Is it ok to take something to try and activate the adrenals . I thought the prednisone was keeping adrenal function lower on purpose? My fatigue sets in around 7&1/2 mg. I know they say it shouldn't happen at that high does, but it always does for me when I am able to get to 7&1/2 mg. I know an endocrinologist won't discuss fatigue until I get down to 5mg.
Thanks for amy response.
My fatigue sets in around 7&1/2 mg. I know they say it shouldn't happen at that high does, but it always does for me when I am able to get to 7&1/2 mg.
Who says it doesn't? Many on here would definitely disagree with that. See this -
healthunlocked.com/pmrgcauk...
To be honest, not much will help except for a lower pred doses so the adrenals need to take up the difference between the pred dose and the physiological dose your body would normally produce if you weren't on steroids , and only a slow taper, small steps, time and patience will do that.
Some people’s adrenals start to work at even higher doses and some much lower. The best way to get them working again is to reduce your dosage of pred. If you have bad adrenal fatigue just hang on on that dose, unless it gets too much. It may take a few weeks or even months before you feel you can reduce again, but you may be fine and have no problem.
There is no such thing as adrenal fatigue - adrenal insufficiency is something different and in our case a natural result of being on long term pred. While there is enough corticosteroid in your system, the body knows not to produce more because, as we all know, too much pred causes side effects. The only thing that stimulates the body to produce more cortisol to top up a reducing dose ofpred is that lower dose of pred. Unfortunately, it is a stage we have to go through to get to lower pred doses so the best approach is tiny reduction steps at long intervals to let the body adjust in its own time.
There are no safe products that would counter the fatigue and none that are able to activate the adrenal function - if there were, doctors would use them. Some of the products sold on the internet are nothing more than ground up animal glands which claim to replace the cortisol - do that, and your body won't ever be stimulated to produce its own cortisol. Plus they can be downright dangerous, produced with no controls at all.
So I'm afraid all you can do is take time, eat a good diet in general and wait patiently. SnazzyD has written loads about her patient wait for her adrenal function to wake up!
It is not on purpose, it is a side-effect. The reason Pred lowers adrenal function is it is a steroid just like your glands’ cortisol. The body treats them more or less as the same. Therefore, when you have more than 8mg or so of Pred which is way more than the body needs it tells the adrenal glands to stop working as there is plenty of steroid on board. Once the dose of Pred drops below the steroid level you normally have for day to day living, the adrenal glands need to wake up. This happens a bit under 8mg for most people. Unfortunately, after a while of being switched off, they don’t always do that quickly enough so you feel rubbish.
I found 7-5mg the hardest time for this because there was still enough Pred in the system to keep the adrenals a bit dozy, but it still wasn’t enough to feel ok and normal. The only way to wake up the adrenal glands is to keep the body too low in steroid so that eventually it notices and starts to produce its own cortisol. This is where it gets difficult because you have to stick at it and reduce very very slowly to keep your levels low for your adrenal glands to notice. If you put your dose back up you are back to square one and the body is swamped in steroid again.
If you were to find something that stimulates the adrenal producing process it is quite possible the body will think it doesn’t have to try on its own and you might become dependent on it. There isn’t currently an easy fix. An endocrinologist is there to make sure you don’t have a crisis if your glands really aren’t working at all once you get below 5mg. All they do is replaced the more potent Pred with a weaker steroid. They aren’t interested above 5mg as you put it, because the Pred is still at a too powerful level even if it is only doing half the job.
Not sure if that is any clearer.
Thank you for all of your responses, it helped a lot
Thank YOU too Linny 😊
The responses helped me a lot too because I’ve tried repeatedly to get below 7mg and have always found it impossible, due to some pain which the rheumatologist thinks is arthritic, but mainly due to overwhelming fatigue. So the great replies you got helped me too - I just have to stick at it, very slowly……And at my last rheumatologist consultation, I was advised not to go below 5mg until I heard more from him (but that’s just me, not necessarily relevant to anyone else).
All the best xx
The post from Nextoneplease is a reminder about another common issue for those of us trying to reduce Pred below about 7mg. As well as the fatigue, it can expose unrelated arthritis which has neverheless been masked by the action of Pred. This can make it difficult to determine whether a relapsing pain is a flare of PMR or something else, even to a rheumatologist.
Probably a bit of both to be honest…
Adrenal Glands, Paramyalgia Rheumatica and Prednisone 
Deathly fatigue but not adrenal function
Adrenal fatigue?
Fatigue relief with increased prednisone?? 
