1. Community
  2. Bones, joints and muscles
  3. Polymyalgia Rheumatica and GCA

I have become very breathless when walking, could it be the steroids?

Posted , 3 users are following.

Sheilamac_Fife
Sheilamac_Fife

I have been diagnosed with PMR and have been on 15mg Prednisolone for almost 4 weeks. This last week I have been very breathless when out walking, particularly bad on even a slight incline. This was not a problem before, could it be the steroids?

Thank you

Sheila

0 likes, 12 replies

12 Replies

  • EileenH
    EileenH Sheilamac_Fife

    Posted

    Yes, one of the side-effects of pred can be breathlessness. I can't give you references here or the post will disappear until it is approved. However - if you just google "breathlessness associated with prednisolone" you should get a load of publications describing it. I know of patients sent by their doctors for cardiac investigations because their doc didn't know it is quite common. Pain in the anatomy but you'll just have to stick to the straight and level and rest more on hills I'm afraid. It happened to me when on Medrol - but not with plain common or garden prednisolone or now prednisone. It might be worth asking your doctor if there is another version of corticosteroid you could try.
    • Sheilamac_Fife
      Sheilamac_Fife EileenH

      Posted

      Wow Eileen! 

      You have found me here as well. Thank you so much! I will look it up. Thought it had to be because it was so sudden. 

      Yes indeed, a nuisance...

      Sheils

    • EileenH
      EileenH Sheilamac_Fife

      Posted

      Hehe - you'll find it difficult to evade me I'm afraid! I'm not a habitual stalker - just one of the few longstanding members who survived their revamps ;-)  Every PMR post is notified to my email. My email is almost permanently on except at night - I might get work sent me (I should be so lucky).

      And I'm a member of all three UK forums - so you don't escape that way either. 

  • Sheilamac_Fife
    Sheilamac_Fife

    Posted

    Ok Eileen!

    Research done and it seems that this is the problem, but nowhere does it say what to do about it. I shall have to ring my GP I think. I don't know whether to push myself or if that would do harm. Not even sure that I can push myself much...

    Annoying because of course I have only just got moving in the last 3 weeks!! Also I have been very keen to walk as a means of maintaining bone density and of course to strengthen muscles that haven't had sufficient use for about 8 months!

    I will be cutting down to 12.5mg from Wednesday but I can't imagine that will make an enormous difference to my breathing.

    And what are assuming? Is this fluid gathering? It isn't gathering anywhere else.

    Ach! Literally 1 step forward and 2 back....

    Sheila

    • EileenH
      EileenH Sheilamac_Fife

      Posted

      Don't push yourself - that is the surest way to make PMR last longer - I'll reply more fully later - it's dinner time here in Italy. I'll get teh sack...
    • MrsO-UK_Surrey
      MrsO-UK_Surrey Sheilamac_Fife

      Posted

      Sheila, I echo what Eileen has said about not pushing yourself.  You were only diagnosed 4 weeks ago and you need to ensure that you don't overdo things at this stage, especially as you're planning to reduce to 12.5 this week.  

      As for "slight inclines", I couldn't manage those during the years I was on steroids - my breathing just wouldn't allow it not to mention the discomfort/weakness in my legs.  Walking is excellent, but only on the flat!  

      So don't worry about those muscles too much at this early stage - they will soon recover as you [/B]gradually[B] increase your walking. More important to take things easy at the moment and allow the steroids to do their job of controlling the inflammation and keeping it there.

    • EileenH
      EileenH Sheilamac_Fife

      Posted

      It will come - but truly don't push or you will end up worse rather than better. Your muscles are currently intolerant of acute exercise - they aren't getting enough oxygen when exercising because the microcirculation (the very small blood vessels) aren't working properly and allowing more blood through on demand. That itself is enough to make you breathless - it was one of the earlier signs of my PMR. I was knackered after walking up the stairs. And that was definitely NOT pred - I didn't get any for 5 years so I am very well aware of what PMR can do without any pred. 

      Walk yes - but on the level and not too fast. Sit and rest if you need to and then walk a bit more. Take the lift up and walk down - that will maintain bone density and is still using muscles usefully. 

      What doyou do about it? Work within the limits. Stop the pred and you won't be able to do anything for the PMR - and there isn't any option besides pred yet. Or at least, the stuff that seems to work also has nasty side effects.

      I would also suggest reducing 1mg at a time, not 2.5mg. Never more than 10% is a common mantra. 10% of 15 is 1.5mg. Enough said. You haven't won anything if you initiate a flare and have to go back up for a week or two. The most common cause of a flare? Reducing too fast. We suggest spreading that reduction over a week or two. I have a reduction scheme published all over the place here - if you can't find it I'll put it up again.

    • EileenH
      EileenH Sheilamac_Fife

      Posted

      Not necessarily at all. A Dutch group did some research and I don't think they found any real identifiable reason. I think it is just the effect on the mitochondria (the power stations of the cells) and the whole supplying energy thing isn't working properly. I can't find the paper just now - give me time.
    • Sheilamac_Fife
      Sheilamac_Fife EileenH

      Posted

      Thanks Eileen! 

      I was just do excited to be moving painfree! Impatient I guess.

      Sheila

    • EileenH
      EileenH Sheilamac_Fife

      Posted

      We all were/are! Just because you are pain-free does not mean you are illness-free. The underlying autoimmune disorder is still there, still active. You have to learn to pace yourself and not overdo things on the good days. Otherwise the PMR will turn round and bite back.

      We've all been there, I don't imagine for a moment you will believe these miserable old curmudgeons about what a sod PMR can be ;-)  But ignore us at your peril!!!! 

Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.