Bad AI symptoms. Should I raise my pred for a few days?

[sferios]

Hi everyone,

Over the last three weeks I have been doing pretty well on 7 mg pred, but the last two days I have this constant anxiety feeling in my stomach. It's that strange nausea symptom I associate with adrenal insufficiency. That and also terrible fatigue and zero appetite.

I can't function like this. Do you think I should go up on the pred for a few days? If so, how much?

I did have a really stressful event happen the day before yesterday, and I know some people here up their pred to get through stressful events.

Thank you.

[piglette]

Ideally if you don’t have to increase the pred for adrenal problems it is better not to, but if it gets really bad going up one or two mg is OK. I must admit I went up 1mg in the end from 5mg to 6mg as the fatigue got too much for me.

[SnazzyD]

I found 7mg to be the area of dose to be in regards feeling naff and not being able to cope with much at all. It was still too high for the adrenal axis to get the proper feedback to spring into action ie. still suppressed. However, the dose was too low to carry me through all that life was throwing to me. I may have said this to you in past replies already. If it is adrenal insufficiency with you, putting up the dose to feel better just puts off the process for longer. Granted, a stressful event or major ongoing stress might require you to put it off by taking an extra 1mg. Reducing slowly and trying not to over do it should get you through this grey area but it is a fine line between being consistently low to trigger your adrenals and having an adrenal crisis. So a really slow reduction and doing not much might be called for. If you go too fast to get off Pred at this stage you become more at risk of a crisis.

You might be unwell in some other way but if 1 or 2mg does the trick it is more likely to be low adrenal function.

[sferios in reply to SnazzyD]

Thanks Snazzy.

I was thinking I might be ready soon to try 6.5 mg, but now I'm hesitant. But if you say it might actually get better at lower doses than perhaps I'll try it. I have my first endo appointment tomorrow also, so I'll see what the doctor says.

[PMRpro Ambassador]

I'd wait and see what the endo says if you can. But it seems very familiar to me - it is a real conundrum, you need it low to poke the adrenal function but when there is stress involved, you feel awful!

[DorsetLady PMRGCAuk volunteer]

As said, probably best if you can manage without an increase… you are at a very difficult dose and sometimes you just have to grin and bear the discomfort.

The last thing your adrenals need is to start popping up and down on the Pred.

Might sound harsh - but the only way to get them going is a very slow taper -time and patience. …and resting when you need.

Stay at 7mg for a good while for now, and give the adrenals time to realise they need to do something….

[Louisa1840]

I am in exactly the same position; hovering on 7 mgs, just started a taper to 6 and a half. Then life throws another curved ball (this time the death of my very close friend's daughter in a car crash) . Stress definitely has a huge effect on us - a silent enemy. Just knowing these things helps.....time and patience is the key. Resist upping your pred unless you absolutely must realising that it's counter-productive if we want our adrenals to get the message. We WILL get there in the end. Be encouraged.....

[sferios in reply to Louisa1840]

Thank you Louisa and I'm so sorry to hear about your friend's daughter.