adrenal crisis?

[Reclus]

i have been on pred for almost 3 years trying to wean myself off. i never seem to get below 8mgs until the symptoms return. i found that having half my dosage early in the morning really helped so thanks for that advice. i now have managed to reduce to 6mgs. and was beginning to congratulate myself. however last week in the supermarket i was half way through my shopping when i started to feel sweaty and dizzy. by the time i got to the checkout i was very concerned as the symptoms were increasing. i had to ask an assistant to help me to a seat and when i was sitting felt very nauseous. thankfully the symptoms passed after resting and i could manage home. i was most concerned but after thinking about the symptoms wondered if it could be an adrenal crisis because i was reducing the dose. i haven't suffered any further symptoms should i continue with the dosage and gradually reduce. it's no good referring to the gp it takes hours to get through to the receptionist to be told there are no appointments available.

[DorsetLady PMRGCAuk volunteer]

Certainly sounds very adrenal related, and probably quite frightening at the time. Would suggest you stay at 6mg for about a month and give the adrenals a bit of a chance to catch up.

Then provided you haven’t had any further similar occurrences try reducing again, very small steps, slower tapering regime [ if not already]. The only way to nudge the adrenals is that way, p,entry of rest, time and patience.

Have a look at this -

healthunlocked.com/pmrgcauk...

And also at these if you aren’t already on a slower tapering plan - very similar but set out slightly differently-

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

[SnazzyD]

It may have been low cortisol but it did seem to pass quite without much intervention other than a sit down. However, who knows if your glands suddenly rallied. It wouldn’t call it a crisis exactly as that is more severe and needs more than a sit down, but I do recognise that coming over all feeble at he most inconvenient times. As DL says, if your adrenals are a bit flakey, you need to take things easier and really slow down the reductions.

However, if it happens again like that, do think about getting it checked out to rule a cardiac event.

[piglette]

My adrenals have caused similar symptoms. In my case I did faint at lunchtime on the check out in our local grocers! I gave entertainment to everyone during their lunch hour!

[PMRpro Ambassador]

It may have been - so slow down your taper a LOT. The longer you have between drops and the smaller they are, the better. And don't try to do too much at a time.

[RT18]

hello, my mum has had adrenal crisis and that doesn’t just pass without immediate extra steroid….but this episode could have been an indication your adrenals are struggling so give them time to catch up amd follow sick day rules should u have infection or gastro illness xx

[PMRnewbie2017]

I'm going to throw something else into the mix. Blood sugar. You don't have to be receiving treatment for diabetes to get episodes of low blood sugar or symptoms akin to that. I am not diabetic or even pre-diabetic but all my life I have experienced what you describe. It happens very occasionally and without warning. I've learned to have a glass of water and/or a sweet. Them I'm fine, I have had two episodes of Adrenal Insufficiency over the years and it does not improve without a dose of Pred, though to be honest I've never wanted to push on through and risk it. I had a basal cortisol test done when I was at 1mg last summer and it was a whopping 640nmol/L so when I had these sicky, sweaty episodes at 3 and 4mg Pred it's probably fair to assume my cortisol output was reasonable.

For many of us the 6,5,4mg area is a hard one to negotiate. The lower you go, the slower you go, and without wanting to be ageist, I see you are 81, so be a tortoise and not a hare!!

[Avadip12]

reducing is an absolute nightmare for many of us , and sadly adrenal insufficiency is not taken serious enough in it mild form . It may be that clinically we are ok with normal blood test such as the morning cortisol or synatchen test., but physically we are struggling. I have as have many been living in a catch 22 situation for months , and in my case , years . There is no answer, take more steroids to feel better or keep reducing slowly and hope that you finally reach 0 mgs and feel normal. Meanwhile you go slow slow for months and months to get there , you may continue to feel ill , and totally fatigued . You don’t know if your having a relapse .so you get more blood test and they are negative to inflammation, and your back in your catch 22 again . And on it goes . Sorry I sound so negative but I am trying to cope . This is not the case for everyone , the lucky ones get PMR it burns it’s self out and steroid treatment stops successfully.

[Avadip12]

I agree with the probability that you experienced a low blood sugar. It happens like that to me .

[Exflex]

I’ve had a few of these in my 4 year journey with PMR, once hospitalised. I always try to carry spare Pred with me when I’m out. Just 1mg can make a big difference, and it’s just a one off hit so you can resume at current dose the next day.