Puzzling me

[Oscarsnan]

On 5.75/5.5 of pred suffering bad anxiety but I’m ok when I wake up but around 2 hours after pred dose the anxiety arrives. My basal cortisol test a few weeks ago was 590 no pred for 24 hours before and done at 08.00. Are my adrenals working and the pred dose suppressing it again it’s so puzzling, has anyone any ideas.

[SnazzyD]

How long does the anxiety last? And how does the anxiety manifest itself?

[Oscarsnan in reply to SnazzyD]

Until around 3 to 4 pm.

[SnazzyD in reply to Oscarsnan]

Have you gave the anxiety on higher doses?

[Oscarsnan]

Yes I’ve had anxiety before on higher doses but I’ve always updosed and it’s abated but now under endocologist and being told I’ve got high cortisol due to the Prednislone I’ve been very slowly tapering but this feels like high cortisol again.

[PMRpro Ambassador in reply to Oscarsnan]

"high cortisol due to the Prednislone"

How on earth do they work THAT out? I don't think they can say that - but it is possible something else is going on. Have you seen an endocrinologist?

[Blearyeyed]

What time to do take your Pred?

[Oscarsnan]

7am

[DorsetLady PMRGCAuk volunteer]

Would say your adrenals are working to a certain degree, but definitely not up to par as yet, nor likely to be for some time. … anxiety is typical of that.

Not sure about Endo’s comments - but it does sound all a bit odd.

Can you just clarify it’s starts around 9am [2 hours after taking pred] and last until 3-4pm?

Just wondering if taking Pred in the evening instead of morning might help [then you might sleep through the worst of it]. Or would be even worse? Others may like to comment on that.

[Oscarsnan]

Yes that’s right when I wake up I have no anxiety but starts around 2 hours after pred dose and then it usually fades around 3/4 pm.

I used to split my dose but my endocologist wanted to stop my evening dose so that I was low overnight to help with the adrenal glands.

[PRL1957]

According to a web-page from Mount Sinai Health System in the USA:

mountsinai.org/health-libra...

the normal range is 140 to 690 nmol/L (nanomoles per litre). So your result (if it is in nmol/L) sounds OK. But, as PMRpro has already said, other things may be going on.

[Chiqui1950]

As DorsetLady suggested---I take prednisone at 2 am thanks to this forum and many symptoms went away--- nonetheless I do get anxious from time to time and I remind myself that it is one of the side effects of prednisone and it eventually goes away--- I wish the same for you!

[Oscarsnan]

Went to see my endocologist yesterday told him about the anxiety I was suffering from, he says it’s from high cortisol basal cortisol of 590 and the 5.25mg of pred I’m taking. His advice was to keep tapering but a bit faster.He also said he could take me off of pred now and nothing bad would happen!!!!as my basal cortisol was excellent.

[PMRpro Ambassador in reply to Oscarsnan]

Except he's only thinking of adrenal function and not the PMR/GCA! Is the fatigue and stuff better?

[Oscarsnan]

Fatigue not so bad if I pace myself. Still have painful arms but paracetamol really helping with that. Also I feel very tense which I feel is causing the painful arms. Reduced to 5 mg this morning I’ll see how it goes.