Advice needed: Down to 6.5mg of prednislone after... - PMRGCAuk

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Advice needed

Oscarsnan profile image
14 Replies

Down to 6.5mg of prednislone after 10 years of PMR.

Suffering with severe anxiety no PMR symptoms.

Endocologist has advised adding in 10mg of Hydrocortisone but haven’t started yet I have been on 6.5mg for 10 days and intend to stay at that dose in hope I will stabilise.

Been having basal cortisol tests every time I taper the last one came back at 387.

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Oscarsnan profile image
Oscarsnan
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14 Replies
PMRpro profile image
PMRproAmbassador

Have to say - endocrinology isn't my field at all but I don't quite get why they are suggesting adding HC when your basal cortisol is that good and you are also on pred.

Has no-one considered the anxiety might be just that - rather than being due to adrenal insufficiency? How long has it been going on? Were you OK at 7mg pred? Because to be honest - I'd rather be on 7mg pred a bit longer than adding in HC which can add more adverse effects.

Oscarsnan profile image
Oscarsnan in reply toPMRpro

Anxiety started around 7months ago whist tapering from 8.5mg to 8mg. I have taken one hydrocortisone 10mg on xmas day due to stress and I must say I felt good for around 5 hours.

PMRpro profile image
PMRproAmbassador in reply toOscarsnan

Which is about how long HC stays in the system. I would have thought that it was 6 and half a dozen whether you take more pred and feel generally less anxious or get a few hours respite from adding HC which will have some suppressive effect too. It is a difficult dose - often not enough to replace adrenal function entirely but not low enough to prod your adrenals back into life.

Or you discuss medication for the anxiety with your GP. Which I think is where I would start.

Gossiplady profile image
Gossiplady in reply toOscarsnan

Hi Oscarsnan! I have been free from Pred since Christmas but severe anxiety has built up. I felt I would just return to the old me of 3 years ago, but I am a completely different person. Decided to see the doc. Lovely lady understood me completely and given me Mirtazapine. This has helped tremendously. She has arranged for a lady from the surgery to ring me very regularly to see how I feel , also exercise with other people and also seeing her in 4 weeks time. At long last I am sleeping really well. Keep smiling.

Oscarsnan profile image
Oscarsnan

I’m on sertraline already I tried to increase but wasn’t successful due to bad side effects on increased dose.

I’ll maybe ask if I can add anything on to sertraline to help. Thank you.

PMRpro profile image
PMRproAmbassador in reply toOscarsnan

Has it been suggested you try non-pharamceutical therapies as well?

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Sounds as if adrenals are struggling a bit ... but as PMRpro has said it could just be anxiety - and there is help out there for that so please discuss with your doctor... medication is not necessarily the only route.

Oscarsnan profile image
Oscarsnan

Thank you both I will try !!! to get appointment with GP to discuss.

It’s all a mess Endocologist first told me I was on to much that’s why I had anxiety and now I may be on to little I won’t give in though.

PMRpro profile image
PMRproAmbassador in reply toOscarsnan

Oh really? So why wasn't it a problem at higher doses??????

Thelmarina profile image
Thelmarina in reply toOscarsnan

You sound as if you could do with a hug - so here is one. The advice here is good. Check your anxiety with your GP before altering your meds - and if it comes to it I would go with Pro and up your Pred before adding in extra meds with potentially more side effects. 🤗

MrsPractical profile image
MrsPractical

hi I just wanted to include my experience. I was suffering anxiety as well as some PMR symptoms. I went to doctor who gave me Sertraline. After 2 days on that I suffered a seizure and was taken to hospital. They eventually found the seizure was caused by low sodium caused by they thought the Sertraline and Lansoprazole. They stopped the Sertraline completely, upped my Pred slightly for a few days , changed me to famotodine and put me on reduced water intake. Within about 5 days my anxiety had gone and hasn’t returned and my sodium returned to normal. I am currently on 1.5 mg of Pred and very occasionally get anxiety spells but they pass within a day or two. I believe these are caused by adrenaline function still stuttering.

Pippah45 profile image
Pippah45

Being low in magnesium causes anxiety for some people. Perhaps worth checking it out. I am reducing too after many years just got to 3.5 and assuming the sore shoulders are old age!

Athas17 profile image
Athas17

I would ask to be switched to methylprednisolone as it has less depression and anxiety side effects.

Oscarsnan profile image
Oscarsnan

Thank you to everyone that has replied I will discuss all with GP after Easter.

Kind regards to all Diane.

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