Connect
← Return to Weaning off of prednisone & pain management
Discussion
Weaning off of prednisone & pain management
Polymyalgia Rheumatica (PMR) | Last Active: Oct 25 10:23am | Replies (156)Comment receiving replies
My rheumy told me the adrenal gland starts making cortisol at around 8 to 10 in the morning. I know I feel better in the afternoon than in the morning. I take turmeric gummy once a day and eat a few prunes, and a cornucopia of other vitamins most days. I mostly avoid the stuff you are not supposed to eat but I figure small transgressions are small. Like one glass of wine as opposed to none. Plenty of sugar in alcohol. Im at 7mg prednisone after hitting a wall at 4mg. At 7 I can once again squeeze toothpaste out of a tube with one hand and ballroom dance for a solid two hours many times a week. At the end of dancing I run in to a wall of exhaustion and head to bed. Sleeping is a challenge, especially with a full moon. Im 65 and male and used to being pretty active. Started my prednisone at 15 mg in beginning of June for PMR. It was barely enough in the beginning. Im guessing another 6 months to taper off the prednisone at 1mg reduction per month. Looking forward to adding tart cherry to my routine.
Replies to "My rheumy told me the adrenal gland starts making cortisol at around 8 to 10 in..."
Connect
"My rheumy told me the adrenal gland starts making cortisol at around 8 to 10 in the morning."
Actually the adrenals start producing more cortisol earlier at 3-4 a.m. in the morning. It is part of the circadian rhythm that begins the waking up process in the morning. Cortisol levels peak at 8-10 a.m in the morning and gradually reduce throughout the day assuming the day isn't too stressful.
https://www.sciencedirect.com/science/article/abs/pii/S0303720719303545#:~:text=The%20HPA%20axis%20exhibits%20pronounced,can%20lead%20to%20disease%20states.
Your rheumatologist is correct because there is a sharp increase in cortisol production after you wake up.
https://www.sciencedirect.com/topics/medicine-and-dentistry/cortisol-awakening-response
----------------------
People with PMR often complain of "early morning" pain and stiffness. The pain I had would wake me up at 3 a.m. in the morning. That is when cortisol levels are at their lowest. It makes sense that inflammation increases and causes pain because inflammation isn't being regulated well when cortisol levels are low. Pain was my cue to take some prednisone.
Some people survive the entire night and wake up in the morning at about 8 a.m. and take their prednisone. Regardless, prednisone still is our cortisol replacement. Unfortunately, oral dosing with prednisone is a poor substitute for everything that cortisol and the HPA axis does.
It is more about the HPA axis being disrupted by prednisone and not solely about adrenal insufficiency and low cortisol levels.