adrenals

[Amilee]

please help , I am feeling really unwell ,dizzy , feel sick ,mentally very low,upset stomach,lost weight ,waking up after 4 hours sleep ,anxiety of the scale.from July till October tapered down from 6mg to 4.5 finished 28 October,stayed there to see how I was , I wasn’t feeling brilliant but I know I have to challenge the adrenals , I am also dealing with Prostatitis on ciprofloxacin for 4 weeks if I can do it ! Is this a flare or the Prostatitis should I up prednisone ? How much and for how long.

[Amilee]

I started on 15 mg in July 2020 have always had problems tapering mostly severe anxiety,2.5 years to get to 6.5 will I ever get off this drug

[DorsetLady PMRGCAuk volunteer]

Three months ago you were given a link re dealing with flare - but linked again here IF it is a flare -

healthunlocked.com/pmrgcauk...

Plus advice on adrenals - which most of your current issues seem to point to -

healthunlocked.com/pmrgcauk...

You might find a return to previous dose you felt okay is enough, but unfortunately we cannot tell you either way... but it might be worth trying. If it doesnt work after a few days, then follow advice re a flare in first link.

[SnazzyD]

Hello, so you dropped about that the rate of about 0.5mg per 4 weeks. This may have been too fast or that you have got to a point and the adrenal glands really need to be able to catch up with your program. It might have been ok without the prostatitis but the bodily stress of that may have been a step too far for the amount of extra cortisol needed for this. I don’t think reducing and challenging the adrenal axis at this time was ideal so if it were me I’d go back to where you were ok and then take stock when the infection has been dealt with.

Some of your symptoms might also be Ciprofloxacin which can make some people feel quite wretched too. One thing that you need to watch out for is that Ciprofloxacin is from the Quinolone group of antibiotics that can have a detrimental effect on tendons, particularly the Achilles. It is cautioned with use in conjunction with steroids because they too can affect the tendon increasing the risk of damage. Any pain at all in the Achilles you must seek medical advice immediately. Did it have to be Ciprofloxacin?

[Amilee in reply to SnazzyD]

Yes ,according to the doctor, I know about the tendon issue I actually contacted NHS24 and asked if it was a problem! According to them no interactions were found but I have read about tendon damage it on the internet !I am at 5 mg today should I go up to 7.5 for a few days then drop back to 5.5 ?

[SnazzyD in reply to Amilee]

It is clearly stated in the British National Formulary the prescribing ‘bible’. See under Important Safety Information for Quinolones, on the NICE website. Even mentions steroids. Can get more official than that.

bnf.nice.org.uk/drugs/cipro...

As for dose, I don’t know. Perhaps increase for a few days if only to see if you feel better as a diagnostic clue. If you feel much better, you have your answer. It does add complication if you reduce during illness and you might have to accept that at this time you need to put your plans to one side. Have you spoken to your doctor though?

[PMRpro Ambassador]

Since you are on antibiotics I think it is reasonable to consider applying the Sick Day Rules but we do also advise discussing it with your GP.

The interaction between pred and cipro is well known and most interaction checkers class it as a Major Interaction so heaven knows what the NHS bunny was looking at! Obviously not the BNF which is usually the NHS bible.

But cipro can make you feel fairly rubbish too. I think you need a discussion with your GP.

[Amilee in reply to PMRpro]

She did quote from the BNF and said risc was increased but still ok☹️I’m very worried now. I don’t want to increase to much as I struggle reducing anyway,I have no PMR symptoms when I reduce ,no aches or pains, just low mood,night sweats, irritability ,lightheaded,feel ill ,tired

[PMRpro Ambassador in reply to Amilee]

Hmmm - I developed tendonitis with cipro and methyl pred and my husband after 2 days on cipro alone and no history of pred. My GP said "I've never seen that!" - I said "You have now". It may be OK - but when it happens it isn't. I was on crutches for 9 months.

[micpenn222 in reply to Amilee]

I was on Cipro for a UTI when I was on Pred. and it made me feel sick. I was getting night fevers and had to stop the Cipro after 5 days of this, night fevers went away so I knew it was the Cipro.

[Koalajane]

it seems to me that you could do with a chat with your doctor about how bad you are feeling

[Amilee]

I’m definitely speaking to doctor tomorrow to get this changed 😡😡😡

[Gluten]

It could be side effects of the Cipro and not the prednisone. You should check with your doctor.

[Carver63]

hi Amilee i was on Pred for 2 yrs with Actimara helping wean of Pred. the side effects of long treatments are frustrating and improvements are slow. But improvements did come for my recovery and after 18 mos of drug free i feel very good. i lost about 40 lbs in this process and changed my diet and exercise program to help the body heal and re grow. hang in there and get off PRED as soon as you can. I lived with a small headache for a yr after but it is getting better so i am hopeful my GCA days are done