Early weeks Prednisone V Adrenaline question?

[RosyPollyandMe]

I would like to ask the experienced team on here if they have seen or investigated if there is a link between the initial “prednisone euphoria” while the adrenal glands are still working…. where one feels like one can carefully manage a reasonable quality of life…. And reducing Prednisone successfully and this stage lasting several weeks ….. to suddenly (in my case from tapering ) losing the simplest of tasks now causing exhaustion and for me burning pain at the end of the day ?

I ask this as I notice that I am not alone in thinking I was managing the balance really well … to not knowing what I can and cannot do without repercussions later in the day… and seeing several similar posts from others

Could this be the coincidental point of where the adrenal glands stop producing natural adrenaline? So the level of steroids can be hard to manage in a daily basis?

I look forward to your thoughts.

[Miserere]

I am wondering about this as well so will follow!

[piglette]

My sister-in-law had cancer and was given steroids and she said she was bouncing round the room on them. Of course she had a very high dose, so it is probably the steroids mainly causing the euphoria.

[DorsetLady PMRGCAuk volunteer]

This link explains in simple terms what happens when you take pred - and yes initially you have too much cortisol in your system - whether that be all chemically induced or part chemical and part natural.

But the major aspect is that once your own adrenals decide they can go to sleep, the cortisol level is static, or reducing slightly as the effect of your daily dose recedes... but it is still above your natural level - so the flight or fight mechanism doesn't get triggered - and you slump. If you do that regularly, then you have to learn what you can and cannot do earlier in the day to try and avoid that. One of the reasons we always talk about pacing yourself... and we know it's not easy to get that balance right early days.

healthunlocked.com/pmrgcauk...

As for studies, there probably are some... but can’t bring one to mind - but I know someone who will.. 😊

[RosyPollyandMe in reply to DorsetLady]

Thank you Dorset Lady! I DID need to refresh my knowledge of the adrenals and the hormones, in particular the links between Cortisol v steroid levels! Very informative.

[PMRpro Ambassador in reply to DorsetLady]

I wouldn't guarantee it ... 🤣

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Well if you cannot find ,probably means there aren’t any!

[SnazzyD]

It’s quite possible that you have got to the lowest dose you need for your autoimmune activity as it is at the moment, hence feeling wiped out and in pain. Nothing to do with adrenaline or cortisol. By now you your adrenal glands will be shut down so no cortisol will be about of your own making. The stimulant effect of a Pred will be less by now so if you take away the previously higher stimulant effect, plus being on too low a dose for PMR you will be feeling ropey. This will be made worse if you are doing too much.

You haven’t stopped producing adrenaline but you have stopped producing cortisol but that doesn’t matter because Pred is swamping you with the artificial version. Pred also affects the neurotransmitters in the brain which affects mood and this effect is variable between people. Some become psychotic, some feel full of pazazz with variations in between. I was always tired but wired and on higher doses I think I was like a boring drunk who doesn’t know when to shut up because they think they are the master of wit when they should have stopped 3 hours ago.

[RosyPollyandMe in reply to SnazzyD]

Thank you SnazzyD. You give some interesting thoughts to consider. I think I have to learn, adapt and accept. Maybe all those “sorting out” tasks might give me that addictive “sense of achievement”

[PMRpro Ambassador]

I don't quite understand what you mean to be honest.

The duration of taking pred and the dose are critical too. If you are on even a relatively low dose, 15mg, then after a couple of months adrenal production of cortisol is suppressed. The euphoria is related to the dose - and even on 20mg I can't say I EVER experienced any euphoria and that is well above the physiological level.

[readingbooks in reply to PMRpro]

I did ! I reacted exactly as SnazzyD describes .