Palpitations/too much Adrenalin?

[scrambledegg]

I started on a very slow taper from 7.5mg pred. daily to 7mg daily about 2 months ago. At around that time I started getting mild heart palpitations lasting just a few seconds. 2 months later and they were still happening so I took myself to the doctors this week-ECG and blood tests all normal.

I am continuing a slow taper (now at 4 days on 7mg, 5th day on 7.5mg) and have just started feeling a bit spaced out in the morning and a slight ringing in my ears. No loss of energy/ fatigue though so I’m wondering if my adrenals are kicking in and I’m getting bursts of too much adrenalin? The palpitations are usually when I’m not moving and I feel the need to move then I feel better.

Anyone else had this?

[SnazzyD]

You may be starting to feel the *lack* of adrenals kicking in. When they do start to work you feel nothing in that you don’t feel tired, shakey or weak. It’s not the adrenaline that’s the issue but cortisol. Your Pred dose has been giving you so much artificial cortisol that your adrenal glands have been told to stand down by the brain. In some people, about now the dose starts to get a bit too low to cover you for daily life and still a bit high for the process to be triggered to make up the shortfall with your own cortisol. I felt my worst at 7mg until I got low enough to trigger my system into making its own cortisol. One of my symptoms was ectopic heart beats, which I tend to get when my body is really struggling with something.

However, keep an eye on it in case inflammation is building in the head area, which can give you morning symptoms. Your tests may not show anything up and as for anything else, it depends what the GP asked for. ECG’s may not show anything if your heart doesn’t ‘perform’ at the right time. I don’t mean to worry you, but just park the idea and not put it all down to low cortisol.

[Tealblue2 in reply to SnazzyD]

Thank you! I have RA as opposed to PMR but what you have described here is how I feel as the inflammation rises in my body - and I’ve been struggling to get anyone to understand

[PMRpro Ambassador]

Not so much the adrenals "kicking in" (they don't, it is a slow and wobbly wake-up) but them NOT doing so.

Low corticosteroid levels will cause palpitations and everything else you mention.

[scrambledegg in reply to PMRpro]

Thanks for that PMR pro. very reassuring. I did mention to the doctor that I was on a slow pred. taper but she didn’t mention that could be the problem and I only thought about it afterwards and that’s only because of all the information on this site.

I’m thinking the best thing is to keep on a very slow taper and hope my adrenals slowly start to wake up?

At least I can demonstrate a reason for not coming off pred. more quickly at my next annual review. At the last one she wanted me to wean off pred. completely over 6 months because I’d been “on it too long”. If I could I would!

[DorsetLady PMRGCAuk volunteer in reply to scrambledegg]

I don’t think many doctors do realise the issues with adrenals - and maybe have a look at this -

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador in reply to scrambledegg]

They want to try living with PMR and getting off pred!!!

[Pusph]

I get palpitations anyway as I have SVT Supraventricular Tachycardia, and I find that whenever I taper to a new dose they get worse for a bit.