Low dose prednisolone lowering cortisol

[SlowDragon]

Thought some members might find this interesting

Last Spring I was prescribed 5mg prednisolone daily to help with pain of osteoarthritis (waiting knee replacement)

I was assured categorically that this low dose steroid would not affect my adrenal hormones at all

It was certain highly effective at pain reduction and I was told I would be able to remain on this low dose indefinitely.

However 6 months later I was feeling increasingly out of sorts, with daily pain in adrenals…….

So I did an early morning Blue Horizon test including cortisol

Cortisol was right at bottom of range

At follow up consultation I was told that “this was probably just my normal cortisol level”

I said I would ween off to see if levels would improve and did so very slowly…..taking 3 months to stop completely

Retested cortisol this week ……now my Cortisol is at top of range

With hindsight …..I wish I had tested cortisol BEFORE starting prednisolone

[Helly75]

My cortisol was tested 20th Feb-320 nmol/L , I've got 2 weeks left of my course of prednisolone, I'd be interested to see what it's like at the end & I'm also in pain.

[Buddy195 Administrator]

Thanks for sharing SD. I’ve got signs of OA in knees so it’s very useful to know this. Do others in your family have knee OA (my elder sister has already had a knee op… so thinking this is on cards for me in the future)?

[SlowDragon Ambassador in reply to Buddy195]

I was wondering if it is a genetic thing

I do have very knocked knees (since childhood) so knees worn badly

Apparently having knocked knees is (yet another) complication of vitamin D deficiency

[Buddy195 Administrator in reply to SlowDragon]

I think mine are the result of x country running in the past …I’ve now swapped for a spin bike as far kinder to my knees! 🤣

[SlowDragon Ambassador in reply to Buddy195]

This article suggests that there’s a genetic predisposition

medlineplus.gov/genetics/co...

Risk factors include

Being female!

Weight gain - common when hypo

inflammation - common with autoimmune diseases

I gained 5 stone ……now lost half that since GF and Dairy free

[Country_Bumpkin87 in reply to SlowDragon]

There must be SOME pre genetic disposition as I’ve had is for years in left hip & ankle through injuries however it then developed into other joints without plus I found osteopenia has increased but still not osteoporosis unlike my younger sis who now has is in her hips too also had to have surgery on 1 & likely replacements like me long term- has to be a genetic factor there as lifestyles fairly different?

C xx

[ajb1969 in reply to SlowDragon]

Hi

I was taking prednisolone for TED‘s disease (thyroid eye disease), and I’ve got Hashimoto’s. And Osteoarthritis. It made me extremely poorly when I had to take higher doses.

The Prednisone depleted a lot of my vitamins and minerals, which get low anyway but what helped me dramatically, was by taking folic acid, after a month or two, (four months supply), I can now climb the stairs again, all the pain is gone.

And every time they start to hurt again, which one knee is atm, my blood test showed low folic levels again.

[SlowDragon Ambassador in reply to ajb1969]

Many (most?) hashimoto’s patients need to supplement vitamin D, separate vitamin B complex and separate magnesium supplements daily and continuously to maintain good vitamin levels

Often necessary to also take separate B12 initially

Please add your most recent vitamin D, folate, ferritin and B12 results and ranges

Say exactly what vitamin supplements you are taking

Are you on strictly gluten free diet

If not get coeliac blood test via GP BEFORE trialing GF

And few months later trialing dairy free.

[ajb1969 in reply to SlowDragon]

Hi

I’ve done all that ta. I keep a check on my vitamin D levels and b12, and take b vitamins, and magnesium daily, vit D when needed, ferritin and folate, keep going low. But my knees always hurt when folate is low so take folic acid meds, as I start taking them pain in my knees go.

I went gluten-free years ago but it didn’t make a real difference to my diet. I was vegetarian and vegan for years and back to meat again.

I’ve had numerous coeliac blood tests because my mum was coeliac but I’m not. However, saying that my immune globulin LGa is low sometimes. I have read. (Perhaps you could check on this or you might know) that sometimes if the LGa is low, it can have a false positive with the coeliac blood test? I haven’t had time to check this with my Drs yet.

[SlowDragon Ambassador in reply to ajb1969]

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

[1eskimo]

It’s the dose corresponding to the natural daily production, so it’s a full replacement. It’s normal that natural production had decreased. And fortunately, it was able to resume after these few weeks, but if you were taking it more time it could have harm you.

[Brightness14]

Thank you for the post. I don't actually have bad knees or pain but have written it in My Health Book for future reference.

I also believe that bad knees are sometimes caused by genes or maybe football.

My adopted family had bad knees but I never and at 78 years old probably never will.

I also ran up until my mid sixties. Your post could help people.

[Country_Bumpkin87]

thanks for sharing…

Never had my cortisol tested when clearly over the years of issues- it should have been!

Especially since prednisone I have as emergency pack with antibs for when chest gets bad- thanks Covid.

I want off low opiates for osteoarthritis & sometimes manage by summer then go backwards again

this past 2 winters due to costochondritis relapses weirdly same time of year hospital initially cleared clots & diagnosed that instead. Then can’t have NSAIDs anyway.

Why the daily prednisone-for pain relief? & how long is your wait for the replacement surgery?

mine is in both hips, part of pelvis & ankles particularly…surgery initially will be right instead of left hip which initially was far worse but scarily shows also how quickly bone changes can occur.

Thanks for reading

Love C Xx

[SlowDragon Ambassador in reply to Country_Bumpkin87]

how long is your wait for the replacement surgery?

No date yet

consultation soon

X Ray shows both knees badly worn