depression/anxiety

[CavalierKC3]

can anyone explain. Read a lot on here about cortisol/adrenaline levels. I will soon be down to 4 mg daily from 50 started August 2022. Can either of these 2 things be a reason why I am so depressed/anxious, cry alot of the time. Get awful heart fluttering ( gp says nothing wrong with heart following ECG)

[Merryfield]

I can’t address your specific cause for depression except to say many changes in drugs can upset your brain/body. I am reducing steroids (been on 10 months) as well as Jardiance and beta blocker thanks to weight loss and have been weepy. And about 2:30, I hit a wall. This is not new. Don’t know if it is PMR or age or general lack of stamina.

[Merryfield]

PS. I guess just to say you are not alone and keep the hope.

[SnazzyD]

It certainly could be you adrenal glands not being able to produce the cortisol needed to make up for the shortfall of the artificial cortisol, Pred. I remember well the emotional fragility. Have you read the bit about adrenal glands in Mrs Nail’s FAQ’s under Pinned Posts? Staying at these low levels should eventually trigger some action but in the meantime you may find that you need to take things easy. I found that if I tried to do too much the symptoms of adrenal insufficiency were worse. For this reason I lived a very boring life for months until the adrenal axis cranked into action. Not everyone takes that long but it pays to keep an open mind.

[Mrsd12f]

Yes. I’m finding it very difficult, at the moment. Same symptoms. I’ve had blood tests and an ECG. All ok, apparently. It’s rotten, isn’t it?

[CavalierKC3 in reply to Mrsd12f]

It sure is an awful situation. Does GP or Rheumatologist not offer any help. Do you have GCA or PMR or both. What dose of Prednisolone did you start at & how much you taking now

[Mrsd12f in reply to CavalierKC3]

I had got down to 2.5, but have gone back to 3.5. It’s a long game!

[DorsetLady PMRGCAuk volunteer]

Reply to CavalierKC3

Anxiety and depression can certainly be signs of adrenals struggling … often discussed on here…as is heart fluttering .. here is fairly recent query with more related posts-

healthunlocked.com/pmrgcauk...

[123-go]

I too had those heart flutters around 4mg pred. ECG showed nothing of concern which was reassuring and eventually those symptoms disappeared. Not nice when it happens but try to stay positive. Are you getting any help for your anxiety?

[PMRpro Ambassador]

While you are on higher levels of pred, the adrenal glands don't produce cortisol - the body requires a certain level of corticosteroid to function but knows that too much is bad for it. Pred does the job, so it doesn't need more cortisol on top. As you reduce the pred dose you get to a stage where you need a top-up to get to that level. That doesn't return overnight and in the intervening period you are a bit low on steroid - it is termed adrenal insufficiency and can cause fatigue, palpitations and low mood amongst other things.

The ECG shows if your heart is beating regularly at that point in time - obviously it won't show anything that doesn't happen during it. Did you feel anything DURING the couple of minutes they were recording? It usually really isn't anything to get too concerned about - unless it goes on for a long time or you feel dizzy, chest pain or otherwise unwell in which case it is sensible to call 999 as paramedics carry ECG devices and may manage to get a tracing while it is actually happening.

Try not to worry about it - that will only make the low mood worse. That is something the GP might be able to help with. Otherwise it is a case of sticking it out until the body catches up and adjusts to the new lower dose of pred. As Snazzy says, doing too much will make it worse, especially if it is something physically or mentally demanding because you would normally get a boost of cortisol triggered by the adrenaline and the adrenals can't respond as usual.

[9lives]

hi sorry you are suffering, and sympathise with you. I also have those symptoms, have had ecg done a couple of times and had one fitted for 24 hrs and all was normal. And Dr Reassured me all was well . I have anxiety and try to manage this with yoga and meditation and breathing. Which all help. It’s very hard when we have other stresses in life. the crying has stopped a while ago and I feel stronger now. It’s like a vicious circle we get anxious and that causes palpitations then we worry about the palpitations and so on. I try to think of things that make me happy or sing and dance along to my favourite songs , hopefully no one hears or sees me xx

Know you are not alone xx