Adrenal Insufficiency -- PMR vs GCA

[montebello]

Hi all,

I went through PMR about 10 years ago, which lasted about 6 years -- and now I'm in the process of going through GCA (about 26 months into it). I don't remember feeling any adrenal insufficiency symptoms while weaning from the PRED with PMR, but I am certainly feeling symptoms of something while weaning from the PRED with GCA.

I'm currently on 3.5 mg PRED and have been very lethargic and sleepy during the day ever since I hit the 5 MG threshold -- and it's either my adrenals that are not yet awoke or something else that's going on.

I realize I could get a test and I'll be seeing the Rheumy in NOV, but in the meantime I was just wondering whether GCA sufferers were more prone to adrenal insufficiency than PMR sufferers.

Any thoughs about this?

Thanks so muc.

[DorsetLady PMRGCAuk volunteer]

Sounds very adrenal-like to me.. and not sure there is a definitive answer on who has more issues.

Is it related to the cumulative amount of Pred taken or the number of years it’s taken, or a combination of both… probably the latter - or just the individual? Other health issues thrown in the mix or age?

Both SnazzyD and I had GCA [no PMR] and probably on Pred for the same amount of time… my cumulative Pred figure may have been slightly higher - and I’m older than her. I had some issues with fatigue but not a lot to write home about, whereas she had a very difficult time.

[montebello in reply to DorsetLady]

Thank you!

[SnazzyD]

It might be down to GCA doses being much higher for longer. Ageing probably doesn’t help. Lastly, although we might get back to normal, it may be that the adrenal axis has come out less good than it was. The second whack of steroids might have a bigger impact.

[montebello in reply to SnazzyD]

Thank you!

[PMRpro Ambassador]

Don't think there is a hard and fast rule - adrenal suppression is a very individual thing and some may never be at high enough PMR doses for long enough to stop cortisol production altogether. But the high starting doses for GCA will almost certainly have an effect that may be harder to recover from. And as already said, age also affects adrenal function but not everyone develops adrenal insufficiency as they age. Think it is a how long is a piece of string question.

[montebello]

Thak you