nausea and fatigue

[Harry8388]

I have reduced Prednisolone over the last year from 12.5 to 3.5

I am now feeling very tired and nauseous I have been reading about adrenal insufficiency and wonder red if anyone could advise me if these are the symptoms

[DorsetLady PMRGCAuk volunteer]

Yes they are- as can be seen in this link -

healthunlocked.com/pmrgcauk...

[piglette]

It sounds very like you have the Deathly Fatigue. I was like a zombie with it!

[PMRnewbie2017]

I had mild nausea and not diarrhoea but noticed i went to the toilet twice day rather than once. I never felt wiped out but lacked energy and my mood was very changeable!

[Pandora2]

Yes Harry, not much doubt that adrenal insufficiency is exactly your problem having just recovered from a bout myself. I suffered for five weeks with the symptoms you have plus a few more. Three clinicians failed to spot it so it was left for this forum and internet research to solve the problem. It would seem to me that you have reduced too quickly but more knowledgeable people will be along to advise further. Good luck, I know how you feel. X

[AmberAliona]

Hi Harry, it sounds like quite a fast reduction to me. It has taken me 4 years to reduce from 25mgs to 5mgs. My Rheumatologist has been great. I really can’t cope on less than 5, and he says many people just can’t. So he is happy for me to stay at 5mgs doubling that dose when I have a flare. Perhaps you just need to slow down and go back up to where you are relatively pain free…it’s not easy and the pain is very limiting. Hope this helps a bit.

[Tuppence55]

Hi Harry,

I found when I dropped to 3mg I also had fatigue but a just stayed there for quite a while and this did improve. I think at this level, unless you have other symptoms such as a return of pain that does not settle, you should just stop at your current level until you are quite sure that it is just you body adjusting. It may take a while. I stayed at 3 for 2 months and only attempted the next reduction when I was stable. I will do it slowly using the DSNS method advised on here. This has served me well. I want to reduce to the lowest level I can without encouraging a flair up. Last week I tried to reduce again but on the day I reduced my husband collapsed on the golf course whilst abroad so I abandoned it and went the the safe level I was at. It was most definitely not the right time. So just stay and wait awhile.

Tuppence

[PMRpro Ambassador in reply to Tuppence55]

Sorry to hear that - is all well?

[Tuppence55 in reply to PMRpro]

Not sure yet PMRpro, he was rushed to hospital and had CT scans, MRI, ECG, EEG Carotid ultra sounds, you name it he had it. But due to his brain surgery and reconstruction they were unable to tell what was going on. So awaiting an MRI with contrast and a neurologist specialist exam. What a palava! Hence me halting any thought of reducing with all this going on. I wasn’t with him as it was a boys thing so felt helpless. It’s a wonder I don’t have a relapse 😅

[DorsetLady PMRGCAuk volunteer in reply to Tuppence55]

So sorry to hear -and as you say all the more worrying because you weren’t there.

If you feel any sort of relapse please act on it quickly -in fact it might be sensible to be proactive and up Pred temporarily just get you through the next couple of weeks.

Best wishes to both of you.

[PMRpro Ambassador in reply to Tuppence55]

Does the insurance not fly you out. When my mother had a cardiac arrest I got a 10 day jaunt to the Rhine, most expenses paid, just had to buy evening meals.

[Harry8388 in reply to Tuppence55]

Thank you for your advice

Sorry to hear about your husband hope everything is ok and he is better.

I am still feeling nausea and fatigue

I have rang GP he plans to ring me tomorrow this feeling is really awful

I thought I had done well with PMR until now not sure if I should up my Pred and if so what to Currently on 3.5

[Tuppence55 in reply to Harry8388]

I think it is good to check out other causes if you are concerned and rule out or reassure everything is fine. If all is ok then it’s patience and see if it resolves and settles. The advice seems to be if you are still not happy to return to the dose that you were comfortable on and try another time but very slowly. I have gone down by a 1/4 mg especially at the lower levels and that has been well tolerated.

[CamGina]

Possibly, but you may just be having trouble adjusting as you taper. Next time, try reducing by just 0.5 mg, and see how it goes. I am now on 3.5, and each time I go down I feel a bit tired and sore for a few weeks, then it settles down until the next taper.

[DorsetLady PMRGCAuk volunteer in reply to CamGina]

Are you using one of the slow tapers we are always recommending -helps that feeling you mention.

[CamGina in reply to DorsetLady]

Yes. 0.5 mg every 6 weeks.

[DorsetLady PMRGCAuk volunteer in reply to CamGina]

Good..but even with that you are having issues?

[CamGina in reply to DorsetLady]

Dw I'm coping...

[DorsetLady PMRGCAuk volunteer in reply to CamGina]

Maybe worth trying 0.25mg a time or extending the taper by repeating each stage - if you can be bothered…. depends how bad you feel..😊

[Karendeena]

I was exactly the same when my GP reduced prednisolone at a rate of approximately 1mg every 2 weeks. I suffered, anxiety, nausea, loss of appetite, weight loss to name a few. I paid to see a rheumatologist who said I had been tapered too quickly and immediately put me back on 5mg daily with a plan to taper 1mg every 2 months. This has been much better and I am now down to 1mg one day alternating to a half mg on every other day. I will do this for 2 weeks and then go to half mg daily for 2 months. Even then I won't stop abruptly I will alternate 1 day half mg and 1 day without. I have learned the hard way 🙂

[JanetGarrettN]

Harry,Sorry to hear. The ACTH stimulation test is the test used most often to diagnose adrenal insufficiency. I had one from my Endocrinologist. Best of luck. Janet

[Poetryb]

Dear Harry,

A couple of months after I was down to 2.5mg of Pred my Dr wanted me off it. I said I felt stiff and uncomfortable but understood that too much is bad for us. I asked her if my adrenal glands were working and she reassured me that they were, although I can't remember her actual words. I never felt sick when taking Pred but know it is important to eat well. So maybe a poached egg for breakfast and bread and vegetable soup for lunch. I am not a big person and ate a smallish dinner of fish or meat and vegetables and some dark chocolate.

Satsumas and grapes too. There is a test for adrenal function so you could ask your Dr about that.

I now have a problem with my hip, and am waiting to find out what intervention I shall be offered. It is a mobility problem more than pain but I have been offered some pain relief.

Like you I feel tired, but do take supplements. A and D and Well Woman. I buy Well Man for my husband. I have lots of interests and belong to the U3A which is a wonderful organisation catering for every kind of interest. Chatting is the best medicine I think.

[PMRpro Ambassador in reply to Poetryb]

So did you stop overnight from 2.5mg to zero? However - she was taking risks alleging your adrenals were working when you were still on 2.5mg since that can be plenty to cover normal daily living - but there can still be no reserve for emergencies and THAT can be life-threatening.

The synacthen test for adrenal function shows that the adrenals are capable of producing cortisol - not that they are reliably doing so at all times. It is said that can take up to a year to settle down even after stopping pred entirely.

[Poetryb]

Dear Harry, please see above what PMR Ambassador says as she implies that I stopped too abruptly.