adrenals kicking in

[Buster1610]

I am on 5mg for the last five weeks now getting lightheaded feelings and sweating is this my adrenals kicking in . Sometimes feeling shaky . I have been on prednisolone since last March .

[DorsetLady PMRGCAuk volunteer]

Very likely -have a look at this - but you have got to 5mg quickly so could be partly that, partly PMR

healthunlocked.com/pmrgcauk...

Very slow tapers, small steps (both for adrenals and PMR) time and patience will get you through….

Same answer as last post really -but is it getting any worse?

[Buster1610 in reply to DorsetLady]

should I stay on 5 mg or go up and then taper slowly

[DorsetLady PMRGCAuk volunteer in reply to Buster1610]

If it’s adrenals then stay at 5mg- and give them time to “catch up” . A month would probably be a decent time.

If however you begin to get more PMR type symptoms then you could be too low on Pred, so just monitor things… and come back for further advice if/when you feel you need it.

[Buster1610 in reply to Buster1610]

yes it seems to be . Spoke to Gp he did not give me any advise .Seeing Rheumy end of June

[DorsetLady PMRGCAuk volunteer in reply to Buster1610]

Do you have any typical PMR symptoms? Aches and pains -or just lightheadedness, sweating, shakiness?

Unfortunately for some the latter do indicate too low a dose, so it’s a bit difficult to say exactly -perhaps you could try a small increase -say 7mg for a few days….

It will probably make you feel better either way. …but it’s sometime trial and error at low doses.

[Buster1610 in reply to DorsetLady]

mainly the lightheaded and shaky

[PMRpro Ambassador]

It isn't really clear from your profile but you have been on pred for over a year and were struggling at 2mg in March 2023 - is that correct?

I think it is less your adrenals "kicking in" (they don't get there overnight, it is a slow process) as them NOT waking up. Were you not like this back in the spring at low doses?

[Buster1610 in reply to PMRpro]

I was struggling in March went up to 7 mg for 10 days been on slow withdrawal to 5mg since

[piglette]

Sounds quite possible it is your adrenals. You may need to slow down in your reduction if your adrenals are complaining about being woken up. Don’t increase unless you really feel you have to.

[PMRpro Ambassador in reply to piglette]

Now now piglette!!!! Surprised autocorrect allowed that ...

[Buster1610 in reply to PMRpro]

made me laugh 😂

[piglette in reply to PMRpro]

whoops!! 😂😂😂

[herdysheep in reply to PMRpro]

missed it!

[PMRpro Ambassador in reply to herdysheep]

You know how i is next to o on the keyboard ...

[LozzaSandstrom]

I too started last March and I am now on 4.5 - I did get as low as 3.5 but all the pains came back, I have felt a bit light headed too but just went with it and it's much better now. Good luck!

[Bringonthemusic]

It is a tricky one, but I do agree that a slow taper does seems to work. At 5.5mg of pred I really didn't feel good. I stuck at that level for 8 weeks, then alternated between 5.5mg and 5mg for 3 weeks, before reducing to 5mg which is where I am now and this worked much better for me. I think we are all different and it really is trial and error.

[BarbB]

The symptoms you describe are not symptoms of your “adrenals kicking in” - but rather of the pred wearing off and your cortisol production NOT ramping up to compensate. Pred has a long half life in the body and it takes a while after lowering the dose to finally re-equilibrate to the lower level.

It took me two years to go from 5 mg to being off it completely. Every time I lowered my dose a tiny bit (.5 mg less every third day) within a couple of weeks I developed withdrawal symptoms - fatigue, dizziness, headaches, indigestion. I waited until these passed, indicating my adrenals had “kicked in” before lowering it again. As long as my symptoms were not the debilitating shoulder/hip/joint pain of PMR I just kept going.

When you are having withdrawal symptoms from low cortisol try to rest and keep stress as low as possible. My withdrawal symptoms abated ~ 3-4 weeks after each tiny dose reduction.