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The affect of beta blockers on adrenaline and cortisol levels.
Polymyalgia Rheumatica (PMR) | Last Active: Nov 7 10:00pm | Replies (14)Comment receiving replies
The "prednisone fix" as you call it is the only way I can get out of bed and function relatively normally at the moment, so I'm not going to "resist" prednisone for now. Things for me may rapidly deteriorate rather than improve without prednisone, and I currently have no PMR pain and am relatively mobile on a split dose 6mg morn/1.5mg evening. The daily pain, immobility and sleep deprivation pre-prednisolone were intolerable, awful. So I can't be converted to a life-is-better-without-prednisone position till I have a reasonably good chance of that being true. Slowly and (hopefully) surely is the way I'll go with the meds reductions.
While we have active PMR, the body needs more cortisol to control inflammation than the 4-6mg equivalent that is usually produced. Otherwise our own bodies would have been able to fight off the PMR inflammatory auto-immune response without prednisone.
Actemra is probably not for me. I have latent TB (was exposed to tuberculosis as a teen but didn't develop the illness at the time) and a tendency to get digestive fungal infections, both high risk problems with Actemra.
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"So I can't be converted to a life-is-better-without-prednisone position till I have a reasonably good chance of that being true."
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The above is really the essence of it all. I wasn't able to resist increasing my prednisone dose either. The treatment for adrenal insufficiency is more prednisone although hydrocortisone is preferred. My endocrinologist said something to me as I was struggling with the idea of stopping prednisone after "decades" of use. She said I "could" and "should" restart prednisone for any reason if I felt the need.
My endocrinologist wouldn't speculate about what "would happen" if I stopped prednisone because she didn't know. She just wanted me to know about things that "could happen" so some safeguards were put in place.
I never converted to the idea that prednisone gave me my life back. I desperately wanted to be off prednisone because my "quality of life" was almost nil when I needed to take prednisone every day.
Prednisone was very hard on my body when I used it "long term" however, "short term" use wasn't so bad. Basically, all the research in the world confirms this. My rheumatologist still prescribes prednisone for trips when I'm away from home just in case a need arises.
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I'm aware of the warnings about the increased risk of serious infections when a person takes Actemra. It is important to weigh those risks before starting Actemra. For me, I weighed the risks against the following: "Infection Risk and Safety of Corticosteroid Use"
https://pmc.ncbi.nlm.nih.gov/articles/PMC4751577/#:~:text=Observational%20studies%20have%20consistently%20demonstrated,risk%20of%20serious%20bacterial%20infections.
My rheumatologist was very concerned about taking Prednisone in combination with any other medication that suppressed my immune system. Fortunately, I was able to taper off Prednisone relatively quickly after Actemra was initiated. There isn't any concern about being unable to stop Actemra abruptly when an infection occurs.