Predisolone

Thanks

Yes he has regular tests, doc was talking about sertraline, he is not depressed , just no energy at all,

Thanks so much, I will try anything

Junie

I do not think so

Junie

When your husband took 15mg pred for PMR it takes over the work of the adrenal glands, they have to start working again at around 7mg or so. Most people then get very tired because of this. At 1mg or even higher, it is normal to check the adrenal glands are working OK, although a lot of doctors do not bother.

Will check this at doctors

Thanks so much

It takes quite a while to do as you have to give saliva tests throughout the day, so a good book is an idea. 

Oh, then I know he has not had that done.

Did not realise that was the test, will be contacting his GP

Thank you

Junie

If you have a synacthen stimulation test done at the hospital it isn't usually saliva samples, it is more likely to be blood samples. You have a blood sample taken at 9am after having not taken any pred for the 24 hours previously to get a baseline level of cortisol in the blood. Then they give you an injection that stimulates the adrenal glands to produce cortisol and take another sample to see if they have done so. That is a short test - there is a longer version where they take another couple of samples at intervals. One lady who had it done simply went to sleep and was woken up after they'd finished! 

The extreme fatigue does sound as if he may have reduced the dose so fast that they body hasn't caught up - once you have been on moderate dose pred for 2 or 3 months the adrenal function is compromised and takes some time to return below 7mg. As ptolemy says, good doctors check this for patients who have been on pred for long but many believe the patient has to be off pred before it can be done. Not so, you just interpret the result differently. But it should be done for anyone who gets below 5mg on a really slow reduction and finds the fatigue gets worse instead of better.

Good luck persuading the GP - I'm struggling to talk mine round! But if he is difficult ask to see an endocrinologist.

Sorry I'm late to the party - I didn't get a notification!

Hi Eileen

We have an appointment on Tuesday with GP.

Will ask to be referred to endocrinologist.

Thank you so much you are very helpful

Junie

Hi Jeanne, what dose of pred are you on?

Thank you

20mg .. will try to get down to 15 in 2 months time .. if I can .. but I have many issue at 20mg from Oct to April .. when it warms up I don't have as many issues and can function without steroids

Have you tried cutting down 1mg at a time?

Yes was down to 7 and had a bad flare up as soon as it got colder .. starting all over again .. going down real slow .. but if 20mg is what I need in colder weather than so be it ..

You poor thing having to increase so much. I have increased from 7mg to 10 mg not because of a flare as such but because I have had the most awful sciatica, so the steroids helped reduce the inflammation. I tried to reduce to 9mg and was in total agony, so am stuck at 10mg at the moment. I do feel very stiff even at that dose.