to move my teeth (to straighten them) I would more than likely lose some of them. So I'm referred back, with suggestions for things he should/could look into. No easy answer. But I'd prefer to keep my teeth than lose them. Onward!

[PMRpro Ambassador]

But you were all worked up about it weren't you? I'd take a one-off 5mg and see if you feel better after it.

[HeronNS in reply to PMRpro]

Yes, and all the other stuff I mentioned in my not so cheerful mother's day post! But 5 seems a lot. Two more than doubles my current dose. I guess I'd better have it now.

[PMRpro Ambassador in reply to HeronNS]

Yes, but it is just a one-off to give the boost you need for a stressful situation. Normally your adrenals would produce a spike of something like 10 times the normal level in some situations, the mean during is 9x the usual level according to a study. And your dose of 2mg is what you need for day to day function, not under stress. If your adrenal function is recovering but still wobbly it probably isn't producing that sort of amount.

[HeronNS in reply to PMRpro]

A few minutes after writing my last reply to you I tore myself away from the computer, and realized that the wobbles were gone, all by themselves. So I didn't take extra, although no doubt a couple of extra mg earlier in the day would have been helpful. Or, see my reply below to Viveka, if I'd actually taken my proper dose yesterday morning!

This is an object lesson for those who think a half mg can't possibly make that much difference. Given the right set of circumstances it certainly can!

[DorsetLady PMRGCAuk volunteer in reply to HeronNS]

You had got yourself really revved up in previous post (about a number of things, not just the actual day) - so adding in this appointment was always going to be difficult..

Hope the extra works…

[Jackoh]

Yes I would say you were under stress and on that level of pred I would imagine it really affected you. Hope you’ve tried extra pred perhaps for a few days and it has helped. Xx💐

[HeronNS in reply to Jackoh]

Apparently in the end I didn;t need it. I waited so long, and in the end the wobbles wobbled off by themselves and I realized extra pred no longer needed. Probably would have helped had I taken a couple of mg earlier in the day.

[Jackoh in reply to HeronNS]

oh that’s good Heron! I know when I had a bad fall a few months back I felt very very shaky on 7 mg and fast heart rate so I did go up for a short time. It’s just knowing your body isn’t it? From my point of view my body and I have had a long time to be acquainted!! 😂

[Tiggy70]

As Pro says you had probably got yourself worked up a bit just thinking about the appointment. I was due to have a tooth removed a few months ago. I lost nearly a whole nights sleep worrying about it only to go to dentist the next day and be told that he had changed his mind about extracting it. In the end I had a root filling which turned out fine. Hoping the wobbles go soon, Tiggy 🌸

[HeronNS in reply to Tiggy70]

In fact they did; noticed they were gone just about the time I was getting ready to take extra, so I didn't.

[Chelseadog]

Has anyone on here tried the natural supplement Ashwagandha? It’s used to support symptoms of Adrenal Fatigue apparently. Any thoughts?

[DorsetLady PMRGCAuk volunteer in reply to Chelseadog]

Just found this with a quick search -

Does ashwagandha interact with medicines?

There is evidence that ashwagandha might interact with some medications, including those for diabetes and high blood pressure, medicines that decrease the immune system response (immunosuppressants like prednisolone), sedatives, anti-seizure medications (anticonvulsants), and thyroid hormone medications.

Any supplement needs to be checked there are no interactions with medicines..

and this -

What are the risks of taking ashwagandha?

Side effects. 

Since ashwagandha has not been well-studied, we don't know all of its side effects. Large doses can cause upset stomach, diarrhea, and vomiting. 

Risks. 

Talk to a doctor before using ashwagandha if you have any health conditions, including cancer, diabetes, thyroid problems, bleeding disorders, ulcers, lupus, multiple sclerosis, or rheumatoid arthritis.

Ashwagandha might interfere with thyroid tests.

Stop taking ashwagandha two weeks before surgery

.Interactions. 

If you take any drugs or supplements regularly, talk to your doctor before you start using ashwagandha supplements.

They could interact with sedatives, blood thinners, thyroid supplements, drugs that suppress the immune system, and drugs for anxiety, high blood pressure, and diabetes.

Ashwagandha might also interact with supplements that cause sleepiness, like St. John's wort, kava, valerian, and others.

[PMRpro Ambassador in reply to Chelseadog]

It has been discussed on the forum before - had you put this up as a new post you would have got related posts probably.

[PMR_sufferer1]

Going to the dentist is stressful . Dont take more pred is my thinking.Its easy to panic so relax

[HeronNS in reply to PMR_sufferer1]

In the end I didn't because the shakiness disappeared before I got around to it!

[Noosat]

I have has PMR 4 yrs. Down to 2.5 MG I findall I have extra atress when go to medical visitsl.so rest and take extra Tylenol for arthritis but no extra pred. After a while body calms and I can go on as usual

[Viveka]

Funnily enough I've just been to the dentist - thought it would be an assessment but found the offending tooth is fractured and the one next to it fractured and probably dead so it is likely to be at least one root canal and an implant. She did a bonding filling as a temporary measure and after the procedure and finding out about second tooth, I was like a spent balloon, if a spent balloon can also be agitated. Felt better after chatting with my hairdresser who needs four implants. Personally I'm dubious about taking more pred unless it's an absolute emergency. Better relax, eat, do nice things and see how you feel in the morning?

[HeronNS in reply to Viveka]

I can imagine how you felt. At least dentists seem able to perform miracles these days. My next steps are almost certainly to be dealing with the offending salivary gland, smoothing off a corner of the main offending tooth, and grafts to rebuild the gum over those offending lower front teeth. Then they'll make the thingy which started the whole adventure to keep the teeth where they are and not let them move any more.

Looks like the two of us are in for an interesting early summer!

Finally pulled myself away from the computer to go take the extra pred and thought, I'm not feeling shaky any more. So I didn't take extra, and am fine this morning. But there's an extra half mg in the container with the dregs of my prescription. I'd counted out what was remaining when arranging for a renewal, and it was going to end up exactly on Friday. So I must have taken 1 mg yesterday instead of 1.5, which means I took a reduced dose two days in a row, not separated by several at 1.5. Who knew this error could be significant? Maybe it wouldn't have mattered on an ordinary day. 🤷

[Viveka]

Yes they have a lot more things they can do. I asked about straightening mine but it involved being in a brace for a year and not being able to eat properly in case food got trapped. Hardly worth it at 66. I hope all your work goes well.

Interesting about the half mg - probably a contributing factor given the added stress. And well done you for getting down to 1.5 transitioning to 1!

[HeronNS in reply to Viveka]

Thanks. I've been here before, so not really holding my breath. It's probably a good thing I had a bit of a heads up that adrenals aren't perhaps as energetic as I hoped!

The orthodontist told me if he attempted to move my teeth I'd probably lose some of them and he wasn't prepared to risk that. I'll be 76 soon so teeth even more precarious. Now I understand the black humour behind the cartoon which says your teeth are fine but your gums have to come out!

Which thought led me to this:

thecreativecomposite.co.uk/...

[Viveka in reply to HeronNS]

I know where to go for dentist jokes now. 😀 Fingers crossed for this time, but whatever happens 1.5/1 is fabulously low.

[Grammy80]

That shakiness sometimes and not being able to write with decent penmanship after the first paragraph....that sort of thing happens frequently to me. I can be happy or sad, stressed--good stress or bad~~I don't even think twice about it any more. I just chalk many things up to my good/evil friend...prednisone.

I asked my rheumy about adrenal insufficiency last visit...I'm on 3mg and Actemra....he said, "You are doing fine, if you were experiencing that, you would feel very poorly." I take this fellow at his word....I do miss my prednisone facelift now that I'm losing weight....I've got wrinkles~!💞The cool thing is, I can see them.