I am down to 7 mg on the pred, and I want my adrenals to come back online. I heard that caffeine might interfere with this. But I cannot confirm it one way or another.
Does anyone know whether/how much it helps to quit caffeine when tapering the lower doses of pred? I kind of don't want to quit it entirely. I drink a small cup of coffee every morning. That's all. I'm worried about getting depressed if I quit. (It's happened to me before.) But I also want my adrenal glands to come back online.
Thank you.
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sferios
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I doubt that one small cup will make a great deal of difference - others may disagree, in fact it’s a bit of a ‘marmite’ subject . But if cutting it out completely affects your mood that’s not good… so it’s finding a balance - again.
Marmite began a "Love it or Hate it" campaign during October 1996, and this resulted in the inventing of the phrase "Marmite effect" or "Marmite reaction" for anything which provoked controversy.
I read that too and have been taking more decaffeinated drinks and I have always drunk decaf fresh coffee. So I notice the energy giving effect of a bit of caffeine through the day and I would miss that too.
I was feeling pretty grim on 5mg, better on 6mg, but a urine infection has caused me to raise my dose to 10mg and my adrenals are dancing again, so it’s been one step forward and ten steps back, as often happens with PMR!
I hadn't heard of this but a quick search only showed two papers from reputable sources. They both said caffeine can increase cortisol production in patients at rest or under stress. TBH unless you are consuming massive amounts of coffee daily I wouldn't worry. Remember that there is caffeine in tea, some fizzy drinks and some OTC painkillers. Plus the articles refer to pure caffeine intake not cups of coffee and the amount of caffeine in a cup of tea or coffee depends on the source and the way it has been processed and brewed.
I read those articles too, but they seem to be talking about people with healthy adrenals. Not people who have been taking pred long term. The likelihood is that caffeine increases cortisol in healthy individuals because caffeine causes the release of adrenaline. Then, in a healthy person, the cortisol is also produced.
What I read (not necessarily on the most reputable webistes, mind you, but still more than one) is that when you have secondary adrenal insufficiency, say from being on pred, the release of adrenaline from caffeine intake can overwork the adrenal glands making it harder for them to release cortisol.
Now, this is a theory, or a story. Just wondering if there's any science behind it.
Most of the stuff about caffeine being bad for adrenal function seems to be on what I call "woo" sites that go on about adrenal fatigue - which simply doesn't exist - adrenal function doesn't simply wear out because of overuse and overstimulation.
There is a lot of psuedoscience to be found on the tinterwebs - often to sell stuff or to gather a following of innocents who think there are yes/no answers to everything. Medicine and biology aren't like that, there is a lot of gray and not so much black or white ...
The sites seem to making the argument that the adrenals have a harder time making cortisol when they are busy making adrenaline (which increases with caffeine intake). Is this just a bunch of kaflooey?
More than likely - these are usually what I'd describe as alternative sites and their knowledge of and belief in scientifically proven physiology is at best sketchy
Adrenaline and cortisol are produced in different parts of the adrenal gland and subject to different mechanisms for release so that "argument" is nonsense I'm afraid. My advice would be the same as PMRpro, As I said earlier, I doubt it is going to make any difference. When the adrenal cortex begins to function again, a very complicated series of hormonal exchanges takes place between the adrenal cortex, the hypothalamus and the pituitary gland. I doubt a couple of cups of coffee is going to influence any of this. Adrenaline is produced in the adrenal medulla not the cortex.
I would be really surprised if one cup of coffee a day would make that much difference, if any. Although, caffeine does have quite a long half life of about 5 hours, so it will be in your bloodstream for quite a long time. but one cup is a lot different to swilling gallons of the stuff all day long. You have to have some small pleasures in life, especially if you look forward to your early morning coffee on waking. Life has to be worth living.
On my first visit 3 years ago my rheumatologist told me to stop all caffeine because it interfered with prednisone’s ability to clear the inflammation of PMR. After a lifetime of caffeine I tapered off and found I no longer needed to take an acid reducer. It was a good thing for me and I no longer miss the caffeine.
Pred seemed to effect me through erratic sleep pattern ( as 40+ years of full leaded tea and coffee drinking did not effect my sleep pattern at all). I gave up caffeinated tea altogether, and have one cup of coffee occasionally in a morning only. Whether it effects my body's ability to absorb pred is a slightly different topic, though the intimation is that the caffeine didn't intrefere so likely the side effect of pred. My sleep is better, and I would attribute this to caffeine intake rather than pred. Perhaps this helps?
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