Side effects of prednisolone

[dont-panic]

I started taking prednisolone a month ago and have had increasing sweating, especially my head. My hair becomes soaked. Is this common? Are there any solutions?

[DorsetLady PMRGCAuk volunteer]

Hi, and welcome.

Unfortunately it’s very common, either with PMR or Pred or both. I would normally say look at related posts, but due a glitch on the HU platform recently they seem to have disappeared- hopefully only on a temporary basis.

Others will be along with advice shortly.

[SnazzyD]

Yes, it had that effect on me. It eased as the dose dropped. However, sweats can be a sign of an increase in inflammation if your Pred dose is not high enough. It would help us give you a better reply if you could put in your bio more info about what your symptoms were, how you were diagnosed, starting dose, it’s effect, where you are now and how you’re doing other than the sweats.

[dont-panic in reply to SnazzyD]

I haven't quite figured out how to do that. I started a month ago on 10mg. I had some sweating before, but now it is getting worse. My blood tests don't indicate inflammation, but my symptoms were textbook. The steroid has greatly reduced the symptoms (especially weird joint pain and feeling like I wasn't walking on my own legs) , and remaining aches and pains are probably ones I'd have anyway.

[SnazzyD in reply to dont-panic]

To update your bio, look at the banner running across the top. Select your picture that says profile under it and that will take you to your details including the bio section.

10mg is lower than the usual lowest starting dose for PMR which is normally 15mg. Your sweating may be both the Pred and inflammation brewing if it wasn’t really contained initially. It can take a couple of weeks for it to rev up again. Even if you were a person who had raised inflammation blood markers at the outset, they can lag behind symptoms. Be alert for symptoms creeping back, especially if you are used to background aches and pains of other origins. What’s the plan from here?

[dont-panic in reply to SnazzyD]

GP is asking rheumatologist how to monitor my case since no indicators showed up in my blood tests.

[DorsetLady PMRGCAuk volunteer in reply to dont-panic]

Studies have shown over the years that between 7-20% of patients don’t have raised blood markers - ever… GP should be concentrating on symptoms - but if they are unsure then by all means refer to Rheumy - but NHS lists are ever longer..

[PMRpro Ambassador in reply to dont-panic]

Symptoms. The clinical response. How you are. You knowing your body and them listening to you,

The blood markers are a mixed blessing anyway as they are so non-specific and will rise with many other events such as UTIs, chest infections, injury. A single raised marker without symptoms shouldn't result in a kneejerk raising of the dose - you wait and monitor to see if there is a rising trend. But in many patients on pred, the markers don't rise for a very long time, by which time the patient may be well into a flare and it means going backwards.

If you have GCA and are started on Actemra, the blood markers are useless anyway, the way it works means the ESR and CRP fall to normal. But there are even rheumies who appear not to have read the documentation and they STILL rely on the bloods and announce with great glee "Your markers are great" when the patient is demonstrating symptoms that show the GCA is not under control.

[DorsetLady PMRGCAuk volunteer in reply to dont-panic]

See this re filling in profile - and would say at 10mg that may not be quite enough - guess you were started that low because of lack of high inflammation markers - but not everyone has them anyway. So your PMR may only just be under control… so do monitor what you think are ordinary aches and pains - as they may not be.

healthunlocked.com/pmrgcauk...

[dont-panic in reply to DorsetLady]

I might ask for a referral to a private specialist as the gp has been talking to rheumatologist for advice on my case but I have not been examined by a specialist. I’m more worried about osteoporosis than pmr so I’m concerned about high doses.

[DorsetLady PMRGCAuk volunteer in reply to dont-panic]

Having had GCA and been on silly doses.. have to say 10mg is not a high dose, but it probably seems like it to you..

Have you requested/had a DEXA scan? Or do you know you are likely to be susceptible to osteoporosis. Are you on a calcium/vitaminD supplement?

The ROS site is a mine of information - theros.org.uk

[dont-panic in reply to DorsetLady]

Thank you. I’ll have a look. I’m on ADCAL since breaking my hip but my bone scans are above average for my age.

[DorsetLady PMRGCAuk volunteer in reply to dont-panic]

Whilst Pred can adversely affect bones density - it does seem very variable from person to person. I can understand that if you have broken your hip you are concerned.

What are your scores from scans?Adcal may be enough but you might have to add in a bisphosphonate as well. .. although that’s a bit of a “marmite” subject 😳

There is lots of info under Bone Heslth in the FAQs as well

[PMRpro Ambassador in reply to dont-panic]

I've been on pred for over 15 years and my bone density has barely changed. By no means everyone develops osteporosis and there are ways of minimising the risk anyway. Inadequately or un-treated PMR is also a risk because either way, your mobility can be badly affected so you can't exercise and uncontrolled inflammation is also thought to have an effect. It isn't as simple as pred bad, no pred good. Even too low a dose of pred allows the inflammation to build up over time. like a dripping tap fills a bucket and it overflows.

[DorsetLady PMRGCAuk volunteer in reply to dont-panic]

If you do, then put up a new post and say roughly where you are and how far willing to travel.. we have a few favoured ones…

[dont-panic in reply to DorsetLady]

I’m in London and would very much welcome a rheumatologist recommendation. There are bound to be good ones here.

[DorsetLady PMRGCAuk volunteer in reply to dont-panic]

Our usual go to man is Prof Rod Hughes - Chertsey -

See this - finder.bupa.co.uk/Consultan...

And ping an email to his secretary -Jody

[dont-panic in reply to DorsetLady]

Thank you! An easy drive from where I live.

[Positive__]

Hi, Here's a few previous posts (my search seems to be working OK), Good Luck :

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

[dont-panic in reply to Positive__]

Thank you! It's reassuring to know this is not uncommon.

[DorsetLady PMRGCAuk volunteer in reply to Positive__]

Search is working.. one thing that is!

[PMRpro Ambassador in reply to DorsetLady]

Makes a change!!!

[PMRpro Ambassador]

Hi and welcome!

It is common unfortunately and has been discussed quite often. Someone has kindly searched for you since Related Posts isn't working. It can be the pred - but also PMR will cause sweats,

10mg is a VERY low starting dose so I hope it is enough to clear out any accumulated inflammation - and it does give you much less leeway when you start to taper which can make it a bit harder.

I usually mention John McEnroe type tennis headbands!

[AshPen9 in reply to PMRpro]

I have just invested in two. However as I have pretty short hair they make me look ridiculous! I think I'll have to try the bigger bandeau type ones which are nearly like a headscarf. They should cover almost everything, so I'll look less odd.

[PMRpro Ambassador in reply to AshPen9]

They are handy from stopping you dripping on something you are doing at home where no-one sees you!

[AshPen9 in reply to PMRpro]

Good point!

[Orange_2022]

Me too - since getting down to around 4mg. Dripping onto the gym mat when the rest of me doesn't sweat at all. I just have random hot flushes otherwise...😬

[piglette]

AHHHGGGG! The sweats are HORRIBLE, but as you reduce they do go away.

[Pr0jection]

Yes, it happens to me too but to be fair I have always sweated more on my head than anywhere else. Either PMR or Pred makes it worse.

[Crusty1949]

Welcome to the wonderful world of prednisone. Sometimes the cure is worse then the cause. Just like the disease, the meds effects everyone differently. Over my two year battle with PMR I saw it all. Look for the light at the end of the tunnel and hopefully it will be to brighter days and not the 4:30 limited headed your way. Things will get better.

[Bramble2000]

Hi, I used to sweat on my head and face so much it would run off in rivers. Another of many severe side effects for me. I don’t know what the solution is, sorry!

[Jamiesons]

I've had PMR (Polymyalgia Rheumatica) for over four years, along with mobility issues. One of the most challenging symptoms has been issues with body temperature regulation and excessive sweating, particularly around my head and face, which is very noticeable to others. My body temperature has increased significantly compared to what it used to be; I rarely need to use central heating, even during most of the winter.

I was on prednisone for three years, which helped improve my mobility, but it didn’t alleviate the fevers or fatigue. Recently, I was recently diagnosed with vasculitis alongside PMR. I’ve tried several medications, including Tocilizumab (TCZ) and methotrexate, but I’m still experiencing excessive sweating both day and night.

My rheumatologist says this is a sign PMR is still active when blood markers aren’t raised

Hope this isn’t too depressing for you, I try to find some positive, here, it’s cheaper heating bills,

[dont-panic in reply to Jamiesons]

Thanks for all that information. I think I need to see a specialist, not just the GP. Good luck with your symptoms too.

[Raven1955]

When I first came down with PMR and began the journey with prednisone, I would have tremendous head sweats at night. Many a pillow died early deaths because of it. As my prednisone dose became less over the years I noticed the night sweats became fewer and fewer until they mostly disappeared. Sometimes the sweats showed up again shortly after I had reduced my pred dosage. I interpreted this as an indicator that I was either a touch too low on my dose or that it was a response by my body to the reduction of the dose. Slowing my dose reduction usually worked. However, in the early days of PMR nothing helped me. For a while I even resorted to taking a bath towel to bed with me.

[GivenUp24]

yeah…. Me too once an hour hot flash, I’ve never had a single one during menopause!!!

[sidra1968]

Very common, I call myself "Sweathead"

[lkcreedon]

Yes I have that exact side effect too. Don't like it much but I doubt there is anything that can be done to stop it. I really don't know. Sometimes it's quite mild other times not. It doesn't happen too often for me thankfully ☺️

[Doublef]

yes I wake up most mornings like that a d have always put it down to pred then get cold due to blood thinners